IMAGE  EVALUATION 
TEST  TARGET  (MT-S) 


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If  I    '^ ' 


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Hiotographic 
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Corporation 


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WEBSTIM.N.Y.  14380 

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CIHM/ICMH 

Microfiche 

Series. 


CIHM/ICMH 
Collection  de 
microfiches. 


Canadian  Institute  for  Historical  Microreproductions  /  Institut  Canadian  de  microreproductions  historiques 


Technical  and  Bibliographic  Notes/Notes  techniques  et  bibliographiques 


The  institute  has  attempted  to  obtain  the  best 
original  copy  available  for  filming.  Features  of  this 
copy  which  may  be  bibliographically  unique, 
which  may  alter  any  of  the  images  in  the 
reproduction,  or  which  may  significantly  change 
the  usual  method  of  filming,  are  checked  below. 


L'Institut  a  microfilm^  le  meilleur  exemplaire 
qu'il  lui  a  6t6  possible  de  se  procurer.  Les  details 
de  cet  exemplaire  qui  sont  peut-dtre  uniques  du 
point  de  vue  bibliographique,  qui  p^uvent  modifier 
une  image  reproduite,  ou  qui  peuvent  exiger  une 
modification  dans  la  mythode  normale  de  filmage 
sont  indiqu6s  ci-dessous. 


n 


Coloured  covers/ 
Couverture  de  couleur 


□    Covers  damaged/ 
Couverture  endommagee 


I      I    Coloured  pages/ 


d 


Pages  de  couleur 

Pages  damaged/ 
Pages  endommag6es 


□    Covers  restored  and/or  laminated/ 
Couverture  restaurde  et/ou  pellicul6e 


□    Pages  restored  and/or  laminated/ 
Pages  restaur^es  et/ou  pellicul6es 


D 


Cover  title  missing/ 

Le  titre  de  couverture  manque 


I     y  Pages  discoloured,  stained  or  foxed/ 
I  \yi    Pages  d6color6es,  tachet6es  ou  piqu6es 


I      I    Coloured  maps/ 


artes  gdographiques  en  couleur 


□Pages  detached/ 
Pages  d6tach6es 


Hi: 


Coloured  ink  (i.e.  other  than  blue  or  black)/ 


ere  de  couleur  (i.e.  autre  que  bleue  ou  noire) 


I    T/ Coloured  plates  and/or  illustrations/ 
I  ^    Planches  et/ou  illustrations  en  couleur 


D 


Bound  with  other  material/ 
Reli6  avec  d'autres  documents 


~7f  Tight  binding  may  cause  shadows  or  distortion 

I    along  interior  margin/ 

La  reliure  serree  peut  causer  de  i'ombre  ou  de  la 
distortion  le  long  de  la  marge  intdrieure 


D 


Blank  leaves  added  during  restoration  may 
appear  within  the  text.  Whenever  possible,  these 
have  been  omitted  from  filming/ 
II  se  peut  que  certaines  pages  blanches  ajoutdes 
lors  d'une  restauration  apparaissent  dans  le  texte, 
mais,  lorsque  cela  6tait  possible,  ces  pages  n'ont 
pas  6t6  filmdes. 


I     1/Showthrough/ 
I  ^   Transparence 


D 
D 

n 

0^ 


Quality  of  print  varies/ 
Quality  in6gale  de  I'impression 

Includes  supplementary  material/ 
Comprend  du  materiel  supplementaire 

Only  edition  available/ 
Seule  Edition  disponible 

Pages  wholly  or  partially  obscured  by  errata 
slips,  tissues,  etc.,  have  been  refilmed  to 
ensure  the  best  possible  image/ 
Les  pages  totalement  ou  partiellement 
obscurcies  par  un  feuillet  d'errata,  une  pelure, 
etc.,  ont  6X6  filmdes  d  nouveau  de  fa^on  d 
obtenir  la  meilleure  image  possible. 


D 


Additional  comments:/ 
Commentaires  suppl6mentaires; 


This  item  is  filmed  at  the  reduction  ratio  checked  below/ 

Ce  document  est  filmd  au  taux  de  reduction  indiquA  ci-dessous. 


10X 

14X 

18X 

22X 

26X 

30X 

7 

12X 


16X 


20X 


24X 


28X 


32X 


The  cppy  filmed  here  ha*  been  reproduced  thanks 
to  the  generosity  of: 

University  of  British  Columbia  Library 


L'exempiaire  fWtri  fut  reproduit  grAce  A  la 
gAntrositt  de: 

University  of  British  Columbia  Library 


Tho  images  appearing  here  are  the  best  quality 
pc'Mible  considering  the  condition  and  legibility 
oJ  the  original  copy  and  in  keeping  with  the 
filming  contract  specifications. 


Las  images  suivantes  ont  4t4  reproduites  avec  le 
plus  grand  soin,  compte  tenu  de  la  condition  at 
de  la  nettet*  de  rexemplaire  film*,  et  en 
conformity  avec  les  conditions  du  contrat  de 
filmage. 


Original  copies  in  printed  paper  covers  are  filmed 
beginning  with  the  front  cover  and  ending  on 
the  last  page  with  a  printed  or  illustrated  impres- 
sion, or  the  back  cover  when  appropriate.  All 
other  original  copies  are  filmed  beginning  on  the 
first  page  with  a  printed  or  illustrated  impres- 
sion, and  ending  on  the  last  page  with  a  printed 
or  illustrated  impression. 


Les  exemplaires  originaux  dont  la  couverture  en 
papier  est  imprimAe  sont  fiim^s  en  commandant 
par  le  premier  plat  et  en  terminant  soit  par  la 
dnrniire  page  qui  comporte  une  empreinte 
d'impression  ou  d'illustration,  soit  par  le  second 
plat,  salon  le  cas.  Tous  les  autres  exemplaires 
originaux  sont  filmis  en  commengant  par  la 
premiere  page  qui  comporte  une  empreinte 
d'impression  ou  d'illustration  et  en  terminant  par 
la  drrniire  page  qui  comporte  une  telle 
empremte. 


The  last  recorded  frame  on  bach  microfiche 
shall  contain  the  symbol  — <^>  (meaning  "CON- 
TINUED"), or  the  symbol  V  (meaning  "END  "I, 
whichever  applies. 


Un  des  symboles  suivants  apparaitra  sur  la 
dernidre  image  de  cheque  microfiche,  selon  le 
cas:  le  symbols  — ^  signifie  "A  SJIVRE ',  le 
symbols  Y  signifie  "FIN". 


Maps,  plates,  charts,  etc..  may  be  filmed  at 
different  reduction  ratios.  Those  too  large  to  be 
entirely  included  in  one  exposure  are  filmed 
beginning  in  the  upper  left  hand  corner,  left  to 
right  and  top  to  bottom,  as  many  frames  as 
required.  The  following  diagrams  illustrate  the 
method: 

V 


t 

2 

3 

Les  cartes,  planches,  tableaux,  etc.,  peuvent  fttre 
fiimis  A  des  taux  de  reduction  diffirents. 
Lorsque  le  document  est  trop  grand  pour  Atre 
reproduit  en  un  seui  clichA,  il  est  filmA  A  partir 
de  Tangle  supArieur  gauche,  de  gauche  A  droits, 
et  de  haut  en  bas,  en  prenant  le  nombre 
d'images  nAcessaire.  lies  diagrammes  suivants 
illustrent  la  mAthode. 


1 

2 

3 

4 

5 

6 

^.^^7 


t&cc^. 


^ 


'rtt  TlIK  IM15 


M:t.rK8,  >5A*^'Sfc; 


»l^Sl^lll  A 


•.^.••^^•;■S^n•JON,  IN    i''LA 


OC  iUil.  T«S 


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4     \ 


KjS 


a::',  -i'  .■      .1   (.  i;:'!  ■,*! 


'VOMES.  4:U>  CHILBRM 


WfS  tot 


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H'i: 


Ijjifj;       ...i^,;, 


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pcltt,  ^nlargelr  anir  Jebiseb  €Mm 


OF 


WARREN'S 


HOUSEHOLD  PHYSICmi 


FOR  THK  i;sK  or 


PHYSICIANS,  FAMILIES,  MARINERS,  AND   MINERS. 

BEINO    A  *. 

BHIi:r   DESCKIPTION,  IX   PLAIN  LANGUAGE, 

OF   ALL  THK 

DISEASES  OF  MEN,  WOMEN,  AND  CHILDREN, 

WITH  THK 

LATEST  AND  MOST  APPROVED  METHODS  OF  TREATMENT. 
IRA   WAKREN,  A.M.,  M.D., 

FelUnc  (if  the  MaMachunett-i  Medical  Snctelij,  etc. 

AND 

A.  E.  SMALL,  A.M.,  M.D., 

President  of  the  Hahnemann  Medical  Cnltege,  Chiaii/o,  lU. 


ILLUSTRATED 

BY  THIRTY-SIX  FIGURES  ON   EIGHT  SPLENDID  COLORED  LITHOGRAPH  PLATES^ 
AND  THREE  HUNDRED  AND  THIRTY-SIX  ENGRAVINGS. 

TUB  RIQUT  or  TRANSLATION  IS  RKSKRyBD. 


iia-A.  B la -A. x) Xj E "sr   &  co. 

168  Washington  Strbbt, 
BOSTON. 

1884. 


EiitiTvMl  iKrconliiig  to  Act  of  CoiigresH,  in  tlie  year  1850,  by 

IMA     WAUUEN, 

in  the  Clerk's  Office  of  the  District  Court  of  the  IMstriet  of  MnfisnchuBOtta. 

Entered  aecoriliiitr  to  Act  of  Congress,  in  the  year  1863,  by 

IRA     WAKUKX. 

It  UieCleikV  Office  of  the  District  Court  of  tlic  l)istrict  of  Nf  assachuiette. 

Entered  according  to  Act  of  Congress,  in  the  yen'  1870,  by 

CllAKLES   ROBINSON,  Jr., 
In  the  Office  of  the  Librarian  of  Congress,  at  Washington. 


PREFACE. 


This  book  is  written  for  the  people.  It  is  based  on  tlie  assumption  that  every 
man  —  the  mechanic,  the  farmer,  and  the  day  laborer,  as  well  as  the  professional 
man  —  has  a  right  to  all  the  knowledge  he  is  capable  of  acquiring,  en  all  sub* 
jects, — medicine  not  excepted.  The  book  aims,  therefore,  to  popularize,  and 
adapt  to  the  many  what  has  been  claimed  as  belonging  only  to  the  few. 

I  do  not  hesitate  to  avow  that  my  sympathies,  as  a  man,  are  with  the  great 
masses,  who  may  be  called  the  bone  and  muscle  of  the  race.  They  are,  in  the 
main,  more  shrewd,  more  endowed  with  common  sense,  more  simple  and  true 
in  their  natural  instincts,  and  consequently  less  perverted,  than  those  who  claim 
more  refinement  and  a  higher  place  in  the  social  scale. 

"All  men,"  says  Hippor-ates,  one  of  the  great  fathers  of  medicine,  "ought 
to  be  acquainted  with  the  medical  art.  I  believe  that  knowledge  of  medicine  is 
the  sister  and  companion  of  wisdom."  Such  knowledge  would  shield  the  many 
from  the  impositions  of  quackery.  No  one,  I  venture  to  say,  who  reads  this  book 
thoroughly,  will  be  often  imposed  upon  thereafter  by  quack  nostrums,  or  quack 
doctors.  Every  man's  physical  organization  is  his  own ;  and  he  is  charged  with 
the  responsibility  of  taking  care  of  it.  To  do  thl  i  properly,  he  needs  knowledge 
of  it;  and  to  withhold  this  from  him,  is  another  form  of  the  old  oppression, 
which  decreed  knowledge  and  power  to  the  few,  and  ignorance  and  obedience  to 
the  many. 

In  accordance  with  the  design  of  the  work,  it  has  been  written  in  plain,  simple 
English,  and  brought  within  the  comprehension  of  all  who  have  medium  powers 
of  mind.  It  has  not  been  thought  needful  to  reduce  its  language  to  the  simper- 
ing style  of  baby-talL ;  that  is  done  only  by  those  who  don't  know  much  about 
the  people. 

In  preparing  this  book,  a  great  number  of  authors  have  been  carefully  consult- 
ed, to  whom  I  acknowledge  large  indebtedness ;  yet  the  work  is  not  a  mere  compi- 
lation. With  the  exception  of  a  few  minor  parts,  as  those  on  Hydropathy,  the 
Management  of  the  Sick-Room,  the  Symptoms  cf  Diseases,  and,  as  in  all  medical 
works,  a  portion  of  the  recipes,  it  has  all  takeu  shape,  coloring,  character,  and 
language,  in  my  own  mind.  In  dealing  with  each  disease,  I  have  aimed  to 
sketch  a  brief  pen-and-ink  portrait,  eo  like  it  that  every  reader  shall  know  th« 


IV 


PREFACE. 


original  whenever  he  sees  it ;  and  then  to  give,  in  the  fewest  words,  the  best 
treatment. 

No  work  of  the  sort  has  ov(!r  explained  the  reasons,  or  given  the  whys  and 
wherefores  of  medicine  to  anything  like  the  extent  of  lu.., ,  nor  has  any  one 
been  so  extensively  illustrated.  The  engravings  amount  to  two  hu/idrod  tnd 
thirty-six  in  number,  and  have  been,  with  few  oxceplions,  done  expressly  for 
this  work.  Of  the  colored  lithographs,  there  are  Thirty-six  Figure-^  on  eight 
splendid  plates.  They  are  inserted  at  groat  expense,  and  add  much  to  .'he  value 
of  the  book. 

L  W. 


SECOND  PREFACE. 


The  Household  Physician  was  written  in  the  belief  that  the  people  were  ready 
and  waiting  for  a  popular  medical  work  based  on  liberal  principles ;  and  that  one 
hundred  thousand  copies  have  already  found  a  welcome  home,  in  as  many  Amer« 
ican  families,  is  a  sufficient  evidence  that  the  belief  was  well-founded.  I  say 
welcome  home ;  and  with  very  little  stretch  of  modesty  I  might  emphasize  the 
word,  for  the  popularity  of  the  book  has  far  outrun  the  author's  hopes  —  many 
persons  assuring  the  author  and  the  publishers  that  fifty  or  one  hundred  dollars 
would  be  no  temptation  for  them  to  part  with  the  copy  they  have  if  they  could 
not  obtain  another.  Such  an  extensive  sale  of  so  large  a  book,  with  the  demand 
constantly  increasing,  has  been  quite  unexpected. 

For  these  evidences  of  public  favor  the  author  is  not  ungrateful  or  unmindful 
of  corresponding  duties  on  his  part.  A  chapter  is  now  added,  therefore,  on 
"  Old  Age  and  its  Diseases,"  —  a  subject  never  before  introduced  into  any  popular 
treatise  on  medicine,  and  very  rarely,  indeed,  into  any  medical  book.  I  have  taken 
great  pains  in  preparing  it,  and  sincerely  hope  that  many  Fathers  and  Mothers 
will,  in  future  years,  be  kindly  remembered  in  consequence  of  the  suggestions  it 
contains.  I  also  hare  the  pleasure  to  present,  from  the  pen  of  Dr.  Dio  Lewis,  a 
very  valuable  contribution  upon  his  new  popular  Gymnastics,  illustrated  with 
many  cuts. 

With  these  and  some  smaller  additions,  —  improvements  I  think  I  may  call 
them,  — I  submit  the  work  again  to  the  popular  judgment. 

I.  W. 


GENERAL   INTRODUCTORY   REMARKS. 


Progress  of  Medicine. 

Medicine  may  be  divided  into  a  science  and  an  art.  It  is  a  science 
as  it  presents  facts  and  evolves  principles ;  an  art  as  it  consists  of 
rules  for  practice.  For  its  present  attainments,  it  is  indebted  partly 
to  researches  scientifically  conducted,  und  partly  to  empirical  and 
hap-hazard  discovery. 

As  a  science,  medicine  is  chiefly  indebted,  and  must  ever  be,  to  the 
members  of  what  is  culled  the  "regular profession."  This  body  of 
men,  while  it  contains  numerous  persons  whose  talents  and  attain- 
ments do  not  raise  them  above  the  merest  quacks,  docs  yet  embrace 
large  numbers  of  men  who  are  alike  ornaments  of  the  race,  and  lights 
of  their  profession.  It  is  to  the  writings  of  this  class  that  every  stu- 
dent must  go  who  would  qualify  himself  for  the  proper  discharge  of 
the  duties  of  a  physician  ;  and  he  who  attempts  the  practice  of  medi- 
cine without  a  knowledge  of  standard  medical  writings  is  either  a 
fool  or  a  knave  —  either  without  the  brains  to  understand  science,  or 
destitute  of  the  honesty  to  deal  fairly  with  men. 

While  this  is  said,  however,- it  must  be  granted  that  a  respectable 
portion  of  the  facts  which  make  up  the  science  of  medicine  have  been 
contributed  by  the  industry  of  men  who  have  not  had  what  is  called 
a  regular  standing  in  the  profession.  I  am  sorry  to  be  obliged  to  add 
that  the  great  body  of  this  class  have  been  quacks  and  charlatans, 
while  only  a  few  of  them  have  had  talents  and  acquirements. 

Nevertheless,  they  have  been  too  indiscriminately  condemned. 
Their  labors  have  been  useful  iu  various  ways,  and  have  contributed 
to  the  advancement  of  medical  knowledge.  A  regard  for  truth;  not 
less  than  justice  to  these  persons,  requires  this  statement. 

One-Idea  Hen.  —  The  "irregulars,"  as  they  have  been  called,  have 
generally  had  their  hobbies,  which  they  have  ridden  with  singular 
diligence,  and  often  in  little  better  than  John  Gilpin  plight.  Yet  they 
have  drawn  attention  to  great  truths,  which  the  regular  profession 
either  did  not  see,  or  would  not  commend ;  and  they  have  done  this 
by  dwelling  incessantly  upon  some  single  idea. 

The  one-idea  men,  of  every  class,  have  been  ridiculed  in  all  ages ; 
and  indeed  have  always  exhibited  some  singular  obliquities.  Yet 
when  they  have  been  men  of  learning  and  talents,  they  have  accom- 
plished great  things,  either  for  good  or  evil. 


\i 


6 


GENERAL    INTRODUCTORY    REMARKS. 


Martin  Luther  was  strictly  a  one-idea  miin.  The  whole  force  of 
his  oxtruordiniiry  charucter  was  given  to  the  propagation  of  the  single 
doctrine  of  justification  by  faith  ;  and  by  the  incessant  efforts  ho  made 
for  this  purpose,  he  sank  the  doctrine  deeper  into  the  heart  of  Europe 
than  a  hundred  equally  powerful  men  could  have  done  by  giving  it 
only  an  ordinary  share  of  attention. 

William  Ellery  Clmiiniiig  was  a  one-ideaist.  Man,  tiio  noblest 
work  of  creation,  to  be  developed,  educated,  adorned,  loved,  made 
like  unto  (Jod,  was  the  thought  of  his  life,  —  a  thought  wliich  ho  em- 
bellished and  moulded  into  all  the  forms  of  beauty  which  our  flexible 
language  is  capable  of  producing.  Under  the  mild  promptings  of 
his  genius,  and  the  workings  of  this  thought,  philanthropy,  quick- 
ened into  a  new  life,  spread  out  her  arms,  and  embraced  the  world. 

Sir  Jsaac  Newton,  was  a  one-ideaist.  So  entirely  did  ho  devote  hia 
great  powers  to  astronomy  and  the  higher  mathematics,  that  ho  be- 
came unfitted  for  the  duties  of  social  and  domestic  life  —  s»,  uiititted, 
that  when  induced  by  his  friends  to  give  a  little  attention  to  courtship, 
he  fell  into  one  of  his  abstractions,  and  detected  himself  in  using  his 
lady-love's  fore-finger  to  poke  down  the  ashes  in  his  pipe  !  But,  Sir 
Isaac  advanced  mathematical  science  to  a  point  far  beyond  its  previ- 
ous attainments,  and  laid  it  under  such  obligations  as  no  general 
scholar  could  have  done. 

It  is  in  this  way,  thou;jh  in  a  vastly  less  degree,  and  without  the 
scientific  method,  that  one-ideaists  in  medicine  benefit  the  world. 
They  seize  upon  some  single  remedy,  — generally  one  which  has  been 
overlooked,  —  and  usmg  it  themselves  to  the  exclusion  of  all  others, 
they  press  it  upon  the  world  as  the  panacea  for  all  its  ills.  With 
them  disease  is  a  unit,  and  they  have  found  its  one  all-important 
remedy.  Thus  convinced,  they  press  it  upon  others  with  the  enthu- 
siasm of  fanatics.  Testing  it  in  all  cases,  they  develop  all  its  virtues. 
Those  who  have  the  good  sense  to  turn  their  attention  to  it  have 
only  to  use  it  in  those  cases  for  which  its  adaptation  is  proved. 

It  is  in  this  way  that  these  men  become,  incidentally,  medical  dis- 
coverers ;  and  not  being  burdened  with  modesty,  they  never  with- 
hold their  importunities  till  the  world  acknowledges  whatever  value 
there  is  in  their  discovery.  And  although  they  may  do  some  mis- 
chief with  the  single-edged  tool  which  thoy  handle  so  industriously,  I 
doubt  if  they  do  much  more  than  many  better  workmen  who  use  too 
many.  At  all  events,  wise  and  generous  men  thank  them  for  their 
gift  to  the  profession,  small,  though  it  may  be,  and  use  it  in  the  light 


of  a  clearer  knowledge. 

Hydropathy.  —  As  an  illustration  of  what  I  have  just  been  saying, 
I  may  reter  to  hydropathy,  or  the  plan  of  treating  all  diseases  by  water. 

The  singularly  careful  avoidance,  by  the  whole  medical  faculty,  for 
many  ages,  of  the  article  of  pure  water  as  a  medicinal,  or,  rather, 
health-imparting  agent,  was  anything  but  creditable  to  the  profession. 

It  is  now  admitted  by  all  sensible  men  that  water,  cold  and  warm, 
used  at  proper  times  and  to  a  reasonable  extent,  has  great  power  over 


GENERAL    INTRODirCTOKY    REMARKS. 


several  diseases,  and  is  a  powerful  promoter  of  hoalth.  No  physicians, 
except  those  who  are  too  indolent  to  know  wlmt  is  f^oing  on  in  the 
world,  or  too  fast  locked  in  old  prejudices  to  touch  new  things,  now 
omit  its  use  in  mawf  cases.  How  warm  and  sincere  my  own  approval 
of  water  as  a  remedy  is,  ahnost  every  page  of  this  volume  will  attest. 
Indeed,  it  may  honestly  be  allowed  that  the  hydropathists  have 
fairly  drowned  the  almost  criminal  professional  prejudice  against 
water.  They  are  in  all  the  nn)re  need  of  this  concession,  since  in 
their  absurd  zeal  to  cure  all  diseases  by  water,  and  make  aquatic  ani- 
mals of  men,  they  have  also  drowned  their  own  common  sense. 

Homeeopatliy.  — -This  mode  of  practice  is  of  comparatively  recent 
origin ;  but  it  has  already  sunk  itself  deep  into  the  popular  heart, 
and  has  drawn  to  its  support  many  of  the  wealthy,  tiio  cultivated, 
and  the  intelligent,  in  our  most  refined  communities.  I  do  not  pro- 
fess to  comprehend  and  appreciate  its  principles,  no-  would  it  be 
honest  in  mc  to  pretend  to  see  how  its  infinitesimal  u  <e3  can  produce 
the  results  which  it  often  shows,  and  which  it  is  fair  \.o  confess  look 
like  singular  success  ;  and  saying  this,  I  can  neither  adopt  nor  ap- 
prove the  violent  denunciations  and  censures  "  hich  so  many  are 
induced  (by  fashion,  I  fear)  to  employ  towards  t".  ' :  generally  well-cul- 
tivated class  '^f  practitioners.  I  hold  them  as  useful  members  of  the 
profession,  ;uiJ  mean  over  to  cultivate  towards  them  rraterual  feelings. 
Th^v  give  great  attention  to  exercise,  diet,  the  use  of  water,  etc.,  — 
things  which  contribute  very  powerfully  to  preserve  health,  and  to 
restore  it  when  lost.  In  this  thing,  the  old  school  practitioners  ought 
to  learn  a  most  important  lesson  from  them.  In  truth,  they  are 
learning  it,  but  very  slowly  and  reluctantly,  I  am  sorry  to  say. 

The  central  idea  of  the  homoeopathist,  that  "  like  euros  like,"  the 
"  great  law  of  cure,"  as  he  styles  it,  I  do  not  feel  called  upon  to  dis- 
cuss —  theories  being  of  much  less  consequence  than  rules  of  prac- 
tice. The  old-school  men  have  certainly  much  to  learn  from  him 
respecting  the  augmented  power  of  medicine  from  the  greatest  possi- 
ble  division  by  trituration.  We  have  learned  from  him,  too, — 
though  many  are  too  ungenerous  to  confess  the  source  of  the  infor- 
mation,—  that  we  may  gain  our  purposes  with  much  less  medicine 
than  we  were  once  in  the  habit  of  giving. 

Eclectics —  There  is  a  large  and  growing  class  of  physicians,  called, 
at  first,  after  the  founder  of  the  school,  Thomsonians.  Subsequently, 
they  were  generally  known  as  Botanic  Physicians.  Now  they  pasa 
under  the  title  of  Eclectics. 

These  men,  directing  their  attention,  at  first,  chiefly  to  cayenne 
and  lobelia,  have  gradually  extended  their  zealous  researches  over 
the  vegetable  kingdom,  and  have  gathered  much  information  worthy 
to  be  preserved.  These  researches  have  revealed  a  sadly  neglected 
duty  on  the  part  of  old-school  practitioners,  and,  in  1852,  drew  from 
the  "  Committee  on  Indigenous  Medical  Botany, '  appointed  by  the 
"American  Medical  Association,"  the  confession  that  our  practi- 
tioners generally  have  been  extremely  ignorant  of  the  medicinal 
plants  even  in  their  own  neighborhoods ;  and  to  this  fact  the  com- 


I 


i 


'ti 


ni 


GENERAL    INTRODUOTORY    REMARKS. 


mittee  attributed  it,  that  the  Eclectic  physicians  had  in  so  many  in- 
stances supplanted  the   '*  regulars  "  in  the  confidence  of  the  people. 

The  education  tnd  talents  of  this  class  of  practitioners  have  grad- 
ually risen,  year  by  year,  until  they  have  several  medical  schools, 
where  students  are  well  instructed  in  the  principles  of  medicine,  by 
men  of  real  ability.  This  is  particularly  true  of  the  school  at  Cin- 
cinnati. They  have  also  a  literature  of  no  mean  significance,  espe- 
cially in  the  department  of  materia  medica.  The  list  of  remedies 
they  have  given  to  the  world,  drawn  from  our  home  plants,  are  a 
boon  of  no  small  value.  I  regard  them  as  equal  in  value  to  all  we 
were  previously  in  possession  of  from  the  vegetable  kingdom.  The 
podophyllin  and  leptaudrin,  as  substitutes,  in  most  cases,  for  mercu- 
rials, can  hardly  be  too  highly  prized. 

And  yet,  it  is  mortifying  that  the  remedies  which  these  men  have 
given  us  are,  by  hundreds  of  our  old-school  practitioners,  not  even 
known  by  name,  and  where  known,  &renerally  not  honored  with  a 
trial.  King's  ♦♦  American  Eclectic  Dispensatory,"  a  book  of  1,300 
pages,  in  which  they  are  well  described,  is  almost  unknown  among  us. 
Aside  from  the  copy  in  my  own  library,  I  do  not  know  that  one  is 
owned  by  any  member  of  the  Massachusetts  Medical  Society,  in 
Boston.  I  consider  this  a  disgrace,  for,  however  learned  a  man  may 
be,  he  is  not  fully  equipped  as  a  practitioner  until  he  is  acquainted 
with  this  class  of  medicines. 

Physiologists.  —  Beside  these  various  direct  practitioners  of  medi- 
cine, there  is  the  large  and  quite  intelligent  class  of  physiologists, 
including  the  phrenologists,  v;iiv^  nearly  discard  medicine,  and,  ap- 
pealing to  the  laws  of  life  establislied  by  the  Creator,  urge  temper- 
ance in  eating  and  drinking ;  exercise  in  the  open  air ;  securing  of 
pure  air  by  ventilating  dwellings,  school-houses,  and  churches ;  bath- 
ing in  cold  and  warm  water ;  cheerfulness  of  mind ;  and  the  culti\a- 
tion  of  the  Christian  virtues,  as  the  only  rational  modes  of  securing 
health  and  life. 

I  confess  myself  inclined  to  fo''give  this  class  their  error  in  ban- 
ishing medicine,  in  view  of  tiieir  zeal  and  success  in  disseminating 
hygienic  information  of  the  utmost  value  and  importance  to  mankind. 
Put  man  into  harmony  with  nature,  and  establish  over  him  the  em- 
pire of  reason,  and  their  theory  would  be  excellent ;  but  as  things 
are,  medicines,  like  prisons,  and  alms-houses,  and  large  cities,  are 
"  necessary  evils." 

Other  Practitioners.  —  Finally,  we  have  Mesmerists,  Pathetists, 
Electro-biologists,  Spiritualists,  Nutritivists,  and  what  not,  all  pre- 
tending to  cure  disease  by  processes  peculiar  to  themselves.  They 
are  alt  experimenters  in  different  departments  of  nature,  —  now 
spreading  over  our  eyes  a  large  plaster  of  humbuggery,  and  now 
drawing  a  small  curtain  and  giving  us  a  peep  into  the  large  and  well- 
furnished  rooms  which  nature  has  fitted  up  for  our  reception,  by  and 
by,  when  wo  are  better  instructed. 

All  Useful  in  a  De^ee.  —  On  the  whole,  I  am  disposed  to  regard 
all  the  operators  in  the  different  departments  of  medicine  as  useful 


le  em- 
things 

ies,  are 


betists, 
11  pre- 
They 
—  now 
d  now 
d  well- 
by  and 

regard 
useful 


GENERAL    INTRODUGTORT    REMARKS. 


9 


in  their  degree;  excepting  always  those  mercenary  quacks,  who  lie 
about  their  remedies  to  make  money.  Each  of  all  these  (I  mean  all 
sincere  and  true  men  who  believe  what  they  teach)  is  aiding  in  some 
measure  the  general  advancement.  And  though  the  truths,  as  they 
gather  and  present  them,  are  but  fragmentary,  they  are  useful  in  the 
hands  of  those  true  Eclectics,  who  have  the  wisdom  and  independence 
to  select  the  best  things  out  of  all  systems. 

General  Conclusion.  —  This  brings  me  to  remark  that  there  is  but 
one  truly  liberal  and  philosophical  school  of  medicine.  It  is  the 
Eclectic,  —  composed  of  those  who  have  liberality  enough  to  reject 
every  exclusive  ay  stem,  and  to  select  out  of  all  systems  those  things 
which  are  approved  by  experience  and  reason. 

I  have  already  spoken  of  a  school  of  practitioners  called  Eclectic. 
To  a  certain  extent  they  are  entitled  to  the  name,  but  I  think  not 
entirely.  They  have  formed  a  separate  and  exclusive  school.  They 
have  turned  some  articles  out  of  the  materia  medica  possibly  for  no 
better  reason  than  because  their  party  is  committed  to  their  rejec- 
tion ;  whereas  they  should  have  no  party,  but  allow  each  man  to  act 
as  if  he  were  a  citizen  of  the  world  only,  and  not  a  member  of  any 
restricted  association.  But  I  will  not  quarrel  with  them  on  this 
point.     I  think  they  are  becoming  eclectic. 

Process  of  Medicine.  —  There  have  been  long  periods  when  the 
science  and  the  art  of  medicine  made  scarcely  any  progress.  They 
are  now  advancing,  —  in  some  departments  quite  fast. 

The  Chemistry  of  Man,  commonly  called  Animal  Chemistry,  is 
opening  new  sources  of  light.  Few  of  the  profession  have  yet 
studied  this  essential  branch  of  medical  science  ;  but  the  delinquents 
are  sleeping  in  the  rear,  and  will  soon  awake  to  find  themselves 
among  the  ghosts  of  a  dead  generation. 

The  writer  was  in  the  habit  of  asserting,  many  years  ago,  that 
most  of  the  true  progress  in  medicine  must  come  through  Animal 
Chemistry ;  and  the  developments  of  the  lust  few  years  have  made 
good  the  assertion.  Liebig,  a  diligent  student  in  chemistry,  has  done 
much  to  open  the  way  for  inquirers  in  this  department.  Simon  has, 
l)erhaps,  done  more.  Mialhe  is  a  yet  later  explorer,  and  has  made 
valuable  discoveries. 

The  result  is,  that  students  have  now  before  their  minds,  and  are 
endeavoring  to  solve  and  act  upon  as  fast  as  possible,  inquiries  and 
propositions  like  these  :  — 

What  is  the  oliemical  composition  of  the  solids  and  fluids  of  the 
healthy  human  body  ? 

What  is  the  nature  of  the  changes  which  occur  in  the  composition 
of  the  solids  and  fluids  during  disease? 

What  alterations  in  the  chemical  composition  of  the  solids  and 
fluids  take  place  during  the  operation  of  medicines? 

Before  it  can  exert  any  remote  action  on  the  animal  economy,  a 
remedy  must  be  absorbed. 

Befoivj  it  can  be  absorbed,  it  must  be  soluble  in  the  fluids  of  the 
living  body. 


10 


•aENERAL    INTRODUGTOBT    REMARKS. 


11 


(ii 


^i^: 


Medicines  are  subject  to  chemical  changes  during  their  passage 
through  the  system. 

These  changes  are  regulated  by  ordinary  chemical  laws,  and  may 
therefore,  to  some  extent,  be  foretold  and  made  available  in  the  cure 
of  disease. 

These  chemical  laws  are  disturbed  and  varied,  to  some  extent,  by 
the  law  of  vitality,  — just  as  the  needle  is  made  to  vary  by  disturb- 
ing forces. 

What  are  those  disturbances,  and  to  what  extent,  and  under  what 
circumstances,  do  they  occur? 

With  these  and  similar  inquiries  and  propositions  before  his  mind, 
diligently  studied,  a  man  will  in  time  learn  to  prescribe  with  some 
intelligent  aim.  He  will  not  know  everything,  to  be  sure,  but  what 
ho  does  know,  he  will  have  a  reason  for  knowing.  If  he  give  a  medi- 
cine, ho  will  have  in  view  the  chemical  changes  of  the  solids  and  fluids 
of  the  body,  known  to  bo  produced  by  the  disease  he  is  combating. 
He  will  also  keep  in  mind  the  soiution  of  the  medicine  iii  the  fluids 
of  the  body,  and  the  chemical  reav^tion  between  its  components  and 
the  acids,  alkalies,  etc.,  found  in  the  alimentary  tube  and  elsewhere. 

As  the  science  of  medicine  advunces,  and  becomes  liberal  and 
eclectic  in  its  character,  gathering  from  all  systems  the  best  attested 
facts,  and  using  them  to  the  exclusion  of  all  mere  theories,  these  factf 
must  not  themselves  degenerate  into  mere  petted  theories,  but  must 
be  held  in  subordination  to  future  experience.  Medical  practitioners, 
who  would  meet  the  wants  of  the  age,  must  be  men  of  progress. 
The  light  of  to-morrow,  with  them,  must  modify  and  improve  the 
light  of  to-day.  They  m  st  knock,  every  hour,  for  admission  into 
eome  new  apartment  of  nature. 

Need  of  Liberality. —  That  medical  progress  may  be  real,  physi- 
cians must  be  free  from  bigotry.  They  must  have  no  narrow  preju- 
dices against  any  man,  or  class  of  men  ;  but  be  ready  to  examine 
candidly  any  new  thought  or  new  remedy  brought  to  their  notice, 
from  whatever  source  it  may  come. 

They  should  not  hedge  themselves  about  with  such  restrictive  by- 
laws and  societary  rules  as  are  calculated  to  fetter  their  thoughts,  and 
turn  their  investigations,  by  a  sort  of  moral  necessity,  into  the  nar- 
row channels  of  party  conservatism ;  remembering  that  he  who  is 
once  enclosed  by  such  restrictions  must  hew  a  path  for  his  feet 
through  bigotry,  and  even  malevolence  itself,  before  he  can  escape 
them,  or  be  a  free  man  in  any  noble  sense. 

The  members  of  medical  societies  do  themselves  no  credit,  in  the 
nineteenth  century,  by  putting  on  airs,  and  telling  others  to  stand  at 
a  distance.  This  would  do  better,  had  medicine  become  an  exact 
science ;  but  while  the  primary  effects  of  even  opium  are  not  settled  — 
some  physicians  considering  it  as  primarily  stimulant,  others  as  seda- 
tive, others  as  stimulant  to  the  nerves  and  sedixtive  to  the  muscles, 
others  as  neither,  and  still  others  as  alterative,  —  such  exclusiveness 
Beems  neither  wise  nor  modest.  When  the  professors  of  the  healing 
art  can  hoard  medical  kno wedge  as  misers  hoard  gold,  and  can  sub- 


passage 

and  may 
the  cure 

ctent,  by 
distur1>- 

der  what 

lis  miud, 
ith  some 
but  what 
e  a  medi- 
nnd  fluids 
mbr.ting. 
Uie  fluids 
lents  and 
Ise  where. 
)eral  and 
t  attested 
hese  factf 
but  must 
stitioners, 
progress, 
jrove  the 
sioa  into 


il,  physi- 
-)W  preju- 
examine 
ir  notice, 

ictive  by- 
ffhts,  and 

the  nar- 
le  who  is 

his  feet 
n  escape 

^it,  in  the 

stand  at 
Ian  exact 
settled  — 

as  seda- 
I  muscles, 

isiveness 
[e  healing 

can  sub- 


GENERAL    INTRODUCTORY    REMAUKS. 


11 


mit  its  purity  to  equally  certain  tests,  it  will  appear  in  better  taste 
for  them  to  grow  exclusive.  Until  then,  the  most  becoming  badge 
they  can  wear  is  the  Christian  direction  :  "  Let  each  esteem  others 
better  than  himself. " 

Medical  societies,  with  liberal  by-laws,  are  fitted  to  do  good ;  but 
it  would  be  hard  to  show  that  those  with  stringently-restrictive  rules 
can  operate  otherwise  than  as  aliecks  upon  progress.  In  truth,  they 
are  apt  to  become  mere  catacombs  in  which  to  embalm  dead  ideas. 
They  are  very  liable  to  be  made  the  instruments  for  accomplishing 
the  ambitious  purposes  of  a  few  leading  men.  They  tend  to  sifippress 
all  sympathy  with  everything  outside  their  organization  ;  iv.v\  they 
beget  a  feeling  like  that  which  would  forbid  the  fixed  stars  to  drop 
their  light  mto  our  atmosphere  without  first  coming  down  and  joining 
the  solar  system. 

Conservative  Lenders,  —  There  are  no  influences  which  hold  so 
steady  a  check  upon  medical  progress  as  the  conservative  leaders  in 
many  of  our  medical  associations.  Not  that  they  are  opposed  to  im- 
provement in  the  medical  art,  or  would  object  to  any  amount  of  dis- 
covery, if  it  could  come  to  the  profession  through  channels  which  they 
have  the  honor  of  opening.  But  against  all  light  from  outside,  or  from 
obscure  sources,  tliey  will  draw  down  the  cintains,  and  close  the 
doors ;  and,  if  it  chance  by  any  means,  in  spite  of  them,  to  get  within 
the  sacred  enclosure,  they  will  call  it  darkness,  and,  as  priests  of  the 
temple,  will  attempt  to  atone  for  the  indignity  offered  to  the  god  of 
medicine,  and  fill  the  whole  sky  with  murky  clouds  from  their  altars. 

These  men  have  strong  faith  in  caste,  and  in  the  right  of  the  few 
to  govern  the  many.  In  the  low  places  of  society,  they  look  for 
nothing  but  ignorance  and  poverty.  Notwithstanding  that  the  light 
of  every  natural  day  l)re,aks  in  the  horizon,  and  ascends,  they  so  far 
despise  analogies  as  to  insist  that  all  medical  light  breaks  at  what 
they  call  the  zenith  of  the  profession,  and  comes  dovm.  With  them 
the  temples  of  Esculapius  are  all  rebuilt,  and  they  are  the  priests ; 
and  to  offer  in  sacrifice  the  smallest  medicinal  plant  is  a  sacrilege, 
unless  it  be  entrusted  to  their  hands. 

Such  persons  measure  and  weigh  a  man  by  the  amount  of  money 
he  has.  Property  is  their  god,  which  gives  laws  to  everything. 
\^''lth  them,  knowledge,  like  property,  goes  to  posterity  by  will, — 
they  being  the  principal  testators.  Like  their  money,  too,  it  goes 
chiefly  to  their  sons,  and  to  certain  favored  institutions,  by  whom,  and 
in  which,  it  is  to  be  hoarded,  and  whence  it  is  to  go  out  only  in  certain 
approved  channels,  weighed  and  stamped,  like  coin  from  the  mint. 

These  are  the  men  who  regard  knowledge  as  a  contraband  article, 
unless  regularly  entered  at  the  custom-house,  with  bills  of  lading 
properly  certified  by  the  conservative  magnates  at  some  other  me- 
tropolis. With  them,  knowledge  is  not  like  the  Avost  wind,  fanning 
the  brow  of  the  peasant  as  gently  as  that  of  the  king,  —  not  like  the 
light  of  heaven,  entering  the  small,  clean  window  of  the  hut,  as 
readily  as  the  larger  one  of  the  palace  ;  not  a  boon  which  comes  alike 
freely  to  all,  and  which  is  to  be  everywhere  amplified,  changed  aa 


Ill 


i  :c 


12 


GENERAL    INTSODUCTORT    REMARKS. 


oirciiniBtances  and  conditions  require,  and  especially  adapted  to  the 
present  hour.  It  is  rather,  as  they  too  often  view  it,  like  litho- 
graphed letters  of  advice,  printed  upon  stamp  paper,  and  carefully 
sealed  up  and  addressed  to  posterity.  And  then,  if  they  can  be 
made  the  mail-carriers,  and  be  permitted  to  pass,  unchallenged,  with 
the  precious  bag,  from  post  to  post,  and  pass  it  over,  carefully  sealed, 
to  the  next  generation,  they  will  think  it  has  done  its  work,  and  that 
they  have  fulfilled  their  mission. 

I  would  not  be  unjust  or  severe,  but  I  cannot  but  remark  further, 
that  these  men  present  but  one  vfew  of  humanity.  They  are  monot- 
onous objects  of  inspection.  Look  at  them  a  thousand  times,  and 
you  see  only  the  same  unaltered  phase  of  life.  To  the  mariner  on 
life's  ocean,  they  are  not  safe  lights.  If  he  approach  them  on  the 
dark  side,  they  remain  black  as  night  to  him,  until  he  comes  round  to 
their  shining  front.  They  are  not  revolving  lights.  They  have 
light ;  it  may  be  bright  and  genial ;  but  it  gleams  out  upon  the  waters 
only  in  one  direction.  It  does  not  sweep  round,  and  throw  its  rays 
upon  every  mariner's  path. 

Such  men  are  useful,  but  only  to  a  certain  class.  They  have  in 
them  no  true  omnilogy  —  they  are  not  all-teaching.  Their  lives  are 
instructive  to  their  friends,  their  clique,  their  party,  their  school ; 
but  a  stumbling-block,  a  hindrance,  an  oppression,  an  offence  to  every- 
body else.  They  are  like  porcupines,  with  fronts  smooth  and  easy 
of  access ;  but  their  backs  bristle  with  quills  to  stick  into  those  on 
the  wrong  side.  They  are  not  whole  men.  Humanity  has  infused 
into  them  only  one  or  two  of  its  elements.  They  have  length,  but  no 
breadth.  They  are  citizens  of  Boston,  New  York,  Philadelphia,  or 
Cincinnati,  but  not  cf  the  world.  Within  certain  circles,  they  are 
genial  friends,  but  cynics  and  haters  outside  of  them.  From  their  high 
places,  they  come  down  to  their  humble  followers  with  tokens  of  friend- 
ly recognition  ;  upon  others  they  frown  and  lower  like  armed  castles. 

The  True  Physician.  —  How  different  the  character  of  the  true  man 
abd  physician  !  He  is  genial  in  his  disposition.  He  has  no  dislikes 
and  antipathies,  and  hates  no  men  except  tyrants.  He  accepts  knowl- 
edge, though  it  come  from  the  humblest  source  ;  believing  there  is  no 
experience  but  will  repay  a  study  of  it,  and  no  husbandman's  plough- 
share but  turns  up  a  soil  worth  analyzing.  He  belongs  exclusively 
to  no  party,  and  can  be  approached  easily  by  respectable  men  of 
every  stamp.  Whether  belonging  to  tlie  same  society  with  him,  or 
not,  you  may  take  hold  of  his  nature  and  draw  it  out,  without  hav- 
ing it  slip  from  your  fingers,  and  spring  back  from  your  presence  into 
a  thousand  kinks,  like  an  overtwisted  thread.  He  is  a  whole  man. 
Grod  made  him  for  the  world,  and  not  for  a  party.  By  some  strong 
influence  you  may  possibly,  for  a  time,  draw  him  from  the  world  into 
some  narrower  sphere,  but  not  only  will  his  reluctant  nature,  like  a 
retiring  tide,  run  back  continually  to  embrace  the  continent,  but  will 
soon  break  from  its  confinement,  and  like  a  full  sea,  come  back,  boil- 
ing and  running  over. 

What  is  now  Wanted.  —  The  foregoing  remarks  indicate  one  great, 


It  is 


high 


leading  want,  in  order  that  medical  knowledge  may  increase. 
liberality,  in  the  true  and  full  sense.     We  want  true  men  in 
places,  who  will  not  only  let  their  own  light  shine  everi/where,  but  will 
cease  to  hinder  other  men's  light  from  shining. 

Beyond  this,  and  of  nearly  equal  importance  with  it,  we  want  medi- 
cal knowledge  diffused  among  the  people.  We  want  —  what  the 
world  has  never  seen  —  a  popular  medical  literature.  We  want  the 
temples  of  Esculapius  pulled  down,  and  the  priests  turned  into  the 
streets  to  become  teachers  of  the  nuiltitude,  rather  than  worshippers 
in  the  iiu^er  sanctuary. 

I  know  this  want  will  be  stoutly  denied,  but  not,  I  think,  on  well- 
considered  grounds.  We  do  not  think  it  necessary  to  confine  a  knowl- 
edge of  the  soul  to  the  ministers  of  religion.  There  is  no  branch  of 
theology  which  we  do  not  deem  it  proper  for  laymen  to  study ;  we 
even  jiopularize  it  for  our  children.  In  the  obscurest  towns  of  New 
England,  laymen  who  follow  the  plough  or  push  the  plane,  become, 
in  many  cases,  eminent  theologians.  Why  should  they  not  study 
the  lower  science  which  relates  to  the  body  ?  They  have  not  been 
able  to  heretofore,  because  its  mysteries  have  been  purposely  hidden 
under  technicalities.     These  coverings  should  bo  torn  off. 

It  is  said  that  those  who  begin  to  read  upon  medicine  are  very  apt 
to  imagine  themselves  afflicted  with  the  various  symptoms  thoy  find 
described.  To  some  small  extent  this  is  true  ;  but  it  is  also  true  that 
the  ligiit  they  obtain  relieves  them  from  many  apprehensions  which 
thoir  previous  ignorance  allowed  to  prey  upon  them ;  as  boys  lose 
their  fears  when  the  light  of  the  morning  changes  to  some  familiar 
object  the  ghost  of  the  preceding  night. 

Physicians  oppose  the  popularizing  of  this  kind  of  knowledge  too 
often,  I  fear,  upon  the  sordid  ground  of  self-interest.  They  think 
their  own  services  will  be  less  sought. 

Wo  do  not  dispense  with  the  services  of  ministers  because  the 
people  study  theology,  neither  shall  we  cease  to  employ  teachers  and 
practitioners  of  medicine  when  each  man  and  woman  is  wise  enough 
to  study  the  healing  art.  The  principal  change  we  shall  witness  will 
l>e  much  larger  attainments  in  knowledge  among  practitioners,  — just 
as  the  ministers  of  religion  now  know,  and  are  obliged  to  know,  ten 
times  as  much  as  in  those  darker  periods  when  the  people  received 
all  o^.iJtual  knowledge  from  their  mouths.  The  teachers  of  any  art 
or  science  are  obliged  to  keep  in  advance  of  their  pupils. '  Let  medi- 
cine become  a  popular  study,  and  we  shall  have  very  few  ignorant 
physicians,  and  quackery  will  become  one  of  the  impossibilities. 
Horaoeopathists,  Eclectics,  Hydropathists,  and  Physiologists,  believe 
in  scattering  medical  books,  stripped  of  their  technicalities,  among 
the  multitude,  and  their  people  purchase  very  few  secret,  advertised 
medicines ;  —  these  being  chiefly  bought  and  consumed  by  the  fol- 
lowers of  those  who  believe  this  kind  of  reading  fosters  quackery  I 


L=_- 


m 

1     -|'! 


A.3Sr  A.  T  O  M  Y. 


Akatout  describes  the  structure  and  oi^anization  of  living  beings. 

Special  Anatomy  treats  of  the  weight,  size,  shape,  color,  etc.,  of 
each  organ  separately. 

General  Anatomy  investigates  the  tissues  or  structures  from  which 
organs  are  formed. 

Surgical  Anatomy  or  Regional  Anatomy  considers  the  relations  of 
organs  to  one  another. 

Physiological  Anatomy  treats  of  the  uses  or  functions  of  organs  in 
health. 

Pathological  Anatomy  describes  the  alterations  made  upon  different 
organs  by  disease. 

We  shall  here  introduce  a  very  brief  compendium  only  of  Special 
Anatomy. 

It  is  of  great  cousequence  that  every  person  should  have  some 
knowledge  of  anatomy  and  physiology.     Self-knowledge 


ought 


to 


extend  to  the  body  as  well  as  the  mind.  To  know  one's  self,  physi- 
cally, is  to  gain  a  new  insight  into  that  wonderfully  skilful  adjustment 
of  means  to  ends  which  is  never  absent  from  the  works  of  God. 
Without  this  knowledge,  one  cannot  know  how  to  take  care  of  the 
health ;  and  without  health,  life  loses  most  of  its  value. 

Structure    of  the   Body. 

The  human  body  is  composed  of  solids  and  fluids. 

The  fluids  are  most  abundant  in  children  and  youth.  It  is  this 
which  gives  softness  and  pliancy  to  their  flesh.  In  old  age  the  fluids 
are  less  abundant,  and  the  flesh  is  more  hard  and  wrinkled. 

The  fluids  contain  the  whole  body,  as  it  were,  in  a  state  of  solution  ; 
or  rather,  they  hold  the  materials  out  of  which  it  is  manufactured. 

Chemical    Properties    of  the   Body. 

The  four  elements,  oxygen,  hydrogen,  carbon,  and  nitrogen,  make 
up  nearly  the  whole  bulk  of  the  fluids  and  soft  solids  of  the  human 
body.  A  number  of  other  elements,  chiefly  in  a  state  of  combina- 
tion, and  in  much  smaller  quantities,  enter  into  several  of  the  tissues. 

Binary  Compoands*  —  Thus,  we  have  carbonic  acid  in  blood,  urine 


ANATOMT. 


15 


and  sweat ;  and  we  have  water  universally  diffused  through  the  sys- 
tem,—each  of  these  substances  being  a  binary  compound,  that  is, 
composed  of  two  elements. 

Componnds  of  more  than  two  Elements  arc  widely  distributed 
over  the  body ;  as, 

Carbonate  of  Soda  in  serum,  saliva,  bile,  mucus,  sweat,  and  tears. 

Carbonate  of  Lime  in  cartilage,  bone,  and  teeth. 

Phosphate  of  Lime  in  bones,  teeth,  and  cartilage. 

PhospJiate  of  Iron  in  blood,  gastric  juice,  and  urine. 

Chloride  of  Sodium  in  blood,  brain,  muscle,  bone,  cartilage  and 
pigment. 

Chloride  of  Potassium  in  blood,  gastric  juice,  milk,  and  saliva. 

Chloride  of  Calcium  iu  gastric  juice. 

Sulphate  of  Potassa  in  urine,  gastric  juice^  and  cartilage. 

Sulphate  of  Soda  in  sweat,  bile,  and  cartilage. 

Sulphate  of  Lime  in  bile,  hair,  and  scarf-skin. 

Oxide  of  Iron  in  blood,  black  pigment,  and  hair. 

Organized  Compounds.  —  Beside  the  above  inorganic  elements  and 
compounds,  several  organized  substances,  or  proximate  elementSy  as 
they  are  called,  exist  largely  in  the  body.  The  chief  of  these  are 
albumen,  fibrine,  gelatine,  mucus,  fat,  caseine,  and  osmazome.  Others 
need  not  be  named. 

Albumen  is  found  in  great  abundance  iu  the  human  body.  It  is 
the  raw  material  out  of  which  the  flesh  and  other  tissues  are  made. 
The  white  of  an  egg,  which  is  nearly  pure  albumen,  is  a  good  speci- 
men of  it. 

librine,  when  removed  from  the  human  body,  changes  from  a  solu- 
ble to  an  insoluble  state.  In  other  words,  it  coagulates  in  a  kind  of 
net-work.  Nearly  the  same  thing  takes  place  constantly  in  the  living 
body,  when  the  liquid  fibrine  leaves  its  soluble  state,  and  is  deposited 
as  solid  flesh.  Fibrine  bears  the  same  relation  to  albumen  that  wool- 
len yarn  does  to  wool ;  it  is  spun  from  it  in  the  busy  wheel  of  or- 
ganic life.  And  the  flesh  or  muscle  is  related  to  fibrine  as  the  cloth 
is  to  yarn  ;  it  is  woven  from  it  in  the  vital  loom.  Fibrine  has  been 
called  liquid  fesh. 

Gelatine  exists  largely  iu  the  ligaments,  cartilages,  bones,  skin,  and 
cellular  tissue.  When  dissolved,  five  parts  in  one  hundred  of  hot 
water,  it  forms  a  thick  jelly.  Isinglass  is  a  form  of  gelatine  obtained 
from  the  air-bladder  of  the  sturgeon  and  the  cod-fish.  Glue  is  still 
another  form  of  gelatine.  It  is  extracted  from  the  bones,  aud  parings 
of  hides,  and  the  hoofs  and  ears  of  cattle,  by  boiling  in  water.  Black 
silk,  varnished  over  with  a  solution  of  gelatine,  forms  court-plaster. 


Hncns  is  a  sticky  fluid  secreted  by  the  gland-cells.     It  is  spread 
over  the  surface  of  the  mucous  membranes,  and  serves  to  moisten  and 
I  defend  them  from  injury. 

Fat  consists  of  celb  held  together  by  cellular  tissue  and  vessels, 
I  and  contains  glycerine,  stearic  acid,  margaric  acid,  and  elaic  acid.     It 


w 


16 


ANATOMY. 


!i 


I  J") 
ill< 


I;! 


has  no  nitrogen.  If  tho  stearic  acid  be  in  excess,  the  fiit  is  hard ;  if 
the  eliiic  acid  preponderate,  it  is  soft.  The  stearine  extracted  from 
fut  is  used  for  mukiiig  very  hard  candles. 

Casfine  is  abundant  in  miiic  and  constitutes  its  curd.  It  is  held  in 
solution  in  milk  by  a  little  soda.  When  dried,  it  is  cheese.  It  is 
found  in  blood,  saliva,  bile,  and  the  lens  of  the  eye.  It  forms  the 
chief  nourishment  of  those  young  animals  which  live  on  milk.  It  is 
found  in  peas,  beans,  and  lentils.  Vegetable  and  animal  caseihe  tiro 
precisely  alike  in  all  their  properties.  Fibrine  and  albumen  contain 
almost  exactly  the  same  amount  of  oxygen,  hydrogen,  carbon,  nitro- 
gen, and  sulphur,  vtrhich  is  found  in  caseine.  This  latter,  when 
taken  into  the  stomach,  therefore,  goes,  without  much  change,  to  the 
formation  of  the  albumen  and  fibrine  of  the  body. 

Physical    Properties    of   the    Body. 

The  Tissues.  —  The  solid  organized  substances  of  which  the  human 
body  is  composed,  are  called  tissues.  There  are  various  kinds  of 
tissues. 

The  Cellular  Tissue,  commonly  called  areolar,  is  made  up  of  small 
fibres  and  bands  woven  together  into  a  sort  of  net-work,  with  numer- 
ous little  spaces  opening  into  each  other.     These  spaces  are  filled  with 
a  watery  fluid ;  and  wlien  this  is  greatly  increased  by  disease,  so  as 
to  cause  the  parts  to  swell,  and  the  skin  to  shine,  the  person  has  ana- 
sarca, or  cell  dro2)sy.     Tho  uses  of  this  tissue  are  to  give  parts  and 
organs  a  kind  of  elastic  cushion  to  rest  upon,  so  that  they  may  not  bo 
bruised  and  injured  by  the  shocks  of  life ;  to  make  a  kind  of  safe 
highway  for  delicate  vessels  to  pass  from  one  part  of  the  body  to 
another ;  and  to  furnish  a  beautifully  arranged  lodgment  for  the  wa-  i 
tery  fluid  which  gives  such  roundness,  smoothness,  and  grace  to  the  > 
human  form.     The  opening  of  the  cells  into  each  other  explains  the  i 
reason  why  feeble  persons  have  >)welled  feet  and  ankles  in  the  even- 
ing, and  not  in  the  morning,  —  the  fluid  settling  down  from  cell  to  cell, 
into  the  lowest  parts,  while  they  are  up  during  the  day,  and  running  I 
back  to  its  proper  place  while  they  are  lying  down  during  the  nigjit. 

The  Hncous  Tissue,  or  mucous  membrane,  lines  all  the  cavities  which 
communicate  with  the  air,  as  the  mouth,  stomach,  bowels,  lungs,  etc. 
It  is  supplied  with  numerous  small  glands  which  secrete  a  sticky  kind 
of  fluid  called  mucus,  to  protect  the  surface  from  any  injury  which 
might  be  inflicted  by  air,  or  by  irritating  substances  suspended  in  it. 

The  Serous  Tissue,  ov  membrane,  lines  all  the  cavities  which  do  not 
communicate  with  the  air,  that  is,  all  those  which  are  shut,  and  have 
no  outward  opening.  The  skull,  the  chest,  and  the  belly  are  lined  by 
this  kind  of  membrane.  The  membrane  itself  forms  the  closed  sack, 
—  one  layer  of  it  being  attached  to  the  cavity  it  lines,  whilo  the  other 
is  folded  back  upon  and  around  the  contents  of  the  cavity,  which  are 
left  outside  of  the  sack.  A  watery  fluid  oozes  from  the  inner  surface 
of  the  sack,  to  make  its  sides  glide  easily  upon  each  other.     When 


ANATOMY 


IT 


some  disease  causes  this  water  to  be  puured  out  too  freely,  so  as  to 
fill  or  partly  till  the  cavity,  we  have  dropsy  of  the  braiu,  or  chest,  or 
belly,  as  iho  case  may  be. 

Tlie  Dermoid  Tissue  covers  the  whole  outside  of  the  body.  "Wo 
call  it  the  skin^  or  cutis.  It  is  similar  in  structure  to  the  mucous  mem- 
branes, which  are  a  mere  continuation  of  it.  It  is  harder  than  the 
mucous  membrane,  because  more  exposed  to  injury.  In  health,  it 
never  ceases  to  secrete  and  throw  off  a  fluid  which  we  call  insensible 
perspiration  while  it  in  in  the  form  of  an  invisil)le  vapor,  and  perspira- 
tion, or  sweat,  when  it  is  so  increased  ar  to  be  seen.  So  great  is  the 
sympathy  between  this  dermoid  cavering  of  the  body  and  the  mucous 
membranes,  tliat  when  it  is  chilled  so  as  to  stop  the  invisible  perspira- 
tion, the  internal  membrane  becomes  afiected,  and  we  have  a  soro 
throiit,  or  diarrhoea,  or  running  at  the  nose  ;  that  is  to  say,  when  the 
skin  cannot  sweat,  the  raucous  membrane  begins  to  sweat. 

The  Fibrous  Tissue  consists  of  closely  united  fibres,  and  for  what- 
ever purpose  used,  forms  a  fine,  dense,  and  enduring  body.  In  some 
cases  it  takes  the  form  of  a  membrane,  as  the  dura  mater,  which  lines 
the  interior  of  the  skull  and  spinal  column.  The  ligaments  which  hold 
the  bones  together,  and  the  tendons  or  cords,  which  fasten  the  muscles 
to  the  bones,  are  fibrous  bodies.  It  is  this  firm  substance  of  whick 
rheumatism  frequently  takes  hold,  and  this  is  the  reason  why  it  lingerft, 
so  much  about  the  joints.  It  sometimes  takes  hold  of  the  ligament 
which  fastens  the  deltoid  muscle  to  the  bone  of  the  upper  arm,  about 
two-thirds  of  the  way  from  the  elbow  to  the  shoulder.  This  muscle 
lifts  up  the  arm.  In  tiiis  form  of  rheumatism,  therefore,  the  arm  hangs 
helpless  at  the  side. 

The  Cartllat^inons  Tissue  covers  the  ends  of  the  bones  where  they 
come  together  lo  make  a  joint.  It  is  well  fitted  to  make  the  joint 
work  easy,  being  smooth,  hard,  and  elastic. 

The  Osseous  or  Bony  Tissue  varies  in  its  composition,  density,  and 
strength,  according  to  the  age  of  the  person,  and  the  uses  of  the  bone. 

The  Muscular  Tissue,  or  muscle,  being  made  for  a  great  deal  of 

pulling  and  lifting,  is  formed  some- 
thing like  a  rope,  except  that  there 
is  no  twisting.  Many  small  fibres  or 
filaments  unite  to  form  fasciculi.  A 
fasciculus  is  a  bundle  of  fibres  sur- 
rounded by  a  delicate  layer  of  cell 
tissue  called  sarcolemma,  — just  as  a 
cord  is  a  number  of  smaller  threads 
of  cotton  or  hemp  bound  together.  A 
number  of  these  fasciculi  united  to- 
gether, make  a  muscle,  — just  as  sev- 
eral chords,  called  strands,  twisted 

together,  make  a  rope.     Figure  1  gives  us  a  good  view  of  the  fibres 

and  bundles,  highly  magnified. 

3 


Via.  1. 


I  ,[',J 


li 


18 


ANATOMY. 


The  Adipose  Tissue  is  tho  material  which  the  human  body  works 
up  into  pots  and  cells  containing  fal.  It  is  found  chiefly  under  the 
skin  and  muscles  of  the  belly,  and  around  the  heart  and  kidneys. 
By  the  increase  of  this  tissue,  persons  may  become  enormously  en- 
larged without  having  their  muscles  at  all  increased  in  size.  Such  a 
condition  is  to  be  deplored,  —  the  body  having  become  merely  the 
store-house  or  depot  of  myriads  of  pots  of  fat. 

The  Nervous  Tissue  is  composed  of  two  distinct  kinds  of  matter, 
—  the  one  gray  and  pulpy,  called  cineritious,  the  other  white  and 
fibrous,  called  medullary.  The  external  part  of  tho  brain  and  Ihe  in- 
ternal portion  of  the  spinal  cord  are  composed  of  the  gray  or  ash- 
colored  tissue  ;  the  nerves  are  made  only  of  the  white  or  fibrous  matter* 
and  are  inclosed  in  a  delicate  sheath  called  neurilemma. 


Vital  Properties  of  the  Body. 

Bodies  begin  their  growth  with  a  simple  ce7Z,  which  is  a  delicate 
little  bladder  or  shut  sack.  Cells  take  their  rise  in  that  portion  of  the 
blood  which  is  capable  of  being  organized,  and  which  is  called  Wa»- 
tema. 

In  animal  bodies,  each  cell  generally  begins  as  a  minute  point  in 
the  blastema,  and  grows  until  a  transparent  bladder  or  vesicle  springs 
out  from  one  side  of  it,and  soon  appears  to  enclose  it.  The  bladder 
is  then  called  the  cell,  and  the  point  or  dot  is  \ts  nucleus.  Within  this 
nucleus  appears  another  dot,  which  is  called  the  nucleolus.  When 
fully  rinened,  the  cell  bursts  and  sets  the  nucleus  free,  and  this,  in  its 
turn,  matures  and  yields  up  its  contents.  Thus  all  cells  have  their 
origin  in  germs  produced  by  previously  existing  parent  cells.  They 
are  multiplied  with  great  rapidity.  Having  grown  to  a  certain  extent, 
they  lose  their  fluid  contents,  and  their  walls  collapsing  or  coming  to- 
gether, they  form  simple  membraneous  discs.  In  this  way,  with  some 
variations,  the  simple  tissues  of  the  body  begin  to  be,  and  the  foun- 
dntion  is  laid  for  the  noble  structure  of  man. 


Anatomy  of  the  Bones. 

The  human  skeleton  is  composed  of  two  hundred  and  eight  bones, 
the  teeth  not  included. 

When  fastened  together  by  natural  ligaments,  the  bones  are  said 
to  form  a  natural  skeleton;  when  attached  by  Avires,  an  artifidal  sTcele- 
ton. 

In  Figure  2,  —  1,  1,  represent  the  spinal  column  ;  2,  the  skull ;  3, 
the  lower  jaw ;  4,  the  breast  bone  (sternum)  ;  6,  the  ribs  ;  7,  the  col- 
lar bone ;  8,  the  bone  of  the  upper  arm  (humerus)  ;  9,  the  shoulder 
joint ;  10,  the  radius ;  11 ,  the  ulna,  12,  the  elbow  joint ;  13,  the  wrist ; 
14,  the  hand ;  15,  the  haunch  bone ;  16,  the  sacrum ;  17,  the  hip  joint ; 
18,  the  thigh  bone ;  19,  the  knee  cap  (patella)  ;  20,  the  knee  joint; 
21,  the  fibula ;  22,  the  tibia ;  23,  ankle  joint ;  24,  the  foot ;  27,  28, 29, 


A\  ■ 


ANATOMY 


19 


the  ligaments  of  the  shoiiUler,  elbow,  iiikI  wrist;  30,  the  large  artery 
of  the  arm;  31,  the  ligaments  of  the  hip  joint;  32,  the  large  blood 
vessels  of  the  thigh ;  33,  the  artery  of  the  leg ;  34,  36,  36,  the  liga- 
ments of  the  knee  cap,  knee,  and  ankle. 


Fifl.  2. 


The  protuberances  or  swellings  in  certain  parts  of  bones  are  called 
processes,  and  are  the  points  to  which  muscles  and  ligaments  are 
fastened. 

The  bones  are  supplied  with  nutritive  vessels,  and,  like  other  parts 
of  the  body,  are  formed  from  the  blood.  At  first  they  are  compara- 
tively soft,  and  cartilaginous.  After  a  time,  in  the  young  animal, 
they  begin  to  change  to  bone  at  certain  places,  called  points  of  ossiji- 
cation.  They  are  covered  with  a  strong  fibrous  membrane  called  the 
periosteum.  A  somewhat  similar  covering  upon  the  cartilages  has  the 
name  of  perichondrium,  and  that  which  covers  the  skull  is  the  pericra- 
nium. 

The  bones  are  compounded  of  earthy  and  animal  miatter*    From 


!    :  i' 

1     ■. 


ti'lil 


20 


ANATOMY. 


th<3  former,  — phoaphute  aud  curbunato  of  limo,  —  they  receive  their 
strength  ;  from  the  latter,  —  cartilage,  —  thoy  derive  their  life. 

Put  a  bono  for  a  few  days  into  diluted  muriatic  acid,  —  one  part  of 
acid  to  six  of  water,  —  and  the  phosphate  and  carbonate  of  lime  will 
all  bo  removed,  while  the  bono  will  remain  the  same  in  shape.  It 
Fio.3.  will   now    bo    comparatively 

soft,  and  may  bo  bent,  or 
even  tied  into  a  knot,  with- 
out breaking.  Place  a  simi- 
lar bono  in  tho  fire  for  a  few 
hours,  and  it  will  also  retain 
its  shape,  but  tho  cartilagi- 
nous portion  will  be  gone. 
It  is  now  brittle,  and  may  be 
picked  in  pieces  with  the  fin- 
gers. 

The  bones  are  divided  into  those  of  the  head,  thirly;  of  tho  body, 
fifill-four;  of  the  upper  limbs,  siidy-four;  and  of  the  lower  limbs, 
»ixty. 


Fio.  4. 


Bones  of  the  Head. 

The  bones  of  the  head  are  divided  into  those  of  tho  .s^■u?2,  the  &ir^ 
and  the /*ace. 

The  skull  has  eight  bones.  They  are  composed  of  two  plates, 
one  above  the  other,  with  a  porous  partition  between.  These  two 
l)latps  are  capable  of  giving  tho  brain  very  powerful  protection  against 
injury,  the  outer  one  being  fibrous  and  tough,  — the  inner  one,  hard 
and  glasH-lilce,  and  hence  called  vitreous. 

The  middle  layer  has  tho  name  of  dtploe.  Its  spongy  nature  deadens 
the  jar  from  a  blow  inflicted  upon  the  outer  table.  In  early  life,  when 
the  bones  are  tender  and  yielding,  this  porous  layer  is  not  needed, 
and  is  not  found. 

That  the  bones  of  the  skull  may  not 
easily  slip  by  each  other,  and  get  out 
of  place,  they  are  dovetailed  together  in 
curious  lines  called  sutures.  In  advanced 
years,  these  generally  close  up,  the  bones 
uniting  firmly  together.  In  early  life 
they  are  quite  open,  the  firm  bones  not 
covering  the  whole  brain.  Tho  opening 
of  the  coronal  suture  in  childhood  is  called 
a  fontanelle.  It  presents  a  soft  place  up- 
on the  top  of  the  head,  where  the  finger 
could  be  pressed  down  into  the  brain.  In 
Figure  4,  —  1,  1,  show  the  coronal  suture 
on  the  front  and  upper  part  of  the  skull ;  2, 
the  sagittal  suture  on  the  top  of  the  skull ; 
aud  3,  3,  the  lambdoidal  suture,  running  down  on  each  side  of  the 
back  part  of  the  skull. 


ANATOMY. 


21 


Figure  5  shows  the  skull  bonos  separiitcd  from  each  other  iit  the 
*^«-  '>•  sutures  :     1 ,    the    frontal 

bono ;  2,  the  parietal ; 
3,  the  occipital ;  4,  the 
temporal ;  /),  the  nasal ; 
6,  the  malar;  7,  tlie  su- 
perior maxillary;  8,  the 
unguis ;  9,  the  inferior 
maxillary.  Arnott  has 
domonst  rated  that  the 
form  of  the  skull  is  the 
best  possible  for  sustain- 
ing weights,  and  resist- 
ing blows.  The  summit 
of  the  head  is  a  complete 
urch,  like  that  of  a  bridge. 
The  ear  has  four  small 
bones,  which  aid  the 
sense  of  hearing. 
The  bones  of  the  face  are  fourteen  in  number.  They  hold  the  soft 
parts  in  place,  and  aid  in  grinding  the  food. 

Bones  of  the  Trunk. 

In  the  trunk  there  are  twenty-four  ribs  ;  twenty-four  pieces  in  the 
Iwick  bone  or  spiiiiii  column  ;  four  bones  in  the  pelvis  and  hips  ;  one 
breast  bone,  cal'  d  sternum;  and  a  bone  at  the  base  of  the  tongue, 
called  OS  hyoidi.s.  They  are  so  put  together  as  to  form  two  great 
cavities,  namely,  the  thorax  or  chest,  and  the  abdomen  or  belly.  . 

The  1-ibs,  connecting  with  the  back  bono  behind,  and  the  breast 
bone  in  front,  form  the  thorax. 


lungs 


and 


Km.  6. 


which    contains    tlu! 

heart.     The  Figure  (5  simws  tlio 

natural  form  of  the  healthy  chest : 

I,  is  the  spine  ;  2,  2,  the  collar 
bones ;  3,  3,  the  seven  upper,  or 
true  ribs ;  4,  4,  the  tivo  lower  or 
false  ribs  ;  f),  the  breast  bone,  to 
which  the  true  ribs  are  united  ;  G, 
the  sword-sliaped  cartilage  which 
constitutes  the  lower  end  of  the 
breast  bone,  called  eiuHiform  car- 
lilage;  7,  7,  the  upper  part  of 
two  lungs;  8,  8,  the  right  lung  , 
seen  between  the  ribs  ;  i),  9,  the  ^k  ' 
left  lung;  10,  10,  the  heart;  11, 

II,  the  diaphragm,  or  midriff;  12, 
12,  the  liver;  13, 13,  the  stomach, 
14,  14,  the  second  stomach,  or  duodr  -um;  15,  the  transverse  colon; 
16,  the  upper  part  of  the  colon  on  right  side ;  17,  upper  part  of  colon 
on  left  side. 


22 


ANATOMY. 


Fig.  T. 


Each  piece  of  the  spinal  column  is  called  a  vertebra.     Upon  every 

one  of  these  are  seven  projection?,  called 

processes,  —  a  part  of  which  are  for  linking 

the  bones  together,  and  the  rest  to  furnish 

attachments  for  the  muscles  of  the  buck. 
The  projections  are  linked  together  in 

such  a  way,  that  a  continuous  channel  or 

opening  runs  down  through  the  whole,  in 

which  is  lodged  the  spinal  cord,  or  medulla 

spinalis.     This  nervous  cord  is  connected 

with  the  base  of  the  brain,  and  is  a  kind  of 

continuation  of  it. 

Between  all  the  vertebra)  arc  certaiii'  car- 

tila^nous  cushions,  which,  when  compressed,  spring  back,  like  India 

rubber,  and  thus  protect  the  brain  from  being  injuriously  jarred  by 

tunning,  leaping,  or  walking. 

^hepelvis  has  four  bones  ;  the  two  nameless  bones,  —  Inaominata, — 

the  sacrum,  and  the  coccyx.     In  the  side  of  each  (jf  the  nameless  bones 

is  a  deep,  smooth  cavity,  called 
the  ace/abuluin.  Into  this  the 
round  head  of  the  thigh  bone  is 
nicely  fitted.  When  the  bone  is 
thrown  out  of  this  cavity,  the 
hip  is  said  to  be  out  of  joint. 
The  sacrum  took  its  name  from 
the  fact  that  the  hfathens  used 
to  ofter  it  in  sacrifice.  With 
them,  it  was  the  sacred  bone. 
The  coccyx  is  the  lower  termi- 
nation of  the  back  bone.  These 
bones  are  represented  in  Figure 

8  :  1,1,  being  the  innr)minata ;  2,  the  sacrum  ;  3,  the  coccyx ;  4,  4,  the 

acetabulum  ;  a,  a,  the  pubic  portion  of  the  nameless  bones ;  d,  the 

arch  of  the  pubes ;  c,  the  union  of  the  sacrum  and  the  lower  end  of 

the  spinal  cohunn. 


Bones  of  the  Upper  Extremities. 

The  shoulder  blade  (scapula) ,  the  collar  bone  (clavicle) ,  the  bone  of 
theupper  arm  (humerus),  iha  two  bones  of  the  fore-arm  (ulna  and  ra- 
dius), the  bones  of  the  wrist  (carpal  bones),  the  bor\es  of  the palmt>  cf 
the  hand  (metacarpal  l)ones),  the  bones  of  the  thumb  and  fingers 
(phalanges),  —  these  are  the  bonos  of  the  upper  limbs. 

The  collar  hone  is  fastened  at  one  end  to  the  breast  bone,  at  the 
other  end  to  the  shoulder  blnde.  It  keeps  the  shoulders  from  drop- 
ping forward.  Many  persons  allow  it  to  fail  of  this  end  by  getting 
very  much  l)ent  in  early  life.  This  liappensat  school,  when  children 
are  allowed  to  sit  in  a  stooping  posture.  In  the  French,  a  race  re- 
markable for  a  straight,  upright  figure,  this  bone  is  said  to  be  longer 
than  in  any  other  people. 


ANATOMY. 


2a 


The  shoulder  blade  lies  upon  the  upper  part  of  the  back,  forming 
the  shoulder.  It  his  a  shallovr  cavity  (glenoid  cavity),  into  which  is 
inserted  the  head  of  the  upper  arm  bone.  Several  strong  muscles 
are  attached  to  the  elevations  of  this  bone,  which  keep  it  in  its  place, 
and  move  it  about  as  circumstances  require. 

The  upper  arm  bone  has  its  round  head  fastened  in  the  glenoid  cav- 
ity, by  the  strong  capsular  ligament,  forming  a  joint  capable  of  a 
great  number  of  movements.  At  the  elbow  it  is  united  with  the  ulna 
of  the  fore-arm.  It  is  a  long  cylindrical  bone,  represented  by  Figure 
9  :  1,  is  the  shaft  of  the  bone  ;  2,  the  large,  round  head  which  fits 
into  the  glenoid  cavity  ;  3,  the  surface  which  unites  with  the  ulna. 

Of  the  two  bones  of  the  fore-arm,  the  ulna  is  on  the  inner  side,  and 
unites  with  the  humerus,  making  an  excellent  hinge-joint.  The  other 
bone  of  the  fore-arm,  the  radius,  lies  on  the  outside  of  the  arm,  —  on 
the  same  side  with  the  thumb,  —  and  unites,  or  articulates,  as  we  say, 
with  the  bones  of  the  wrist.  In  Figure  10  :  1,  is  the  body  of  the 
ulna ;  2,  the  shaft  of  the  radius ;  4,  the  articulating  sm'face,  with 
which  the  lower  end  of  the  humerus  unites  ;  5,  the  upper  extremity 
of  the  ulna,  called  the  olecranon  process,  w  hich  forms  the  elbow  joint ; 
6,  the  point  where  the  ulna  articulate  with  the  wrist. 


Fig.  9. 


Fio.  n. 


Fig.  10. 


The  eight  bones  of  the  wrist  or  carpus  are  ranged  in  two  rows,  and 
being  bound  close  together,  do  not  admit  of  very  free  motion.  In 
Figure  11 :  s,  is  the  scaphoid  bone ;  l,  the  semilunar  bone  ;  c,  the 
cuneiform  bone  ;  p,  the  pisiform  bone  ;  t,  t,  the  trapezium  and  trape- 
kiuid  bones ;  m,  the  os  magnum ;  u,  the  cuneiform  bone.  The  last 
four  form  the  second  row  of  carpal  bones.  11,  11,  are  the  metacar- 
pal bones  of  the  hand  ;  2,  2,  the  first  range  of  the  finger  bones ;  3, 
3,  the  second  range  of  finger  bones  ;  4,4,  the  third  range  of  finger 
bones ;  5,  6,  the  bones  of  the  thumb. 


4 


is 


'   -t 


.u 


TTW" 


84 


ANATOMY. 


i 


Of  the  five  metacarpal  bones,  four  are  attached  below  to  the  first 
range  of  the  finger  bones,  and  the  other  to  the  first  bone  of  the 
thumb,  while  the  whole  are  united  to  the  second  range  of  the  carpal 
bones  above. 


I    .■     •:: 


I 


Bones  of  the  Lower  Extremities. 

These  are  the  t?n(/h  bone  (femur),  the  knee  pan  (patella) ,  the  shin^ 
bone  (tibia),  the  stnall  bone  of  the  leg  (fibula),  the  bones  of  the  instep 
(tarsal  bones),  the  bones  of  the  middle  of  the  foot  (metatarsal  bones), 
and  the  bones  of  the  toes  (phalanges). 

The  thigh  bone  is  the  longest  bone  in  the  system.  Its  head,  which 
is  large  and  round,  fits  admirably  into  the  cavity  in  the  fio.h. 
innominatum,  called  acetabulum,  and  forms  what  is 
called  a  ball-and-socket  joint.  In  Figure  12  :  1,  is  the 
shaft  of  the  thigh  bone  (femur)  ;  2,  is  a  projection  culled 
the  trochanter  minor,  to  which  some  strong  muscles  are 
attached ;  3,  is  the  head  of  the  femur  which  fits  into  the 
acetabulum ;  5,  is  the  external  projection  of  the  femur, 
called  the  external  condyle  ;  6,  the  internal  condyle ;  7, 
the  surface  which  articulates  with  the  tibia,  and  on  which 
the  patella  slides. 

The  knee  pan  or  knee  cap  (patella)  is  placed  on  the 
front  of  the  knee,  and  being  attached  to  the  tendon  of 
the  extensor  n^uscles  alove,  and  to  the  tibia  by  a  strong 
ligament  below,  it  acts  a^;  a  pulley  in  lifting  up  the  leg. 
The  shin  bone  (tibia)  is  the  largest  of  the  two  in  the 
lower  leg,  and  is  considerably  enlarged  at  each  end. 

The  small  bone  of  the  leg  (fibula)  lier  jn 
the  outside,  and  is  bound  to  the  larger  bone 
at  both  ends.  Figure  13  shows  the  two 
bones  of  the  leg :  1,  being  the  tibia  ;  5,  the 
fibula ;  8,  the  space  between  the  two  ;  6,  the 
junction  of  the  tibia  and  fibula  at  the  upper 
extremity ;  3,  the  internal  ankle ;  4,  the  lower 
end  of  the  tibia  that  unites  with  one  of  the 
tarsal  bones  to  form  the  ankle  joint ;  7,  the  upper  end  of 
the  tibia  which  unites  with  the  femur. 

The  instep  (tarsus)  has  seven  bones,  which,  like  those 
of  the  wrist,  are  bo  firmly  bound  together  as  to  allow  but 
a  limited  motion. 

The  metatarsal  bones,  coi'responding  with  the  palm  of 
the  hand,  are  five  in  number,  and  unite  at  one  end  with 
the  tarsal  bones,  and  at  the  other  with  the  first  range  of 
the  toe-bones. 

The  tarsal  and  metatarsal  bones  are  put  together  in  the 

form  of  an  arch,  the  spring  of  wuich,  when  the  weight  of 

the  body  descends  upon  Xt'va.  walking,  prevents  injury  to 

the  organs  above.     (Fig.  14.) 

The  phalanges  have  fourteen  bones.    The  groat  toe  has 


Fig.  13. 


IHATOMT. 


25 


Figure  15  gives  a 


two  ranges  of  bones ;  the  other  toes  ha'^a  three. 

view  of  the  upper  surface  of  the  bones  of  the  foot ;  1,  is  the  surface 

of  the  astragahis  where  it  unites  with  the  tibia ;  2,  the  body  of  the 


Fio.  16. 


Vlo.li. 


astragahis  ;  3,  the  he^l  bone  (os  cnlcis)  ;  4,  the  scaphoid  bone ;  5,  6, 
7,  the  cuneiform  bon«s ;  8,  the  cuboid  ;  9,  9,  9,  the  metatarsal  bones ; 
10,  the  first  bone  of  the  great  toe  ;  11,  the  second  bone  ;  12,  13,  14, 
three  ranges  of  bones  forming  the  small  toes. 

The  Joints. 

That  bones  may  be  of  any  use,  they  must  be  jointed  together. 
Joints  are  of  the  greatest  importance.  It  is  necessary  they  should  be 
so  constructed  that  there  shall  be  no  harsh  grating  of  the  bones  upon 
each  other,  and  no  injurious  jars  in  walking,  etc.  To  prevent  these 
things,  a  hard,  smooth,  and  yet  yielding,  cushion-like  substance  is 
required  between  them  in  joints.  Such  are  the  cartilages.  Figure  16 
Fia.  16.  gives  a  specimen  of  these 

intervening  cartilages.  D, 
is  the  body  of  a  bone,  at 
I  the  end  of  which  is  a  sock- 
I  et ;  C,  the  cartilage  lining 
the  socket,  thick  at  the  sides 
'  and  thin  in  the  centre ;  B, 
the  body  of  a  bone,  at  the  end  of  which  is  a  round  head  ;  C,  the  in- 
vesting cartilage,  thin  at  the  sides  and  thick  in  the  centre. 

Cartilage  grows  thinner,  harder,  and  less  elastic  in  old  age.  Hence 
old  people  are  not  quite  as  tall  as  in  middle  life,  and  a  little  stiffer  iu 
their  joints. 

The  synovial  membrane  is  a  thin  layer  covering  the  cartilage,  and 
being  bent  back  upon  the  inner  surface  of  the  ligaments,  it  forms  a 
closed  sack.  From  its  inner  surface  a  sticky  fluid  oozes  out,  which 
helps  the  joints  to  play  easily. 


ft  ■ ;s  'J 


I'i: 


■m 


'i:  ^1;!i 


Pli 


26 


ANATOMY. 


There  are  other  smaller  sacks  connected  witb  the  joints,  called 
bursa  mucosae.  They  secrete  a  fluid  similar  to  that  from  the  syno- 
vial membrane. 

The  ligaments.  To  retain  the  bones  in  their  places  at  the  joints, 
some  strong,  flexible  straps  are  required  to  stretch  across  from  one  to 
the  other,  and  to  firmly  unite  them.     Such  are  the  ligaments. 

They  are  the' pearl-colored,  lustrous,  shining  parts  about  the  joints, 
in  the  form  of  straps  and  cords.  I'here  are  a  number  of  them  so 
woven  together  as  to  form  a  complete  covering  of  the  joint,  called  a 
capsular  ligament.  In  Figure  17  :  1,2,  are  ligaments  extending  from 
the  hip  bone,  6,  to  the  femur,  4.     In  Figure  18  :  1,  is  the  socket  ai 


Fio.  IT. 


Fio.  18. 


Flo.  10. 


the  hip  joint ;  2,  the  head  of  femur,  lodged  in  the  socket ;  3,  the 
ligament  within  the  socket.  In  Figure  19  :  1,  is  the  tendon  of  the 
muscle  which  extends  the  leg ;  2,  the  knee  cap  (patella)  ;  3,  the  ante- 
rior ligament  of  the  patella;  6,  the  long  external  lateral  ligament; 
4,  4,  the  synovial  membrane  ;  5,  the  internal  lateral  ligament ;  7,  the 
anterior  and  superior  ligament  that  unites  the  tibia  with  the  fibula. 

Uses  of  the  Bones. 

The  bones  are  to  the  body  what  the  frame  is  to  the  house.  They 
hold  up  and  retain  the  other  parts  in  their  proper  places.  They  fur- 
nish points  of  attachment  for  the  muscles,  to  hold  the  body  together, 
and  to  give  it  motion.  They  also  furnish  strong,  bony  cavities  for  the 
lodgment  and  protection  of  such  delicate  organs  as  the  eye,  the  brain, 
and  the  heart. 

A  single  bone,  examined  by  itself,  might  not  seem  to  have  much 
beauty  or  design  about  it ;  it  might  even  look  clumsy  and  misshapen. 
But  when  all  the  bones  are  inspected  with  reference  to  each  other,  we 
immediately  discover  a  general  plan  upon  which  they  are  made,  and 
are  compelled  to  admire  their  beautiful  harmony,  and  the  symmetrical 
gcace  with  which  thev  act.  They  show  us  that  God  can  command 
our  wonder,  even  in  the  bony  frame  of  our  bodies. 


ANATOaiY. 


The   Muscles. 

That  part  of  the  animal's  body  which  we  call  lean  meat  is  com- 
posed of  muscles.  "We  have  already  explained  that  muscles  are  com> 
posed  of  threads,  etc. ,  put  together  in  great  numbers,  forming  bundles. 
So  numerous  are  these  threads  and  bundles  in  some  cases,  that  the  mus- 
cles which  are  composed  of  them  have  a  strength  truly  wonderful. 

Toward  the  end  of  the  muscle,  the  fibres  cease,  and  the  structure 
is  so  modified  f.s  to  become  a  white  cord  of  great  density  and  strength. 
This  cordy  substance  is  fastened  to  the  bone  so  strongly,  that  it  is 
impossible,  except  in  some  rare  case,  to  detach  it.  Generally  the 
bone  will  sooner  break  than  this  attachment  will  give  way.  Some- 
times this  cord  spreads  out  like  a  membrane.  It  is  then  called yascea 
or  aponeurosis. 

The  fibres  of  a  muscle  have  the  peculiar  property  of  contracting 
under  a  nervous  stimulus  sent  to  them  by  the  will.  These  contrac- 
tions cause  them  to  act  as  pullies,  and  to  move  the  bones,  and  conse- 
quently the  limbs  and  body,  in  such  direction  as  the  will  commands. 
This  is  the  special  use  of  the  nuiscles.  All  our  movements  are  caused 
by  them.  They  pull  us  about,  not  blindly  and  at  random,  but  under 
the  direction  of  an  intelligent  will. 

The  manner  in  which  a  muscle  acts,  with  the  cord  attached,  may 
be  seen  by  examining  the  leg  or  "  drum-stick  "of  a  fowl.  If  the  cord 
on  one  side  be  pulled,  the  claws  are  shut ;  if  that  upon  the  other 
side  be  drawn,  they  will  open.  If  both  be  pulled,  they  are  held  fast 
in  one  position,  neither  opening  nor  shutting. 

An  examination  of  a  piece  of  boiled  lean  meat,  will  show  the 
threads  of  which  it  is  composed .  With  proper  instruments,  these  may 
be  unravelled,  as  it  were,  until  fibres  will  be  found  not  larger  than  a 
spider's  web.  These,  covered  with  sheaths  of  great  delicacy,  Extend 
beyond  the  deshy  fibre,  and  with  the  cell  substance  connecting  the 
fibres,  are  condensed  into  tendon. 

Millions  of  these  sheathed  fibres  are  gathered  into  a  bundle,  and 
covered  Avith  a  sheath,  and  thus  form  what  is  called  n  fasciculus.  A 
muscle  is  a  number  of  these  fasciculi  made  into  a  bundle,  and  covered 
with  a  sheath  called  &  fascia.     (Fig.  1.) 

The  arm  is  a  number  of  muscles  bundled  together,  and  covered, 
likewise,  by  a  fascia. 

The  fibres  in  a  fasciculus  being  parallel,  act  together.  Butthefas- 
ciculous  bundles,  which  make  up  a  muscle,  act  in  various  ways. 


FlO.90. 


Shape  of  tbe  Muscles.  —  Some  muscles  are  fusiform  or  spindle- 
shupud,  so  that  the  attachment  occupies  but  a 
small  space.     (Fig.  20.) 

Othermusclesare  radiate  or  fan-shaped.  (Fig.21.) 
Such  is  the  temporal  muscle,  the  thin  edge  of  fig.  21. 

which  is  attached  to  the  side  of  the  head,  without 
producing  an  elevation  or  deformity. 

In  some  cases  the  fasciculi  are  arranged  upon 
one  or  both  sides  of  a  tendon.    In  this  way  a 


•;  t,  I 


Bri  i 


i  '  t< 


>■  t! 


28 


ANATOMY. 


great  number  may  oo;  icentrate  their  action  upon  a  single  point.   Such 
muscles  are  called  pe:  iniform,  —  being  shaped  like        •    fio.  2x 
the  feather  end  of  a  pen.     (Fig.  22.) 

In  other  instances,  the  fasciculi  form  circular 
muscles,  —  orbiculares,  or  sphincters,  as  they  are  called.     These  sur- 
round certain  openings  into  the  body,  which  they  are  designed  to 
Pio.  23.    close,  either  in  whole  or  in  part.     They  surround  the  eye- 
lids, the  aous,  the  mouth  of  the  womb,  etc.     (Fig.  23.) 

In  still  other  instances  the  fasciculi  are  ranged  side  by  side 
in  rings,  forming  muscular  tubes.  By  the  successive  contrac- 
tion of  these  rings,  any  substance  is  driven  through  the  tube,  —  as 
food  or  drink  through  the  fio.  24. 

gullet  of  a  cow.  Figure 
24  is  a  section  of  the  gul- 
let:  a,  6,  show  the  circu- 
lar fibres ;  c,  the  longitudinal. 

Sometimes  the  fasciculi  curve  around  in  parallel  layers,  or  interlace 

with  each  other,  forming  a  bag  or 
pouch.  By  the  contraction  of  these 
fasciculi,  the  contents  of  the  bag 
will  be  turned  from  side  to  side, 
as  in  the  case  of  the  stomach, 
or  driven  out,  as  in  that  of  the 
heart.  Figure  25  shows  the  mus- 
cles of  the  stomach ;  l,  represents 
the  fibres  running  in  one  direc- 
tion ;  c,  in  another ;  e,  lower  end 
of  gullet ;  o,  pylorus ;  d,  begin- 
ning of  duodenum,  or  second 
stomach. 


Fig.  26. 


Number  of  Nasdes.  —  The  muscles  of  the  body  are  as  numerous 
as  the  ropes  of  a  ship,  — there  being  five  hundred  or  more.  Some 
anatomists  reckon  more,  some  less. 

They  are  divided  into  those  of  the  head  and  neck,  those  of  the 
trunk,  those  of  the  upper  extremities,  and  those  of  the  lower  extremi- 
ties. 

They  are  too  numerous  to  be  named  and  individually  described  in 
this  brief  account  of  them.  A  part  of  them  are  voluntary,  that  is, 
under  the  control  of  the  will ;  while  another  part  are  involuntary, 
moving  without  reference  to  the  will.  The  heart  is  of  the  latter  kind, 
it  being  necessary  for  it  to  keep  moving  when  the  will  and  mind  are 
asleep. 

On  the  back  there  are  six  layers  of  muscles,  one  above  another. 
Such  a  number  are  necessary  to  perform  the  numerous  movements 
of  the  back,  neck,  arms,  etc.  Every  expression  of  the  human  face,  as 
joy,  Borrow,  love,  hate,  hope,  fear,  etc.,  is  produced  by  the  gentle  pul- 
ling of  muscles,  made  expressly  to  indicate  these  emotions. 

The  diaphragm  is  a  large  flat  muscle,  reaching  across  the  great 
cavity  of  the  body,  and  dividirig  the  chest  from  the  belly.     It  is  poo- 


t. 

Such 

2X 

^^ 

eso  sur- 

^ned  to 

the 

eye- 

ANATOMY. 


etrnted  by  the  food-pipe  going  to  the  stomach,  and  by  the  great  blood- 
vessels leading  to  and  from  the  heart.  It  is  shaped  like  the  covei 
of  a  dinner-dish,  the  convex  surface  being  turned  up.  When  the 
breath  is  drawn  in,  it  sinks  down  towards  a  level,  thus  enlarging 
the  chest  at  the  expense  of  the  belly.  When  the  breath  is  thrown 
out,  the  reverse  takes  place. 

node  of  Action. —  The  conlraclihility  of  a  muscle,  of  which  I  have 
spoken,  is  simply  its  power  of  shortening  itself.  The  hand  is  raised 
by  the  shortening  of  a  muscle  in  front,  attached  to  the  bono  above 
Fio.  26.  the  elbow,  and  to  a  bone  be- 

low the  elbow.  The  con- 
traction of  an  antagonistic 
muscle  behind,  also  attached 
above  and  below  the  elbow, 
brings  the  hand  back  to  its 
place.  Figure  26  shows  how 
all  joints  are  moved:  1,  is 
the  bono  of  the  arm  above 
the  elbow ;  2,  one  of  the 
bones  below  the  elbow  ;  3,  the  muscle  whicb  '  ends  the  elbow ;  4,  5, 
attachments  of  muscles  to  bones ;  6,  the  muscle  that  extends  the 
elbow  ;  7,  attachment  to  elbow ;  8,  weight  in  hand.  The  muscle,  3, 
contracts  at  the  central  part,  and  brings  the  hand  up  to  9,  10. 

The  complication,  variety,  and  swiftness  of  motion,  executed  hy 
muscles,  are  past  conception.  Every  movement  which  a  human  be- 
ing makes,  from  the  heavier  motions  of  the  farmer  in  cultivating  his 
fields,  up  to  the  magic  touches  of  the  painter's  brush,  and  the  method- 
ical frenzy  with  which  the  groat  master's  fingers  sweep  the  piano,  are 
all  made  by  muscles  obeying  an  intelligent  will. 

The  Teeth. 

The  teeth  are  not  like  other  bones,  either  in  composition,  method  of 
nutrition,  or  growth.  When  broken  they  do  not  unite,  not  being  fur- 
nished with  the  necessary  power  of  reproduction  of  lost  parts. 

Both  the  upper  and  lower  teeth  are  set  into  bony  sockets,  called 
alveolar  processes.  These,  with  the  fibrous  gums,  give  the  teeth  a 
very  firm  setting. 

Origfin The  teeth  have  their  origin  in  little  membraneous  pouches 

within  the  bone  of  the  jaw ;  and  in  their  interior,  have  a  fleshy  bud. 
From  the  surface  of  this  the  bone  or  ivory  exudes.  The  tooth  and 
the  bony  socket  are  developed  and  rise  up  together,  —  the  former, 
when  sufficiently  long,  pushing  itself  through  the  gum. 

Number.  —  The  first  set  of  teeth  are  only  temporary,  and  are  called 
milk  teeth.  There  are  but  twenty  of  them.  Between  the  age  of  six 
and  fourteen,  these  become  loose,  and  drop  out,  and  the  permanent 
teeth  appear  in  their  places.  Of  these  there  are  thirty-two,  sixteen 
in  each  jaw. 


II'  1^ 


m. 


80 


ANATOMY. 


Wames.  —  The  four  front  teeth  in  each  jaw,  a,  b,  Figure  27,  are  the 
euUing  teeth  (incisors)  ;  the  next  one,  c,  is  an  eye  tooth  (cuspid)  ;  the 

Fio.  *T. 


am 


m 


next  two,  d,  e,  are  small  grinders  (bicuspids)  ;  the  last  three,  y,^,  A, 
are  grinders  (molars).  One  appears  late  on  each  side,  from  the  age 
of  twenty  to  twenty-four,  and  is  called  loiadom  tooth. 

Composition.  —  A  tooth  is  composed  of  ivorj/  and  enamel.  The 
internal  part  is  ivory,  which  is  harder  than  bone.  The  coating  Bpon 
the  surface  is  enamel,  which  is  still  harder  than  ivory.  That  part 
which  rises  above  the  jaw  bone  is  called  the  crown;  it  is  this  only 
which  is  covered  with  enamel.  The  part  within  the  jaw  is  called  the 
root  or  fang  ;  this  is  composed  of  bony  matter,  through  which  small 
vessels  pass  in  to  nourish  the  tooth.  Small  white  nerves  also  pass 
into  the  tooth,  — of  the  presence  of  which  we  have  terrible  evidenco 
in  tooth-ache. 

Use  of  the  Teeth. 

The  incisors  cut  the  food  asunder;  the  molars  break  down  its 
solid  parts,  and  grind  it  to  a  fineness  which  fits  it  for  the  stomach. 

In  masticating  the  food,  the  lower  jaw  has  two  movements,  the  up 
and  down  motion,  like  a  pair  of  shears,  and  the  lateral  or  grindii)<; 
motion.  These  two  movements  are  performed  by  different  sets  ot 
muscles.  Flesh-eating  animals  have  only  the  up  and  down  motion , 
vegetable  eating  animals  have  only  the  lateral  or  grinding  motion  ; 
while  man  has  both  the  up  and  down  and  the  lateral.  This  seems 
a  pretty  clear  intimation  that  he  is  to  eat  both  flesh  and  vegeta- 
bles. 

The  teeth  aid  us  in  articulating  words,  and  they  give  a  roundness 
and  symmetry  to  the  lower  part  of  the  face.  When  well  formed,  and 
kept  in  good  condition,  they  idd  much  to  the  beauty  of  the  face,  and 
their  decay  is  an  irreparable  loss.  Their  proper  care  and  treatment 
are  spoken  of  in  another  place. 


ANATOMY. 


31 


Fia.28. 


The  Digestive  Organs. 

The  alimentary  organs  are  the  mouth,  the  teeth,  the  salivary  glands, 
the  pharynx,  the  stomach-pipe  (oesophagus),  stomach,  bowels  (intes- 
tines), chyle  vessels  (lacteals"),  thoracic  duct,  liver,  and  sweet  bread 
(pancreas). 

The  preparatory  process  of  digestion,  the  mastication  of  food,  takes 
place  in  the  mouth,  where  the  food  is  mixed  with  saliva,  p  secretion  of 
the  salivary  glands.     Of  these  glands  there  are  six,  three  on  each  side. 

The  Parotid  Gland  lies  in  front  of  the  external  ear.  It  has  a  duct 
opening  into  the  mouth  opposite  the  second  molar  tooth  of  the  upper 
jaw.  This  is  the  gland  that  swells  in  the  disease  called  mumps. 
Hence  the  disease  is  also  called  parotitis. 

The  Submaxillary  Gland  is  inclosed  within  the  lower  jaw,  in  front  of 

its  angle.  Its  duct  opens 
into  the  mouth  by  the  side 
of  the  bridle  of  the  tongue 
(frtenum  linguse). 

On  each  side  of  this  string 
or  bridle,  and  under  the  mu- 
cous membrane  of  the  floor 
of  the  mouth,  lies  the  avblinr 
gual  gland,  which  pours 
its  saliva  into  the  mouth 
through  seven  or  eight  small 
ducts.  A  disease  called  the 
frog,  consists  in  the  swel- 
ling of  this  gland.  Figure 
28:  1,  the  parotid  gland; 
2,  its  duct ;  3,  the  submaxil- 
lary ;  4,  its  duct ;  5,  the  sublingual. 

The  Pharynx  is  a  continuation  of  the 
mouth,  and  is  the  cavity  just  below  the 
soft  palate.  The  two  passages  going  to 
the  nose  (posterior  nares),  the  one  gping 
to  the  stomach  (cesophagus) ,  and  the  one 
going  to  the  lungs  (larynx  and  trachea) , 
all  meet  in  this  cavity.  In  Figure  29  :  1, 
is  the  trachea ;  2,  the  larynx ;  3,  the  ceso- 
phagus ;  4,  4,  4,  muscles  of  the  pharynx ; 
5,  muscles  of  the  cheek ;  6,  the  muscle 
which  surrounds  the  mouth ;  7,  the  mus- 
cle forming  the  floor  of  the  mouth. 

The  Stomach  Pipe  is  a  long  tube,  like 
the  fireman's  hose,  descending  behind  the 
wind-pipe,  the  lungs,  and  the  heart,  through 
the  diaphragm  into  the  stomach.     It  is  composed  of  two  membranes 
laid  together,  like  two  pieces  of  cloth.    The  inner  one  is  mucous,  the 


FlO.20. 


!■      1' 


■•{■■:. 


n 


''     ;i 


.!    Af 


11 


ill 


32 


ANATOMT. 


outer  muscular.     The  two  sots  of  fibres  composing  the  muscular  coat 
are  arranged  circularly  and  longitudinally.     (Fig.  25.) 

The  Stomach  lies  in  the  upper  part  of  the  belly,  to  the  left,  and  di- 
rectly under  the  diaphragm.  It  has  an  upper  opening,  where  the 
stomach-pipe  enters  it,  called  the  cardiac  orifice.  This  is  the  larger 
end  of  the  stomach,  and  lies  on  the  left  side  ;  the  smaller  end  con- 
nects with  the  upper  bowel,  at  which  point  it  has  an  opening  called 
the  pyloric  orifice.  In  addition  to  mucous  and  muscular  coats,  simi- 
lar to  those  Avhich  com[)oso  the  cDsophagus,  the  stomach  has  still 
another  over  both,  a  serous  coat,  very  strong  and  tough,  to  give  this 
working  organ  additional  endurance.  Within,  it  has  many  glands  to 
secrete  the  gastric  juice. 

The  Intestines,  or  alimentary  tube,  or  bowels,  are  divided  into  the 
small  and  the  large  intestines. 

The  small  intestine  has  a  length  of  about  twenty-five  feet,  and  is 
divided  into  three  parts,  —  the  duodenum  i\\G  jejunum  ixwiX  the  ileum. 

Of  these  three  divisions,  the  duodenum  is  the  largest,  and  is  about 
a  foot  in  length.  It  begins  at  the  pyloric  orifice  of  the  stomach,  and 
passes  backward  to  the  under  surface  of  the  liver,  whence  it  drops 
down  perpendicularly  in  front  of  the  right  kidney,  and  passes  across 
the  belly  behind  the  colon,  and  ends  in  i\\e  jejunum. 

Tlie  Jejunum  continues  the  above,  and  terminates  in  the  ileum. 

The  Ileum  is  a  continuation  of  i\\G  jejunum,  and  opens,  at  an  obtuse 
angle,  near  the  haunch  bone,  into  the  colon.  A  valve  is  located  here, 
to  prevent  the  backward  passage  of  substances  from  the  colon  into 
the  ileum. 

At  this  point  the  large  intestines  begin,  and  here  is  situated  the 
caecum^  a  blind  pouch,  or  cul-de-sac,  attached  to  which  is  the  apperi' 
dix  vermi/ormis,  a  worm-shaped  tube,  of  the  size  of  a  goose  quill, 
and  from  one  to  six  inches  long. 

The  Colon,  or  large  intestine,  is  divided  into  the  ascending  colon,  thd 
transverse  colon,  and  the  descending  colon. 

The  Ascending  Colon  rises  from  the  right  haunch  bone  to  the  under 
surface  of  the  liver,  whence  it  bends  inward,  and  crosses  the  upper 
part  of  the  belly,  below  the  liver  and  stomach,  to  the  left  side.  This 
portion  which  crosses  over  is  the  transverse  colon.  From  this  point, 
on  the  left  side,  it  turns  down  to  the  left  haunch,  and  has  the  name 
of  the  descending  colon.  Here  it  makes  a  curve  like  the  letter  S, 
which  is  called  the  sigmoid  flexure. 

The  Rectum  is  the  lower  portion  of  the  large  intestine,  terminating 
at  the  anus. 

The  Lacteals  are  small  vessels  which  begin  in  the  villi,  upon  the 
mucous  membrane  of  the  small  bowels.  From  here  they  pass  be- 
tween membranes  of  the  mesentery  to  small  glands,  from  which  larger 
vessels  run  to  another  collection  of  glands ;  and  after  passing,  for  a 
Bpace,  from  one  collection  of  glands  to  another,  at  each  stage  of  their 
progress  increased  in  size  and  diminished  in  number,  the  lact«als  pour 


ANATOMY. 


33 


Fio.  ao. 


Fio.  81. 


their  contents  into  the  thoracic  duct.  This  having  passed  up  through 
the  diaphragm,  out  ot  the  belly,  makes  a  sudden  turn  downward  and 
forward,  and  empties  its  burden  into  a  large  vein  which  ends  in  the 
right  heart.     Figure   30 :    1,  is   the   bowel ;  2,  3,  4,  the   meaenterio 

glands  through  which  the  lacteals  pass ; 
5,  the  thoracic  duct ;  7,  the  spinal  column ; 
8,  the  diaphragm. 

By  the  help  of  a  magnifying  glass,  an 
infinite  number  of  these  small  vessels  may 
be  seen  starting  from  the  rough,  shuggy  in- 
ternal coat  of  the  bowel. 

The  mesentery  is  a  thick  sheet  of  menr 
brane,  formed  of  several  fold*  of  the  peri 
toneum,  and  spread  out  from  the  vertebrie 
like  a  fan.  The  bowels  are  attached  to 
its  edge,  and  are  held  by  it  in  their  place, 
and  at  the  same  time,  have  free  motion. 
Between  its  layers  are  a  great  number  of 
glands,  which  sometimes  become  diseased 
and  swollen  in  childhood,  and  prevent  the  chyle  from  passing  along  to 
the  thoracic  duct.  Thus  affected,  children  are  not  nourished,  and  waste 
away  with  a  disease  sometimes  called  mesenteric  consumption. 

The  Liver  is  a  large  gland,  lying  under  the  short  riba  on  the  right 
side,  below  the  diaphragm,  it 
is  convex  on  the  upper  surface 
and  concave  on  the  under,  and 
is  composed  of  several  lobes. 
Its  office  is  to  secrete  bile.  It 
weighs  about  four  pounds,  be- 
ing the  largest  organ  in  the 
body.  Figure  31  represents  the 
liver :  1,  being  the  right  lobe ; 
2,  left  lobe  ;  3,  4,  smaller  lobes ; 
10,  gall  bladder ;  17,  the  notch 
into  which  the  spinal  column  is 
fitted. 

The  Gall-Bladilfr  lies  on  the  under  side  of  the  liver,  and  receivea 
it  is  supposed,  the  surplus  bile,  which  is  reserved  for  sjiecial  occa^ 
sions.     It  opens  into  the  gall  duct,  which  carries  the  bile  along,  and 
pours  it  into  the  duodenum. 
The  Paiierens,  Figure  32,  is  a  long,  flat  gland,  something  like  the  sail. 
j.jg  32_  vary  glands.     It  lies  trans- 

versely across  the  back  wall 
of  the  abdomer.  behind  the 
stomach.  It  secretes  a  fluid 
called  the  pancreatic  juice^ 
a  peculiar  kind  of  saliva, 
the  oflice  of  which  is  to 
emulsion  fat,  so  that  the 


I' 


Will! 


/actuals  can  absorb  it.     This  fluid  is  carried  by  a  duct,  and  poured 
into  the  diiodtMium  just  where  the  bile  dnc^t  enterH. 

Tlie  Spleen  or  milt,  has  an  oblong,  flattened  form.  It  lies  on  the 
left  side,  just  under  the  diaphragm,  e.nd  close  to  the  stomach  and  pan- 
creas. It  is  supposed  to  be  a  reservoir  for  holding  the  surplus  blood 
of  the  liver.  It  was  thought  by  the  ancients  to  be  the  seat  of  melan- 
choly. The  blood  in  passing  through  it  h)aes  a  portion  of  ita  red 
globules. 

The  Onieiitum  or  caul  is  a  doubling  and  extension  of  the  peri- 
toneum. It  is  a  kind  of  fatty  body,  which  lies  upon  the  surface  of 
the  bowels,  and  is  attached  to  the  stomach.  Its  use  sf^ems  to  be  to 
lubricate  the  bowels,  and  especially  to  protect  and  keep  them  warm. 
Hence  it  is  often  called  the  apron. 

The  Urinary  System. 

The  organs  of  this  system  are  devoted  to  separating  the  urine  from 
the  blood,  arid  carrying  it  out  of  the  body.  These  organs  are  the 
kidnei/s,  the  ureters,  the  bladder,  and  the  urethra. 

Tlie  Kidneys  lie  one  on  each  side  of  the  back  bone,  in  the  lumbar 
region,  behind  the  peritoneum.  They  are  four  or  five  inches  long, 
and  two  and  a  half  broad.  They  are  in  shape  like  the  kidney  bean, 
and  weigh  about  half  a  pound  each.  In  the  centre  there  is  a  bag 
calleu  the  pelvis,  which  tapers  like  a  funnel,  and  forms  the  ureter 
which  conveys  the  urine  to  the  bladder.  The  texture  of  the  kidney 
is  dense,  presenting  in  its  interior,  two  structures,  an  external  or 
cortical,  and  an  internal  or  medullary.  The  cortical  portion  has  the 
blood  vessels,  the  medullary  is  condposed  of  tubes  which  carry  away 
the  urine. 

The  Ureters  are  membranous  tubes  of  the  size  of  a  goose  quill, 
and  eighteen  inches  long,  which  run  down  the  back  wall  of  the  abdo- 
men, behind  the  peritoneum,  to  the  bladder,  into  each  side  of  which 
they  empty  their  contents. 

The  Bladder  is  located  in  the  pelvis  or  basin,  in  front  of  the  rec- 
tum. It  is  composed  of  three  coats  ;  the  external  is  serous,  the  middle 
muscular,  and  the  internal  mucous.  Trie  external  coat  is  strong  and 
fibrous  ;  the  internal  is  drawn  into  wrJnkic /,  which  makes  it  thick  and 
shaggy  ;  it  secretes  a  mucus  which  prevents  it  from  being  injured  by 
the  corrosiveness  of  the  urine.  The  uvin  3  is  retained  in  the  bladder  by 
means  of  a  circular  muscle,  called  a  sphincter,  which  draws  the  mouth 
of  the  organ  togetlier.  When  the  quantity  of  urine  is  so  increased 
as  to  give  some  uneasiness  or  pain,  this  muscle,  by  a  sort  of  instinct, 
relaxes  and  lets  it  out. 

The  bladder  is  attached  to  the  rectum,  to  the  hip  bones,  to  the  peri- 
toneum, and  to  the  navel,  by  several  ligaments.  In  the  female  the 
bladder  has  the  womb  between  it  and  the  rectum. 

This  organ  is  wisely  provided  as  a  receptacle  for  the  urine ;  which, 
without  it,  would  produce  great  inconvenience  by  being  constantly 
dribbling  away. 


ANATOMY. 


30 


The  Urethra  is  a  membranous  canal  which  leads  from  the  neck 
of  the  bladder.  It  is  componed  of  1\vo  hyrrs,  a  mucous,  and  an  elas- 
tic fibrous.  Through  this  channel,  which  is  curved  in  its  course,  the 
urine  passes  out  of  the  body. 


^ 


'^i; 


The  Respiratory  Orgfans. 

These  organs  consist  of  the  wind-pipe  (trachea) ;  divisions  and  sub- 
divisions of  the  wind  pipe  (bronchia) ;  air  cells ;  and  the  Linffs  or 
liffhts. 

Tlie  Windpipe  (trachea)  extends  from  the  larynx,  —  the  seat  of  the 
voice,  —  to  Ihe  third  dorsal  vertebra,  where  it  divides  into  two  tubes, 
called  bronchia.  It  runs  down  the  front  part  of  the  throat,  with  the 
oesophagus  behind  and  between  it  and  the  spinal  column.  It  is  com- 
posed mainly  of  rings  of  cartilage,  one  above  another. 

Tlie  Rroiieliial  Tiilien  are,  at  the  division  of  the  windpipe,  two  in 
nuinlHT,  but  tiicy  ilivide  and  subdivide  until  they  become  very  nu- 
merous. 

Tlie  Air  Tells  or  Vesleles  av.  small,  bladder-like  expansions  at  the 
ends  of  the  tubes.  They  are  elastic,  and  swell  out  when  the  air 
passes  in. 

The  Iiiiiis:$i  fill  the  greater  part  of  the  chest,  the  heart,  being  the  only 
other  organ  which  occupies  much  space  in  the  cavity.  The  size  of 
these  organs  is  large  or  small,  according  to  the  capacity  of  the  chest. 
Each  lung,  —  for  there  are  two,  —  is  a  kind  of  cone,  with  its  base 
resting  upon  the  diaphragm,  and  its  apex  behind  the  collar  bone. 
They  are  concave  on  the  bottom,  to  fit  the  diaphragm,  which  is  (ton- 
vex  on  its  upper  side. 

There  are  two  lungs,  a  right  and  a  left.     These  are  separated  from 

each  other  by  a  partition  formed  from  the  pleUra,  and  called  the  7ned- 

[iastirmm.      Two  portions  of  the  pleura,  coming  oflf  from  the  spine, 

I  form  this  partition ;  and  the  heart,  covered  by  the  pericardium,  lies 

in  the  centre,  between  them.     The  right  lung  is   divided  into  three 

I  lobes ;  the  left  into  two. 

Each  lobe  of  the  lungs  is  divided  into  a  great  many  lobules,  which 
lare  connected  by  cellular  tissue.     These  lobules  are  again  divided 
linto  very  fine  air-cells.     Beside  these,  the  substance  of  the  lungs  if 
[composed  likewise  of  blood  vessels,  and  lymphatics,  and  is  well  sup 
Iplied  with  nerves. 

In  the  fetal  state,  before  the  lungs  have  been  filled  with  air,  they 
lare  solid  and  heavy,  something  like  other  flesh,  but  after  all  their  cells 
have  been  filled  with  air,  and  breathing  has  been  established,  they  are 
joxceedingly  light  and  spongy,  and  float  upon  water. 

In  cases  where  the  murder  of  children  is  suspected,  and  where  it  is 
icsirablc  to  know  whether  they  were  still-bom,  or  born  alive  and  hilled 
ifterwards,  the  specific  gravity  of  the  lungs,  compared  with  watei; 
"  often  BTtdo  the  question. 


d6 


ANATOMY. 


Ill 


I  ! 


The  Organs  of  Circnlation. 

The  food  having  'jeen  digested,  changed  to  chyle,  absorbed  by  the 
lacteals,  carried  to  the  veins,  poured  into  the  right  heart,  sent  up  to 
the  lungs,  and  prepared  for  nourishing  the  body,  will  still  be  useless, 
if  no  i  distributed  to  every  part  of  the  system.  The  organs  for  effect- 
ing this  distribution,  are  the  heart,  the  arteries,  the  veins,  and  the  cap- 
tilaries. 

Tlie  Ilenrt  is  placed  obliquely  in  the  chest,  with  one  lung  on  each 
*ide,  and  is  enclosed  between  the  two  folds  of  the  mediastinum.  Its 
form  is  something  like  a  cone.  Its  base  is  turned  upward  and  back- 
ward in  the  direction  of  the  right  shoulder ;  the  apex  forward  and  to 
the  left,  occupying  the  space  between  the  fifth  and  sixth  ribs,  about 
three  inches  from  the  breast-bone.  It  is  surrounded  by  a  membranous 
case  or  sac,  called  the  pericardium. 

The  heart  is  a  muscular  body,  and  has  its  fibres  so  interwoven  that 
it  is  endowed  with  great  strength.  It  is  a  double  organ  having  two 
sides,  a  righ""  and  a  left,  which  are  divided  from  each  othci  by  a  mus- 
cular partition,  called  a  septum.  The  right  heart  sends  the  blood  to 
the  lungs;  the  left  heart  distributes  it  to  the  general  system.  Each 
side  is  divided  into  two  compartments,  an  auricle  and  a  ventricle. 

Tlie  Auricles  have  thinner  walls  than  the  ventricles,  being  only  reser- 
voirs to  hold  the  blood  until  the  ventricles  force  it  along  to  other  parts. 

The  Veiitricles  have  within  them  fleshy  columns,  called  columrue 
carnefc.  The  walls  of  the  ief*;  ventricle  are  thicker  than  those  of  the 
right,  being  required  to  contract  with  more  force.  Each  of  the  four 
cavities  will  contain  from  one  and  a  half  to  two  ounces  of  blood. 

Tlie  Tri-ctiLSpid  valves  are  situated  between  the  auricle  and  ventricle 
On  the  right  side,  and  consist  of  three  folds  of  a  thin,  triangular 
membrane.  The  mitral  valves  occupy  the  same  position  on  the  .left 
side.  Small  white  corf's,  called  chorda:  tendince,  pass  from  the  floating 
edge  of  these  to  the  coiumnae  carneap,  to  prevent  the  backward  pressure 
df  the  blood  from  carrying  the  valves  into  the  auricles. 

The  pulmonary  artery  is  the  outlet  of  the  right  ventricle ;  the  large: 
artery,  called  aorta,  of  the  left  ventricle.  At  the 
opening  of  these  arteries,  are  membranous  folds, 
called  semilunar  valves.  Figure  33  gives  a  fine 
view  of  the  heart :  1,  is  the  right  auricle ;  2,  the 
left  auricle  ;  3,  the  right  ventricle ;  4,  the  left  ven- 
tricle ;  5,  6,  7,  8,  9,  10,  the  vessels  which  bring  the 
blood  to  and  carry  it  away  from  the  heart. 

The  Arteries  are  the  round  tubes  which  carry 
the  red  blood  frt)ui  I  he  left  side  of  the  heart  to 
every  part  of  the  body. 

The  sides  of  .irteries  are  stifl'  and  hard,  and  do 
not  fall  together  when  empty.  They  may  often 
be  seeji  Oj,.  n  in  a  piece  of  boiled  beef. 

The  '•rteries  have  three  coats,  —  an  external,  which  is  cellular,  firm 


and  strong ;  a  middle,  which  is  fibrous  and  elastic ;  and  an  internal, 
which  is  serous,  and  smooth,  being  a  continuation  of  the  lining  of 
the  heart  They  are  surrounded  by  a  cell  Testment  called  a  sheath, 
which  separates  them  from  surrounding  organs. 

The  Pulmonary  Aitei^  starts  from  the  right  ventricle  in  front  of  the 
opening  of  the  aorta,  and  ascends  to  the  under  surface  of  the  aortic 
arch,  where  it  parts  into  two  branches,  sending  one  to  the  right,  the 
other  to  the  leR  lung.  Having  divided  a  id  subdivided  to  a  great  extent, 
they  end  in  the  capillary  vessels,  unitiig,  joining  their  mouths,  and 
becoming  continuous  with  the  pulmonary  veins  just  whe*^  they  pass 
around  the  air-cells.  • 

The  Aorta  is  the  largest  artery  in  the  body.  It  takes  a  slight  turn 
in  the  cheat,  called  the  arch  of  the  aorta,  from  which  are  given  ofT  the 
arteries  which  carry  the  blood  to  the  head,  etc. ;  thence  it  descends 
into  the  belly  along  the  side  of  the  back  bone,  and  at  the  bottom  of 
the  abdomen  it  divides  into  two  arteries,  called  the  ilia^s  —  one  going 
to  each  of  the  lower  limbs.  The  branches  the  aorta  gives  off  supply 
red  blood  to  every  part  of  the  body. 

The  Veins  carry  the  dark  or  purple  blood.  Being  made  red  .md 
vits.1  by  meeting  atmospheric  air  in  the  lungs,  and  then  conveyed  to 
every  part  of  the  body  in  the  arteries,  the  blood  loses  its  redness  in 
the  capillaries,  and  comes  back  to  the  heart  in  the  veins,  dark  and 
purple,  and  unfit  to  support  liff.  The  veins  are  more  numerous  and 
nearer  the  surface  than  the  arteries.  They  have,  likewise,  Lhiriner 
walls,  and  when  empty,  they  collapse  or  fall  together.  They  begin 
in  the  small  capillaries,  and  rur.ning  together,  they  grow  larger  and 
larger,  and  finally  form  the  great  trunks  which  pour  i.he  dark  blood 
into  the  right  auricle.  The  veins  are  composed  of  three  coats,  similar 
to  those  of  the  arteries,  with  the  exception  of  being  thinner  and  more 
delicate.  These  vessels  have  valves  all  along  their  inner  surface,  to 
aid  in  circulating  the  blood. 

The  large  vein  which  receives  all  t.^e  dark  blood  from  above,  and 
pours  it  into  the  right  auricle,  is  ealkd  the  vena  cava  descerulens  ;  the 
one  which  takes  it  from  below,  and  Ji'sposes  of  it  in  the  same  manner, 
is  the  vena  cava  ascendens. 

The  pulmonary  veins  bring  the  red  blood  from  the  lungs  to  the  left 
aur'cle,  and  thus  are  exceptional  in  their  use,  —  being  the  only  veins 
K^hich  carry  red  blood. 

.  Tlie  Capilluries  are  the  extreriely  fine  net-work  of  vessels  between 
the  ends  of  the  arteries  on  tho  one  side,  and  of  the  veins  on  the  other. 
They  inosculate,  or  join  their  mouths  to  the  very  small  arteries  at 
one  end,  and  to  the  equally  small  veins  at  the  other.  They  are  the 
industriov,g  little  builders, of  the  human  frame.  Receiving  the  blood, 
red,  and  full  of  life,  from  the  terminal  extremities  of  the  arteries,  they 
take  the  living  particles  out  of  ?■;  and  apply  them  to  the  renewing 
and  vitalizing  of  XAe  body,  and  then  pass  it  along  into  the  hair-like 
beginnings  of  the  veins,  dark  and  bereft  of  vitality,  to  be  tarried  up  for 


I    ! 


i'li' 


38 


ANATOMY. 


ill 


m 
m 


!  :^  'i 


Fia  34. 


anothpr  frpight  cf  chyle,  uviu  Lu  be  a^aiu  viiaiized  b^  being  touched 
in  the  lungs  by  the  breath  of  heaven. 

In  Figure  34  we  have  a  good  ideal  illustration  of  the  whols  circu' 
lation.  From  the  right  ventricle 
of  the  heart,  2,  the  dark  blood  is 
thrown  into  the  pulmonary  arte- 
ry, 3,  and  its  branches,  4, 4,  carry 
it  to  both  lungs.  In  the  capillary 
vessels,  6,  6,  the  blood  comes  in 
contact  with  the  air,  and  becomes 
red  and  vitalized.  Thence  it  is 
returned  to  the  left  auricle  of  the 
heart,  9,  by  the  veins,  7, 8.  Thence 
it  passes  into  the  left  ventricle, 
10.  A  forcible  contraction  of  this 
sends  it  forward  into  the  aorta,  11. 
Its  branches,  12, 13, 13,  distribute 
it  to  all  parts  of  the  body.  The 
arteries  terminate  in  the  capilla- 
ries, 14, 14.  Here  the  bK)od  loses 
its  redness,  and  goes  back  to  the 
right  auricle,  1,  by  the  vena  cava 
descendens,  15,  and  the  vena 
cava  ascendens,  16.  The  tricus- 
pid valves,  17,  prevent  the  reflow 
of  the  blood  from  the  right  ven- 
tricle to  the  right  auricle.  The 
semilunar  valves,  18,  prevent  ths 
blood  from  passing  back  from  the 
pulmonary  artery  to  the  right  ventricle.  The  mitral  valves,  19,  pre- 
vent its  being  forced  back  from  the  left  ventricle  to  the  left  auricle. 
The  semilunar  valves,  20,  prevent  the  backward  flow  from  the  aorta 
to  the  left  ventricle. 

By  a  careful  examination  of  this  diagram,  with  these  explanations, 
the  reader  may  understand  the  circulation  very  well. 

The  passage  of  the  blood  from  the  right  heart,  through  the  lungs, 
and  back  to  the  left  heart,  is  called  the  lesser,  or  pulmonic  circulation ; 
its  passage  froin  the  left  heart  through  all  parts  of  the  body,  and  back 
to  the  riglit  heart,  is  the  greater  or  systemic  circulation. 

The  Absorbent  Vessels. 

The  vessels  which  absorb  the  chyle  from  the  small  intestines,  and 
convey  it  onward  towards  th(!  blood,  are  the  lacteals.  They  have 
been  described.  The  veins  are  also  supposed  to  have  the  power  of 
absorption,  particularly  the  small  commencement  of  the  veins.  These 
have  likewise  been  described. 

The  Lymphatic  vessels  resemble  the  lacteals.  They  abound  in  the 
skin,  the  mucous  membranes,  and  the  lungs.  They  are  very  small  at 
their  origin,  and,  like  the  veins,  they  inciease  in  size,  as  they  d.im'Hisb 


w 


w: 


ANATOMY. 


39 


Fio.  35. 


in  numbers.  Like  the  veins,  too,  they  travel  towards  the  heart,  and 
their  contents  are  poured  into  it.  Their  walls  are  composed  of  *wo 
coats ;  the  external  is  cellular,  and  distensible  ;  the  internal  is  folded 
into  valves,  like  that  of  the  veins. 

These  vessels,  on  their  way  to  the  heart,  pass  through  soft  bodies., 
called  lymphatic  g-lands,  which  bear  to  them  the    .elation  that  the 

mesenteric  glands  do  to  the  lac- 
'  teals.  These  glands  are  a  collection 
>of  small  vessels.  The  jyniphalic 
glands  are  most  numerous  in  the 
neck,  chest,  abdomen,  armpits,  and  groins.  They  are  also  found,  to 
some  extent,  in  other  parts  of  j-j^  gg 

the  body.  Figure  35  shows  a 
single  lymphatic  vessel,  much 
magnified;  Figure  36  exhibits 
the  valves  along  one  of  the 
lymphatic  trunks ;  Figure  37 
sl.ows  a  lymphatic  gland,  with 
•:  vessels  passing  thmugh  it. 


Fio.  36. 


Fio.  37 


Figure  3;,  .fpresentn  the 
lymphatic  vesiH'ls  and  glands. 
1,  2,  3,  4,  5,  6,  show  tiiese  ves- 
sels of  the  lower  limbs;  7,  the 
inguinal  glands ;  8,  the  com- 
mencement of  the  thoracic 
duct,  into  which  the  contents 
of  rl'  lymphatics  are  pouied; 
9,  I'o  '•'«  ohatics  of  the  kid- 
neys;,  ■'>.  !,ci*v^  of  the  stom- 
i*cri;  XI.  those  of  the  liver; 
12,  is,  those  of  the  lungs;  13, 
14, 1'j,  those  of  the  arm ;  IC,  17,  18,  those  of  the  face  and  neck ;  19, 


1 1 


-'>'! 


40 


ANATOMY. 


Fio.  sa 


20,  the  large  veins ;  21,  the  thoracic  duct ;  26,  the  lymphatics  of  the 
heart 

A  cold  will  often  cause  lymphatic  glands  to  swell.  These  swell- 
ings are  called  kernels.  They  often  swell,  also,  without  the  irritation 
from  cold,  and  become  very  much  and  permanently  enlarged,  particu- 
larly in  scrofula.  In  scrofulous  subjects  they  sometimes  suppurate 
and  break,  forming  bad  sores  upon  the  neck. 

The  Organs  of  Secretion. 

Thk  exhalants,  the  follicles,  and  the  glands  are  the  organs  of  secre- 
turn. 

Tlie  Exhalants  are  the  sweat-glands.  These  have  external  termina- 
tions upon  the  skin,  thus  communicating  with  the  air,  and  internal 
terminations  upon  the  surfaces  of  organs  not  having  an  outward  ex- 
posure. 

The  Follicles  are  svt  >'  ^f-'s,  located  in  the  true  skin  and  mu'ous 
membranes.     The  pores*  >  skin, are  the  mouths  or  outlets  of  these 

little  bags.     Veins  and  or^.    \<i  nerves  are  sent  to  these  vessels. 

Glands  are  soft  organs,  having  a  variety  of  structure,  and  perform- 
ing many  kinds  of  secretion.  A  gland  is 
made  up  of  several  lobules,  united  in  one 
mass,  and  each  of  these  lobules  has  a  small 
duct  communicating  with  a  main  duct 
which  forms  the  outlet.  Figure  39  shows  a 
gland  ;  2,  the  small  ducts  spread  through  its 
body,  and  running  together ;  1,  the  large 
duct,  through  which  the  secreted  substance 
is  carried  away. 

The  mesenteric  and  lymphatic  glands 
merely  modify  the  fluids  which  pass  through  them ;  others  secrete 
from  the  blood  either  fluids  to  br  used  in  the  body,  or  such  as  are  to 
be  cast  away. 

The  Vocal  Organs. 

No  sounds  touch  the  heart  like  those  of  the  human  voice,  for  no' 
mechanic,  however  scientific  and  skilful^  has  ever  been  able  to  make 
an  instrument  which  could  produce  sounds  as  beautiful,  tones  as 
varied,  a  timbre  as  melodious,  and  inflexions  as  manifold  and  agree- 
able. It  has  been  compared  to  wind,  reed,  and  stringed  instriiments. 
In  touching  expression,  it  is  most  resembled  by  the  concert-horn,  the 
bassoon,  and  the  hautboy. 

Vocal  sounds,  past  all  question,  are  produced  in  the  larynx,  but 
these  sounds  a  ^  grouped,  or  formed  into  articulate  speech,  by  the 
pharynx,  the  nasal  cavities,  the  tongue,  the  teeth,  etc. 

The  Larynx  is  a  kind  of  cavity  or  tube  at  the  top  of  the  whidpipe, 
formed  by  the  union  of  five  cartilages,  namely,  the  thyroid,  the  cricoid, 
the  two  arytenoid,  and  the  epiglottis.  Ligaments  bind  these  together, 
and  muscles  move  them. 


ANATOMY. 


41 


Fio.4a 


Fio.  41. 


The  Thyroid  Cartilage  is  composed  of  two  parts,  and  has  a  con> 

nection  with  the  bone  of  the  tongue  above,  and  with  the  cricoid  car- 
tilage below. 
The  Cricoid  Cartilage  is  shaped  like  a  ring,  and  hence  its  Greek 
name.  It  is  narrowest  in  front,  and  broadest  be- 
hind. It  connects  with  the  thyroid  cartilage  above, 
and  with  the  first  ring  of  the  trachea  below.  Fig- 
ure 40  gives  a  side  view  of  the  cartilages  of  the 
larynx  :  1,  bone  at  the  base  of  the  tongue  (os  hyo- 
ides) ;  2,  the  ligament  connecting  hyoid  bone  and 
the  thyroid  cartilage ;  3,  the  front  of  the  thyroid 
cartilage ;  4,  the  thyroid  cartilage  •  6,  the  cricoid 
cartilage  ;  7,  the  windpipe. 

Figure  41  is  a  back  view  of  the  cartilages  and 
ligaments  of  i'  larynx:  1,  is 
the  back  surface  of  the  epiglot- 
tis ;  3,  3,  the  os  hyoides ;  4,  4, 
the  lateral  ligaments  connect- 
ing the  os  hyoides  and  the  thyroid  cartilage ;  5, 
5,  the  back  face  of  the  thyroid  cartilage  ;  6,  6, 
the  arytenoid  cartilages  ;  7,  the  cricoid  cartilage ; 
8,  the  first  ring  of  the  windpipe. 

Tlie  Arytenoid  Cartilages  are  upon  the  back 
part  of  the  cricoid,  and  are  connected  with  the 
thyroid  cartilage  by  the  vocal  cords. 

Tlie  Epiglottis  is  a  fibro-cartimgmous  lid,  shaped 
like  a  leaf  of  parsley,  which  covers  ihe  upper  open- 
ing of  the  larynx.  It  is  connected  by  k  cartilage 
to  the  bone  of  the  tongue  (os  hyoides)  and  to  the  thyroid  cartilage. 
Breathing  opens  and  shuts  it;  and  in  swallowing,  it  clos  i  down  upon 
the  top  of  the  larynx,  to  prevent  food  and  drink  from  passing  down 
the  windpipe. 

The  Vocal  Cords  are  two  ligaments,  formed  of  elastic  and  parallel 

fibres,  enclosed  in  a  fold  of  mucous  mem- 
brane. They  are  about  two  lines  in  width, 
and  inserted  behind  into  the  anterior  pro- 
jection of  the  arytenoid  canilages,  and 
passing  forward,  are  fixed  to  the  anterior 
angle  of  the  thyroid.  There  ar?  four  liga- 
ments crossing  the  larynx,  two  superior, 
and  two  inferior,  —  the  latter  being  called 
vocal  cords.  The  interval  between  them 
is  the  glottis.  The  ligaments  themselves 
are  sometimes  called  the  lips  of  the  ^hUis. 
The  depression  between  the  superior  and 
inferior  ligaments  is  the  ventricle  of  the 
larynx. 

Figure  42  represents  a  view  of  the  larynx  from  above  :  o,  6,  c,  the 
thyroid  cartilage,  enclosing  the  ring  of  the  cricoid ;   A,  A,  e,  e,  the 


FlQ.  42. 


J) 


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f 

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™ 

■  \ 

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Wt)) 


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arytenoid  cartilages  c^onnected  by  the  transverse  arytenoid  muscle ; 
t,  t,  the  vocal  cords ;  o,  o,  the  crico-arytenoid  ligaments. 

The  mupcles  which  are  attached  to  the  cartilages,  have  the  power 
of  pulling  tliein  about  so  as  to  change  in  various  ways  the  shape  of 
the  laryngeal  cavity ;  to  enlarge  or  diminish  the  size  of  the  glottis ; 
and  to  relax  or  tighten  the  vocal  cords.  By  these  means,  and  some 
others,  the  sounds  of  the  voice  receive  their  various  modifications. 
Tightening  the  cords,  for  example  raises  the  pitch. 

The  Skin. 


The  skin  is  a  membrane  composed  of  two  layets,  covering  the 
entire  person.  The  outer  layer  is  the  scarf-skin  or  cuticle ;  the  inner 
is  the  true  skin  or  cutis  vera.  These  layers  differ  in  their  structure 
and  uses. 

The  Scarf-kSkiu,  called  also  cuticle,  and  epidermis,  is  a  thin  mem- 
brane, partially  transparent,  like  a  thin  shaving  of  horn.  Having  no 
blood  vessels  or  nerves,  and  conse-  .,     „ 

quently  no  feeling,  it  appears  to  be 
a  simple  covering  to  protect  the 
true  skin  from  injury  by  external 
agents.  It  is  thickest  on  those 
parts  most  exposed  to  friction. 

The  scarf-skin  is  the  production 
of  the  true  skin,  —  an  exudation 
from  it  in  the  shape  of  a  fluid 
which  is  spread  out  as  a  thin  layer, 
and  dries  up  into  flattened  scales. 
The  cuticle  is  composed  chiefly  of 
these  scales,  and  is  constantly  be-  *  \ 
ing  rubbed  oft'  as  scurf,  while  new 
layers  are  forming  underneath. 

The  lower,  softer,  and  more  newly-formed  layers  of  the  scarf-skin, 
are  the  seat  of  color.  In  this  part,  the  cells  contain  a  pigment,  incor- 
porated with  the  elementary  granules,  which  gives  to  the  various 
races  their  several  shades  of  color.  The  depth  of  hue  is  dependent 
entirely  on  the  amount  of  this  coloring  matter. 

Some  physiologists  describe  the  skin  as  composed  of  three  layers 
—  reckoning  this  colored  part  of  the  cuticle  as  one,  and  naming  it 
rete  mucosum,  or  the  mucous  coat. 

Tlie  True  Skin,  which  is  called  cutis  vera,  and  corium,  is  a  kind  of 
web,  woven  of  small  fibres  collected  into  strands.  In  the  upper  por- 
tion, the  web  is  fine  and  firm,  but  grows  coarser  below.  Connected 
with  its  under  surface  is  a  fibrous  web  in  which  the  fat  is  deposited. 
Upon  its  upper  surface  is  the  sensitive  or  papillary  layer,  composed 
of  blood  vessels  and  nerves,  doubled  into  loops,  which  give  little 
prominences  called  papillee.  Figure  43  gives  an  ideal  view  of  these 
clevaiions,  composed,  as  they  are,  of  a  nerve,  an  artery,  and  a  vein, 
lying  side  by  side :  1,  1,  represent  the  true  skin ;  2,  2,  the  papillary 


ANATOMT; 


43 


layer ;  3,  3,  the  arteries ;  4,  4,  the  veins ;  and  5,  5,  the  nerves  of  the 
papiliee. 

The  arteries,  veins,  and  nerves  are  spread  over  the  true  skin  in 
great  numbers,  —  so  profusely,  that  it  is  impossible  to  push  the  point 
of  the  finest  needle  into  it,  i/ithout  piercing  a  blood  vessel  and  a 
nerve. 

Figure  44  gives  a  view  of  the  skin  :  o,  a,  the  c^cicle  ;  b,  b,  the  col- 
ored layer  of  the  cuticle  ;  c,  c,  d,  d,,  the  true  skin ;  e,  e,  e,  fat  cells, 
ff  fff,  sweat  tubes. 


Fia.45. 


The  lymphatics  are  very  numerous  in  the  skin,  beside  which  there 
are  oil  glands  and  tubes,  and  sweat  glands  and  tubes. 

The  Oil  Glands  are  imbedded  in  the  skin,  and  communicate  with 
the  surface  by  small  tubes.  They  are  most  abundant  on  the  face, 
nose  and  ears,  ^^igure  45  shows  an  oil  gland,  —  a,  being  the  gland, 
b,  the  tube,  and  c,  its  mouth. 

The  Sweat  Apparatus  consists  of  small  tubes  which  pass  dowq 


:  :   1., 

1 . 

!  ■      ■' 

wM ' 

•;;  ' 

'K\  I 


i\  •  ^ 


ft  r' 


^i:;l 


throagh  the  trae  skin,  and  terminate  in  the  meshes  at  the  bottom, 
where  it  coils  upon  itself  into  a  kind  of  baudle,  called  the  perspirik' 
tory  gland.  Figure  46  gives  one  of  these  tubes,  with  the  gland,  mag- 
nified forty  diameters:  1,  beins  the  coiled  tube  or  gland;  2,  2,  the 
two  excretory  ducts  from  the  ^and.  These  uniting,  form  one  spiral 
tube,  which  opens  at  4,  which  is  the  surface  of  the  cuticle ;  3,  are  the 
fat  cells. 
The  hair  and  the  nails  are  appendages  of  the  skin. 


The  Neryons  System. 

The  IVeiTons  System  consists  of  the  brain  and  spinal  cord,  connected 
with  each  other,  and  called  the  cerebrospinal  axis ;  the  cranial  nerves ; 
the  spinal  nerves  and  the  sympathetic  nerve. 

The  Brain  is  that  mass  of  nervous  matter  lodged  within  the  skull 
bones.  It  is  made  up  of  three  parts,  —  the  cerebrum,  the  cerebellum, 
and  the  medulla  oblongata.  These  are  nicely  covered  and  protected 
by  three  membranes,  the  dura  mater,  the  arachnoid,  and  thepta  mater. 

Figure  47  shows  a  considerable  portion  of  the  brain,  —  the  skull 
bones    and    membranes     being    re- 
moved.    The  scalp  turned  down  is 


Fio.  47. 


represented  by  a,  a  ;  e,  i^;,  k,  show 
the  cut  edge  of  the  bones ;  c,  is  the 
dura  mater,  drawn  up  with  a  hook ; 
F,  the  convolutions  of  the  brain. 

Tlie  Cerebrum  is  the  upper  and 
larger  portion  of  the  brain,  and  is 
divided  into  two  hemispheres  by  a 
fissure.  A  portion  of  the  dv^a  mater 
dips  into  this  cleft,  and  from  its  re- 
semblance to  a  sickle,  is  called  the 
falx  cerebri.  The  design  of  this 
seems  to  be  to  support  each  half  of 
the  brain,  and  to  prevent  it  from 
pressing  upon  the  other  half  when 
the  head  reclines  to  one  side.  . 

The  undulating  surface  of  the 
cerebrum  is  produced  by  what  are  called  convolutions.  The  lower 
surface  of  this  organ  is  divid'^d  into  three  lobes,  —  the  anterior,  the 
middle,  and  the  posterior. 

The  surface  of  the  cerebrum  is  of  a  gray  color,  called  cortical,  or 
dneritious ;  the  central  portion  is  white,  and  is  called  meduUarj/. 

The  Cerebellnm  is  about  one-sixth  the  size  of  the  cerebrum.  It 
lies  just  under  the  posterior  lobe  of  the  cerebrum,  and  is  separated 
firom  it  by  an  extension  of  the  dura  mater,  called  the  tentorium.  It 
is  composed  of  white  and  gray  matter ;  when  the  former  is  cut  into, 
there  is  presented  the  appearance  of  the  trunk  and  branches  of  a  tree, 
tailed  arbor  vitce. 


ui; 


ANATOMY. 


46 


The  Medulla  Oblonjpata  is  the  top  of  the  spinal  cord ;  but  being  with- 
in the  enclosure  of  the  skuii,  it  passes  for  a  portion  of  the  brain.  It 
consists  of  three  pairs  of  bodies,  united  so  as  to  form  a  bulb. 

The  Dura  Hater  is  a  strong,  fibrous  membrane  which  lines  the  skuU 
and  spinal  column,  and  sends  processes  inward  to  support  the  brain, 
and  forward,  ac  sheaths  for  the  nerves  which  go  out  from  the  brain 
and  spinal  cord. 

The  Arachnoid  is  a  serous  membrane,  and  like  all  other  serous  mem* 
branes,  is  a  closed  sac.  It  is  reflected  upon  the  inner  surface  of  the 
dura  mater. 

The  Pia  Hater  is  a  vascular  membrane,  and  lies  next  to  and  invests 
the  whole  surface  of  the  brain,  —  dipping  into  its  convolutions.  .  It 
furnishes  nutriment  to  the  brain. 

The  Cranial  Nerves  which  go  out  from  the  brain  are  in  twelve  pairs. 
In  reading  a  description  of  them,  let  the  reader  keep  his  eye  on  Fig- 
ure 48. 

The  First  Pair,  olfactory  (6),  passes  through   several  small  open- 
Fw«  48.  ings  in  the  ethmoid  bone,  and 

is  distributed  to  the  mucous 
membrane  which  lines  the 
nose.  Destroy  •  this,  and  the 
sense  of  smell  is  gone. 

The  Second  Pair,  optic  nerve, 

(7),  passes  through   the  base 

of  the   skull,  and   enters  the 

I  cavity  of  the  eye  where  it  is 

'expanded  upon  the  retina.    It 

is  a    disease    of   this    nerve 

which    occasions    a   gradual 

loss  of  sight,  called  amaurosis. 

The  Third  Pair,  motores  oc- 

ulorum  (9),  passes  through  the 

sphenoid  bone  to  the  muscleB 

of  the  eye. 

The  Fourth  Pair,  patheticus  (10),  passes  to  the  superior  oblique 
muscle  of  the  eye. 

The  Fifth  Pair,  trifacial  nerve  (11),  like  the  spinal  nerves  has  two 
roots,  and  divides  into  three  branches,  one  going  to  the  eye,  fore- 
head!, and  nose,  and  called  the  opthalmic  branch ;  another  going  to  the 
eye,  the  teeth  of  the  upper  jaw,  etc.,  called  the  superior  maxillary ; 
and  the  third  going  to  the  ear,  the  tongue,  and  the  teeth  of  the  lower 
jaw,  and  called  the  inferior  maxillary.  It  is  a  painful  condition  of 
the  branches  of  the  fifth  pair,  which  constitutes  the  terrible  neuralgic 
affection  called  tic  douloureux. 

The  Sixth  Pair,  abducentes  (12),  passes  through  the  opening  by 
which  the  carotid  artery  enters  the  cavity  of  the  skull,  and  goes  to  the 
external  straight  mascle  of  the  eye. 


I,    .1 


1M' 


•1 


I     ;   „,',''il(l 


46 


ANATOMY. 


The  Seventh  Pair,  portio  mollis  (13),  is  distributed  upon  the  inter- 
nal  ear. 

Tlie  Eighth  Pair,  facial  nerve  (14),  is  distributed  over  the  face.  It 
sends  nervous  filaments  to  the  muscles. 

TTie  Ninth  Pair,  giosso-pharyngcal  nerve  (14),  passes  through  the 
same  opening  with  the  jugular  vein,  and  is  distributed  upon  the  mu- 
cous membrane  of  the  tongue  and  throat, 

Tlie  Tenth  Pair,  pneumogastric  nerve  (15),  sends  its  branches  to  the 
pharynx,  larynx,  stoniach-pipe.  lungs,  spleen,  pancreas,  liver,  stomach, 
and  bowels. 

Tile  Eleventh  Pair,  spinal  accessory  nerve  (16),  connects  with  the 
ninth  and  tenth  pairs,  and  is  distributed  to  the  muscles  of  the  neck. 

Tlie  Twelfth  Pair,  hypo-glossal  nerve  (17),  goes  to  the  tongue,  and 
is  its  motion-producing  nerve.  It  is  a  nerve  of  great  energy  in  those 
who  talk  much. 

Tlie  Spiiiiil  Cord  extends  from  the  medulla  oblongata,  where  it  is  in 
wnnection  with  the  brain,  down  to  the  second  lumbar  vertebra.  The 
upper  end  of  the  cord  presents  a  bulbous  swelling,  or  enlargement. 
Another  swelling  is  found  where  the  nerves  are  givan  off  which  go  to 
the  upper  extremities ;  and  a  third  near  the  end  of  the  cord,  where 
the  nerves  begin  which  go  to  the  lower  extremities. 

Fif  sures  dip  into  the  cord  before  and  behind,  and  divide  it  into  two 
lateral  parts,  which  are  united  by  a  thin  layer  of  white  substance. 

These  lateral  columns  are  divided  by  furrows  into  anterior,  lateral, 
and  posterior  columns;  —  the  anterior  being  supposed  to  be  the 
motor  column,  the  posterior  that  of  sensation,  and  the  lateral  divided 
in  function  between  motion  and  sensation. 

The  Spinal  IVerves,  connecting  with  the  cord,  are  in  pairs,  of  which 
there  are  thirty -one. 
Each  pair  has  two 
roots,  —  a  motor 
root,  C,  Figure  49, 
arising  from  the 
anterior  columns  of 
the  cord,  and  a 
sensitive  root,  D, 
springing  from  the 
posterior    columns.  ^ 

A,  is  a  section  of 
the  cord,  surround- 
ed   by   its    sheath. 

B,  is  the  spinal  nerve,  formed  by  the  union  of  the  motor  and  sensitive 
roots.  After  the  union,  the  nerve,  with  its  motor  and  its  sensitive 
filaments,  divides  and  subdivides  as  it  passes  on,  and  is  distributed  to 
the  tissues  of  the  several  organs. 

The  thirty-one  pairs  of  spinal  nerves  are  divided  into  eight  pairs  of 
cervical,  twelve  pairs  of  dorsal^  five  pairs  of  lun^ar,  and  six  pairs  of 
*acral  nerves. 


Fia.  49. 


ANATOMY. 


47 


Figure  50  t^ives  a  view  of  the  brain  and  spinal  cord,  with  the  nerves 
given  off  by  the  latter :  1,  1,  being  the  two  hemispheres  of  the  brain  ; 
3,  3,  the  cerebeUum  ;  4,  the  olfaetorj  nerve ;  5,  the  optic;  7,  the  third 
pair;  8,  the  pons  varolii,  so  called;  9,  the  fourth  pair;  10,  the  lower 
jartion  of  the  medulla  oblongata;  II,  II,  the  spinal  cord;  12,  12, 
the  spinal  nerves;  13,  13,  the  brachial  olexus;  14,  14,  the  lumbar  and 
■acral  plexus. 

Fid.  ea  Fiu.  r,i. 


The  Bracliial  Pleins  is  formed  by  the  interlacing  of  the  four  lower 
cervical  and  upper  dorsal  pairs  of 'nerves.  It  gives  off  six  nerves, 
which  are  distributed  to  the  muscles  and  skin  of  the  upper  extremities. 

The  Lumbar  and  Sacral  Plexus  is  formed  by  the  last  dorsal  and  five 
lumbar  nerves,  from  vrhich  nerves  go  to  the  muscles  and  skin  of  the 
lower  extremities,  and  the  last  lumbar  and  four  sacral,  from  which 
nerves  are  sent  to  the  muscles  and  skin  of  the  hips  and  lower  extremi- 
ties. 

The  Sympathetic  Nerve  consists  of  a  series  of  knots  (ganglia),  lying 
along  on  each  side  of  the  spinal  column,  and  fonning  a  knotted  chain. 
There  is  a  knot  for  each  intervertebral  space,  the  neck  excepted.  These 
knots  are  composed  of  both  cineritious  and  medullary  matter. 


■in*;; 


!1^ 


Fill. 


mm 


I   ■'•■ 


i.: 


48 


ANATOMT. 


Each  knot  is  a  distinct  centre,  and  gives  off  branches  upward, 
downward,  externallv,  and  internally.  All  the  internal  organs  are 
supplied  with  branches  from  the  Hympathetic  nerve.  It  is  called  the 
nerve  of  organic  life,  and  is  supposed  to  preside  over  nutrition,  secre- 
tion, etc.,  as  the  nerves  of  the  brain  and  cord  preside  over  motion  and 
sensation. 

Figure  51  is  a  fine  represei.tation  of  the  great  sympathetic,  with 
its  knots,  and  connections  with  other  nerves.  A,  A,  A,  is  the  semilu* 
nar  ganglion  and  solar  plexus,  lying  just  under  the  diaphragm  and 
behind  the  stomach.  Its  presence  in  this  region  is  the  reason  why  a 
blow  upon  the  pit  of  the  stomach  sometimes  destroys  life.  D,  D,  D, 
are  the  thoracic  ganglia  ;  E,  E,  the  external  and  internal  branches 

of  the  same  ;  G,  F,  the  right  and  left  coro- 
nary plexus  upon  the  heart;  I,  N,  Q,  the 
inf(!rior,  middle,  and  superior  cervical  gan- 
glia; ],  the  renal  plexus  around  the  kid- 
neys ;  2,  the  lumbar  ganglion ;  3,  the  inter- 
nal branches ;  4,  the  external  branches ;  5, 
the  aortic  plexus. 

Figure  52  represents  a  plexus,  showing 
how  the  filaments  of  one*nerve  pass  to  be  enclosed  in  the  sheath  of 
another.  In  this  way  they  change  at  once  the  direction  of  their  jour- 
ney, and  their  companions  upon  the  way. 


Fio.  62. 


Fio.68. 


The  Organs  of  Sight. 

The  organs  of  vision  are  the  optic  nerve,  the  globe  of  the  eye,  the 
muscles  of  the  eye,  and  the  organs  of  protection. 

The  Optic  Nerve  begins  by  two  roots  at  the  base  of  the  biain,  the 
fibres  from  each  of  which  meet,  as  they 
come  forward,  and  some  of  them  cross 
each  other.  The  two  nerves  then  sepa- 
rate, and  enter  the  back  part  of  the 
globe  of  the  eyes,  and  then  spread  out 
into  a  kind  of  membrane.  In  Figure 
53  •  1,  1,  show  the  globe  of  the  eye ; 
2,  the  crossing  of  the  optic  nerve ;  8, 
tba  origin  of  two  pairs  of  cranial  nerves. 

The  Glohe  of  the  Eye  is  a  better  con- 
structed optical  instrument  than  man 
ever  made.  Its  interior  is  filled  with 
what  are  called  refracting  humors  or 
mediums,  wh'f'h  are  surrounded  and  held  in  their  place  by  membranes, 
called  coats. 

The  Coats  are  the  sclerotic  and  cornea;  the  choroid,  iris,  and  ciliary 
processes  ;  and  the  retina. 

The  Sclerotic  Coat  is  a  fibrous  membrane,  covering  the  largest  portioq 


ANATOMY. 


49 


of  the  gl()b«'.  To  this  the  muscles  are  attached.  It  ia  the  part  which 
is  called  the  tvhile  of  the  eye.  It  has  a  beveled  edge  iu  front,  into 
which  the  cornea  is  fitted. 

The  Cloriiea  is  a  transparent  layer  which  projects  in  front,  and  forma 
about  one-lift h  of  the  globe.  It  ia  shaped  like  a  watch  glass.  ltd 
bicod-vessels  are  too  small  to  receive  the  red  particles  of  blood. 

The  Choroid  Tout  is  a  vas<mlar  membrane.  Its  color  is  brown  ext«r- 
nnlly.  and  black  within.  It  is  coimected  with  the  sclerotic  coat  in- 
ternally, and  internally  with  the  retina.  It  is  composed  of  three 
layers. 

The  Iris  is  named  from  its  having  a  variety  of  color  in  difTerent 
p<>rsons.  It  is  the  partition  between  the  antt'rior  and  posterior  cham* 
bers  of  the  eye,  and  has  a  circular  opening  in  the  centre  called  the 
jwpil.  Of  its  two  layers,  the  fibres  of  the  anterior  one  are  radiating, 
and  dilate  the  pupil,  while  those  of  the  other  are  circular,  and  cauao 
its  contraction. 

The  CiliHr}'  l»roces.ses  are  a  number  of  folda  formed  from  the  intei<- 
nal  layer  of  the  choroid  coat. 

The  Rethia  has  three  layera.  The  external  ia  extremely  thin ;  the 
middle  is  nervous,  being  an  expansion  of  the  optic  nerve ;  the 
internal  is  vascular,  and  consista  of  a  ramification  of  minute  blood 
vessels. 

The  divided  edge  of  their  coats,  may  be  seen  in  Figure  54, 
namely,  the  sclerotic,  the  choroid,  and  the  retina;  2,  is  the  pupil;  3, 
the  iris ;  4,  the  ciliary  process ;  5,  the  scolloped  border  of  the  retina 


Fia.5t. 


ria.Hk 


The  Humors  of  the  Eye  are  the  aqueous^  the  crystalline,  and  the 
vitremiK. 

The  Aqueous  or  watery  humor  ia  situated  iu  the  chambers  of  the 
eye.  It  is  an  albuminous  fluid,  with  an  alkaline  reaction,  and  a  sp». 
cific  gravity  a  little  greater  than  distilled  watei 


i    f 


If . 


I  ■lil.-i 


50 


ANATOMY. 


The  Crystalline  H^iinor  is  immediately  behind  the  pupil.  It  is  a 
lens,  and  is  convex  both  on  the  posterior  and  the  anterio)    ;urface. 

The  Vitreous  Humor  hi  also  an  ;iIbuminous  fluid,  something  like  the 
aqueous  humor,  but  more  dense. 

In  Figiire  55  we  have  in  E  a  good  view  of  the  cornea  fitted  into 
the  scleroti'-;  coat ;  A,  is  the  choroid  ;  B,  the  pigmentuni  nigrum  ;  C, 
the  retina;  K,  the  vitreoas  humor;  D,  the  opt^c  nerve  ;  1,  the  lens  ; 
C,  the  iris,  painted  on  the  back  sids  with  [)igment ;  F,'the  aqueous 
humor. 

The  muscles  of  the  eye,  six  in  r  umber,  are  attached  to  the  bones 
of  the  orbit  behind,  and  to  the  .-ornea  in  front,  by  their  tendons. 
These  tendons  give  the  eye  its  pearly  appearance.  In  Figure 
56,  five  of  the  muscles  are  indicated  by  a,  b,  c,  d,  e;  /is  the  optic 
nerve. 

If  the  internal  muscle    be  ""'  '^■ 

too  short,  the  eye  is  drawn! 
in  towards  the  nose,  and  thel 
squinting  called  "  cross  eye  "] 
is  produced. 

The  Orbits  are  bony  sock- 
ets which  enclose  the  eye.  Thcl 
optic  nerve  passes  through  a\ 
large  hole  at  the  bottom. 

The  Eyebrows  are  the  pro-J 
jecting  arches  above,  covered 
Avith  short  hair.     They  prevent  the  sweat  from  running  down  into  the 
eyes,  and  also  shade  them  from  strong  liglit. 

The  Eyelids  are  the  curtains  which  rise  and  fall  in  front.  The 
smooth  membrane  which  lines  them  is  called  the  conjunctiva.  It 
secretes  a  fluid  which  makes  the  eyelids  opeh  and  shut  easily. 

The  Lachrymal  Gland  is  at  the  upper  and  outer  angle  of  the  orbi  • . 

Several  small  ducts  open  from  it  upon  the 
I  upper  eyelid,  through  which  the  tears  run  down 
I  upon  the  conjunctiva. 

The  Lachrymal  Canals  begin  near  the  ititer- 
Inal  angle  of  the  eye,  i»y  two  small  tear  points, 
which  communicate  witl)  the  sac  at  the  upper 
I  part  of  the  nasal  duct. 

The  Nasal  Duct  is  a  canal  al)out  three-r|uar- 
Iters  of  tm  inch  long,  which  runs  down  to  the 
I  inferior  chan;;el  of  the  nose. 

Figure  57  shows  these  organs:  1,  bemg 
I  the  lachrymal  gland;  2,  the  ducts  loading 
to  the  upper  eyelid ;  3,  3,  the  tear  points 
(puncta  lachrymalis)  ;  4,  the  uaaal  sac;  5,  the  termination  of  tho 
nasal  duct. 


Fio.  fi7. 


■ 


ANATOMY. 


51 


The  Organs  of  Hearing. 

The  External  Ear  is  composed  of  the  pavilion  of  the  ear  (the  pinna), 
and  the  auditory  canal  (th«'  meatus  anditorius  externus). 

The  IMuna  surrounds  the  entrance  to  the  auditory  canal.     It  stands 
out  from  the  head,  and  is  in  connnon  lanc^uage  called  the  ear. 

'file  Meatus-  Anditorius  is  a  canal  ahont  an  inch  long,  ))artly  bony 
KiG.  58.  i«iid    partly    cart ila'i;i nous,   which 

goes  iVom  the  pavilion  of  the  cur 
to  iIk'  (Inini  of  the  ear. 

Tlie  Dniui  of  the  Ear  (m(M>i- 
hnina  lynipani)  is  an  oval-shaped 
thin  Mienihranc,  inserted  into  a 
groove  around  the  auditory  ca- 
nal. 

The  Tvni{|ianu»i  is  a  cavity 
within  the  ttmporal  bone. 

The  Eustiii-hiaii  Tuhe  is  a  chan- 
nel o^'comnMUiication  between  the 
tymp.iiiiin;,  and  the  upper  part  of 
the  pharyn  <.  The  object  of  this 
is  to  convey  air  lo  ihe  drum  of 
the  ear,  as  withou    air,  no  sound  can  be  prochiced. 

Tlie  Lahvriuth  is  a  serits  '"'  "^ 

of     chM;",bers    through     the 
petrnua    bone, —  embracing  , 
the  vestibule  a  three-cornered 
cavity  within  the  tympanum ; 
the  semi-circular  canals,  com- 1 
municating   with    the   vesti- 
bule, and  the  cochlea,  which] 
makes  two  and  a  half  turns 
UTound   an   axis,  called    the 
modiolus. 

In  Figure  5S,  a,  is  the 
pavilion  of  the  ear;  c,  the 
auditory  canal;  ^,  the  mei.'i- 
brana  tymj)ani;  A*,  the  tym- 
paiiuai;  e,  the  bones  of  the 
car;  b,  the  senucircuhr  ca- 
nals;/, the  cochlea;  A,  the 
vestibule  ;  t,  the  ensta(  liian  tube  ;  <l,  the  auditc^ry  nerve. 

In  Figure  59,  we  have  a  view   of  the    lal>yrinth    laid   open,  and 
highly  magnified:   1,  1,  being  the   cochlea;   '■Z,\\,   the    chaimels  that 
wind  around  the  ce  jfral  point  (5);  7,  7,  the  vestibule;  8,  the  foramen 
Irotundum  ;  9,  the  fenestra  ovalis  ;  4,  G,  JO,  the  Beniicircuhir  canals. 


'■%'.  I 


'Hi 


■■':  i 


;n 


,ii! 


(.  ■■  H 


4  r 


..  1 

U' 


PHYSIOLOGICAL  LAWS  OF  LIFE  AND  HEALTH....HYGIENK 


'M 


Life-,  the  Infancy  of  Being. 

It  may  be  stated  as  a  general  truth  that  man  has  but  just  learned 
to  live  when  he  is  ready  to  die.  We  expend  a  large  portion  of  our 
lives  in  searching  out  our  mistakes,  and  in  striving  to  undo  the  niis« 
chiefs  they  have  occasioned.  This  is  true  in  reference  both  to  our 
moral  and  our  physical  life ;  and  I  draw  from  it  the  conclusion  that 
the  present  must  be  cmly  the  infancy  of  our  being,  and  that  our  blun- 
ders and  consequent  sufTerings  here,  will  cause  us,  in  the  great  here- 
after, to  place  a  higher  value  upon  knowledge,  and  to  struggle  with 
new  fortitude  to  rid  ourselves  of  every  bondage. 

A  life  which  has  just  begun  to  take  shape  and  symmetry,  cannot 
be  permitted,  I  think,  under  the  rule  of  a  benevolent  Creator,  to  be- 
come extinct.  We  shall  certainly  be  permitted  to  take  up  the  broken 
thread  of  life,  and,  in  the  clearer  light  of  the  future,  with  the  warning 
experience  of  the  past,  and  surrounded  by  better  guards,  to  try  again. 
In  the  mean  time,  while  here,  the  sooner  we  become  acquainted  with 
the  laws  of  life,  and  the  better  we  obey  them,  the  more,  we  shall  ea* 

joy- 

The  Nervous  System. 

Man  is  brought  into  connection  with  the  outwari  world  through 
the  senses  of  feeling,  seeing,  hearing,  etc.  These  communicate  with 
the  brain  and  mind  through  the  nerves  of  sensation. 

The  nervous  system  is  divided  into  two  greptt  central  portions, 
the  brain  and  the  spinal  cord;  and  these  together  are  called,  by  the 
learned,  the  cerebrospinal  centre.  There  are  numerous  pulpy  white 
cords,  called  nerves,  which  at  one  end  are  connected  with  this  great 
axis  or  centre,  and  from  thence  run  to  all  parts  of  the  system.  A 
portion  of  these  nerves  start  from  the  base  of  the  brain  and  run  to 
the  eye,  the  ear,  the  tongue,  etc.  (Fig.  48.) ;  while  another,  and  a 
larger  part  spring  from  the  cord  which  runs  through  the  back-bone, 
and  are  distributed  over  the  body,  and  the  lower  extremities.  (Figs. 
50  and  60.)     One  portion  of  these  cords  produce  feeling ;  another 

Eart,  motion.     The  former  we  call  sensitive ;  the  latter,  motor.     Both 
inds  are  widely  distributed  over  the  body.     Those  which  spring 
from  the  soinal  cord  have  two  roots,  one  uniting  with  the  backf  the 


HTOIENE. 


53 


Fio.  aa 


Other  with  the  front  part  of  the  cord.  Cut  off  the  back  root,  and  the 
part  to  which  it  is  distributed  loees  its  feeling.  As  we  say  in  com- 
mon language,  it  be. 
comes  numb,  though  it 
may  move  as  wen  as 
before.  Cut  the  front 
root,  which  is  motion- 
producing,  and  the  part 
to  which  it  goes  cannot 
move.  It  is  palsied, 
though  it  may  stil!  feel 
acutely.  The  numerous 
nerves  that  spring  from 
the  spinal  column  are 
pretty  well  represented 
in  cut  60. 

If  the  cranial  nerves 
of  motion  which  go  to 
the  face  be  cut,  no  emo- 
tion or  passion  can  be 
expressed.  The  features 
will  all  be  immovable, 
like  statuary.  To  smile, 
'to  laugh,  to  frown,  to 
give  expression  to  the 
feeling  of  pity,  or  an- 
guish, or  love,  is  alike 
impossible.  And  yet  a 
breath  of  air  upon  the 
face  wil'  /r// as  readi- 
ly as  bciuit  Paralysis, 
or  palsy,  ao  it  is  caiUd, 
partial  or  general,  i  ihe 
result  of  injury  upon  few 
or  many  of  these  motion- 
producing  nerves.  Neu- 
ralgia, tic  douloureuX| 
etc.,  arise  from  some  dis- 
ease, pi'rhaps  inilatnma- 
tion,  of  the  nerve*  of 
sensation. 

How  the  Mind  Gets  Knowledge.  —  Everything  the  mind  knows  of 
the  external  world,  it  learns  through  the  organs  of  sense,  which  com- 
municate with  it  through  these  nerves.  Thus,  the  nerves  are  acted 
on  by  external  agents,  and  then  they  act  on  the  brain  and  cause  sen- 
sations. When  the  hand  is  burned  the  nerves  of  sensation  run  with 
the  intelligence  to  the  brain,  which,  quick  as  thought,  through  the 
nerves  of  motion,  despatches  orders  to  the  muscles  to  repel  the 
iiyury. 
Comparison.  —  The  arrangement  and  operation  of  the  nervous  sys- 


I         L 


54 


HYGIENE. 


tern  are  like  those  of  the  electric  fire-alarm  system  of  Boston.  The 
brain  is  the  intelligent  centre,  like  the  central  office  at  City  Hall.  Th? 
nerves  of  sensation  which  carry  to  the  brain,  with  electric  speed,  in- 
telligence of  what  is  going  on  outside,  arc  like  the  wires  which  run 
to  the  City  Hall  from  the  several  station-boxes.  The  quick  carrying 
to  the  brain  of  any  information  of  injury  done  to  some  part  of  the 
body,  is  like  i:'mding  to  the  City  Hall  from  a  station-box  the  intelli- 
gence of  fire  in  one  of  the  districts.  The  rapid  transmission  of  orders 
from  the  mind  to  the  muscles,  is  like  flashing  the  alarm  over  the  wires 
to  every  part  of  the  city.  And,  finally,  the  powerful  action  of  the 
muscles  ui  warding  off  danger,  is  like  the  dashing  of  firemen  over  the 
pavements,  and  the  energetic  plying  of  the  engine**. 

Sensations. 

An  effect,  produced  on  the  mind  through  a  nerve,  is  called  a  sensa- 
tion. Hunger  is  a  sensation.  It  is  an  efi'ect  produced  upo!j  the  mind 
through  a  certain  nerve  by  the  condition  of  the  stomach.  Thirst, 
pain,  heat,  cold,  arc  sensations  in  a  similar  sense.  Nausea  is  a  sensa- 
tion produced  by  some  injurious  substance  acting  upon  the  coats  of 
the  stomach. 

StreiigtJi  of  Sensation.  —  Some  sensations  are  mud-  stronger  than 
others ;  some  are  very  intense.  A  very  strong  sensation  is  called  a 
feeling.  It  is  common  to  say,  "  I  feel  cold,"  or,  •'  1  fet;!  hot.''  We 
simply  mean  by  this,  that  the  temperature  of  the  weather  makes  a 
very  powerful  impression  upon  us. 

Kinds  of  Sensation.  —  Sensations  are  either  pleasurable  or  painful. 
Pleasurable  sensations  arise  from  the  proper  exercise  of  some  healthy 
part  of  the  body  ;  and  they  are  a  suitable  reward  for  any  care  the 
mind  may  take  of  the  corporeal  organs. 

The  sensations  arising  from  a  proper  amount  of  exercise  are  pleas- 
urable. The  muscles  hnd  a  sort  of  enjoyment  in  action.  He  who 
leads  a  sedentary  life,  either  from  choice  or  necessity,  loses  much  enjoy- 
ment. Hence  there  is  ])leasure  in  labor;  and  the  working  man, 
though  often  pitied  by  the  wealthy,  is  geiierjilly  tiie  happiest  of  men. 
The  eye  and  the  ear,  when  directed  to  ariceable  sights  and  sound.s, 
derive  the  most  agreeable  sensations  from  exerci.se.  The  air  of  a 
beautiful  spring  morning  gives  imj)ressioiis  which  none  can  describe, 
but  whi«!h  all  know  to  be  delightful.  These  impressions  are  well 
fitted  to  reward  us  for  taking  at  that  season,  in  the  open  air,  the  ex- 
ercise we  so  much  need. 

Mornl  Uses  of  Sensations. —  How  little  we  reflect  upon  the  amount 
of  happiness  it  is  in  our  po\^er  to  create  by  making  agreeable  impres- 
sions upon  others.  A  civil  and  polite  address  makes  a  pleasant  im- 
pression. A  kind  word,  fitly  spoken,  makes  the  hear  glad.  Heads 
of  families  might  do  much  to  increase  the  happiness  of  their  domes- 
tics in  the  kitchen  by  meeting  them  with  a  plea.sant  countenancte,  and 
dropping  in  their  ear,  now  and  then,  a  word  of  approval.     Such  little 


acts  of  b( 
agreeable 
of  life,  — 
and  whic 
us  like  sp 


In  aimi 
be  govern 
of  happir 
stairs,  —  i 
refining  ii 
or  for  reel 
to  wear  a 
flowers  o: 

Every 
ism  of  wl 
urable  or 
life,  it  she 
Wives  n 
lion  of  t 
h'-diC  of  1 

the  husbi 
pressions 
fully.  M 
the  heads 
.raying,  oi 
other.  ^ 
loved  eitl 
who  desi 
life,  the  v 
sions  upc 


li.M: 


HYGIENE. 


55 


acts  of  benevolence  are  easily  performed,  and  tliey  make  the  most 

agreeable  and  lasting  impressions  upon  persons  in  the  lower  stations 

of  life,  —  creating  attachments*,  i;i  fact,  which  end  only  with  death, 

and  which  in  hours  of  future  sorrow,  which  come  to  all,  may  refresh 

us  like  springs  of  water  in  the  desert, 
f 

Full  many  a  shaft  at  random  sent, 

Finds  mark  tho  an-her  little  meant ;  , 

Full  many  a  word  at  random  spoken. 

Ma)  Ir'al  a  wounded  heart  that's  broken. 

WALTBlt  Scf>TT. 

In  aiming  to  make  agreeable  impressions  upon  domestics,  we  should 
be  governed  by  the  simple  desire  to  create  hapi)iness.  Their  sources 
of  happiness  are  comparatively  few.  They  spend  their  dayts  below- 
stairs,  —  shut  out  from  a  portion  of  the  light  of  day,  and  from  the 
refining  influences  of  the  drawing-room,  —  having  little  time  for  rest 
or  for  recreation.  How  unfeeling  to  treat  such  persons  with  harshne.s.s, 
to  wear  a  frowning  face  in  their  presence,  and  thus  wither  the  few 
ilowers  of  happiness  which  bloom  around  them  ! 

Evtry  human  being  is  endowed  with  the  beautiful  nervous  organ- 
ism of  which  I  have  spoken,  and  I3  daily  receiving  impressions,  pleas- 
urable or  painful,  from  thousands  of  sources.  In  all  the  relations  of 
life,  it  should  be  our  aim  to  touch  delicately  this  sensitive  structure. 
Wives  may  ad<[  much  to  the  happiness,  and  I  may  say,  to  the  affec- 
tion of  their  husbands,  by  always  wearing  a  pleasant  face ;  and  the 
h-"-iix  of  the  wife  may  be  made  light  and  glad  by  gentle  words  from 
the  husband.  We  cannot  but  love  those  who  make  pleasurable  im- 
pressions upon  us,  and  we  necessarily  dislike  such  as  impress  us  pain- 
fully. Most  of  the  coldness  and  alienations  which  grow  uji.  between 
the  heads  of  families,  spring  from  the  habit,  of  one  of  the  parties,  of 
.laying,  or  doing,  or  looking  something  which  painfully  impresses  the 
other.  A.  woman  who  habitually  wears  a'  "  sour "  face,  cannot  be 
loved  either  by  her  husband  cr  her  children.  The  man  or  the  woman 
who  desires  to  be  loved,  must  cultivate  a  manner,  a  look,  a  speech,  a 
life,  the  whole  scope  of  which  is  fitted  to  make  pleasurable  impres- 
sions upon  others.     It  is  against  nature  to  love  what  gives  us  pain. 

Ag:reeable  Seiiisations,  a  Source  of  Health.  —  Pleasurable  stMisations 
not  only  beget  love,  and  increase  happiness,  but  tl  y  add  much  to 
health.  They  exhilarate  the  spirits  and  drive  away  melancholy. 
Travelling  promotes  health  and  prolongs  life,  by  the  number  and 
variety  of  the  pleasing  impressions  it  makes  upon  the  uiind. 

Cure  of  the  Sit'k.  —  If  the  above  statements  be  correct,  how  im- 
portant that  the  sick  should  be  so  dealt  with  as  to  have  none  but 
agreeable  sensations  made  upon  them.  Many  a  life  has  been  sacri- 
ficed to  the  peevish  temper  of  a  nurse.  When  the  nerves  are  weak 
from  disease,  even  slight  causes  make  powerful  impressions ;  and  if 
these  impressions  are  of  a  painful  kind,  the  results  are  mpst  deplora- 
ble. To  treat  harshly  the  sick,  espeeiallv  those  whose  nervous  system 
is  broken,  implies  either  great  thoughth     uess,  or  extreme  cruelty.     A 


■J! 


1  i       •■■!  ■ 


56 


HYGIENE. 


single  harsh  word,  which  would  scarcely  move  one  when  well,  may 
8end  the  same  person,  when  sick,  almost  to  distraction.  Every  word 
spoken  to  persons  in  sickness  should,  therefore,  be  gentle  and  sooth- 
ing. Every  feature  of  the  face  should  express  either  cheerfulness, 
or  tenderness  and  pity. 

As  the  painful  impressions,  which  disease  is  making,  tends  to  de- 
press the  spirits  and  create  melancholy,  it  is  not  expected  that  persons 
when  sick  will  exhibit  as  amiable  tempers  as  when  well ;  and  for 
this,  all  due  allowance  must  be  made. 

Effect  upon  the  Disposf^f^n. —  This  leads  me  to  say  that  pleasura- 
ble sensations  improve  the  i>  mper  and  disposition.  This  is  a  fact  of 
very  great  importance,  and  parents  should  never  lose  sight  of  it  in 
dealing  with  their  children.  There  are  few  children  but  would  grow 
up  amiable  and  useful  members  of  society,  were  they  dealt  with  in 
the  gentle  and  tender  manner  which  their  young  and  impressible 
natures  require.  From  the  moment  the  young  mind  wakes  to  intel- 
ligence, it  will  be  occupied  with  something.  Parents  and  guardians 
should  aim,  therefore,  to  turn  it  to  all  those  things  which  will  impress 
it  pleasantly,  and  at  the  same  time  do  it  no  harm.  Exercise,  songs, 
playthings,  flowers,  —  to  the  and  other  entertainments  it  should  be 
led  by  gentle  hands.  No  thoughtful  parent  will  ever  pain  a  child  by 
harsh  threats  and  denunciations,  or  shock  it  by  an  oath. 

Bad  Effect  of  Unpleasant  Sensations.  —  If  pleasurable  sensations 
improve  the  health  and  temper,  unpleasant  ones  do  just  the  opposite. 
They  break  down  the  health,  and  spoil  the  disposition. 

They  are  intended  to  give  us  a  warning  of  impending  injury. 
Thus,  we  have  painful  sensations  when  we  have  overworked  the  body 
or  mind.  The  sensation  of  weariness  tells  us  that  the  muscles  have 
worked  as  long  as  their  good  requires,  and  that  they  need  rest.  Were 
this  sensation  unheeded,  exhaustion  and  entire  prostration  would  be 
the  result. 

When  fatigue  begins  to  be  felt,  either  of  body  or  mind,  the  sensa- 
tion may  be  dissipated  by  strong  tea,  or  intoxicating  drink,  or  opium ; 
but  to  drive  it  away  in  this  manner,  for  the  purpose  of  working  longer, 
is  wrong,  and  leads,  in  the  end,  to  disease  or  exhaustion.  It  is  said 
ihat  one  of  the  most  brilliant  advocates  of  our  time  is  dependent 
upon  opium  for  the  stimulus  to  carry  him  through  his  extraordinary 
flights  of  eloquence  ;  but  his  restless  motion  and  nervous  face  remind 
us  that  he  has  bent  his  bow  very  nearly  to  the  snapping  point,  and 
that  a  sudden  collapse  of  his  vital  powers,  at  no  distant  day,  may 
be  feared  as  the  result  of  such  tension. 

Persons  in  aflliction,  whose  spirits  are  depressed  and  broken  by 
sorrow,  should  have  their  thoughts  turned  away  from  all  sombre  ob- 
jects and  contemplations.  They  should  be  taken  into  the  open  sun- 
light, and  be  diverted  by  the  beautiful  things  of  nature.  They  should 
visit  cheerful  society,  and  open  their  hearts  to  pleasurable  impres> 
sions. 

When  we  permit  any  part  of  the  body  to  remain  idle,  neglecting 
to  use  it  as  much  as  we  ought,  unpleasant  sensations  remind  us  of 


HTOIENS. 


57 


our  fault  The  muscles,  when  unused,  waste  away  and  become  feeble. 
This  is  sure  to  produce  an  uneasy,  nervous  state  of  feeling,  which 
says  to  us  as  plainly  a  i  a  sensation  can,  that  the  muscles  are  hungry 
for  exercise,  and  that  it  is  injurious  to  let  them  rest  longer. 

Need  of  a  Healthy  Brain. —  In  order  that  we  may  get  correct  ideas 
of  the  external  world,  it  is  necessary  that  the  brain,  the  nerves,  and 
the  organs  of  sense  through  which  sensations  are  made  upon  the 
mind,  should  be  in  a  healthy  condition.  It  is  evident  that  if  the  in- 
struments of  sensation  be  diseased,  the  sensation  cannot  be  natural, 
and  will  make  a  false  report  to  the  mind.  It  is  of  the  highest  impor- 
tance, therefore,  that  the  brain  should  be  sound. 

Improper  Intemiarriages.  —  This  organ,  like  every  other,  may  in- 
herit disease  from  parents.  Insanity,  which  spring.^  from  a  diseased 
brain,  h  often  hereditary.  When  both  parents  are  diseased,  the  off- 
Bpring  are  of  course  more  liable  to  partake  of  their  dettots.  Among 
the  wealthy,  and  particularly  among  the  royal  families  in  Europe, 
nervous  diseases  and  sterility  are  very  common.  This  arises,  in  a 
great  part,  from  intermarriages  among  blood  relations,  —  a  practice 
under  which  any  people  will  degenerate,  and  finally  perish.  The 
wisdom  of  the  Old  Testament  prohibition  of  marriage  within  certain 
degrees  of  consanguinity,  has  been  established  by  the  observations  of 
philosophers,  and  the  experience  of  mankind.  When  a  man  commits 
the  folly  of  marrying  his  first  cousin,  he  generally  either  his  no  issue, 
or  his  children  are  afflicted  with  deafness,  or  some  shocking  form  of 
nervous  disease.  Let  those  who  will  transmit  to  their  descendants  a 
sound  mind  in  a  sound  body,  observe  the  laws  of  life,  and  avoid  all 
marriages  with  blood  relations. 

Need  of  a  Good  Supply  of  Blood.  —  For  a  proper  performance  of 
its  duties,  the  brain  requires  and  receives  a  larger  supply  of  blood 
than  any  other  part  of  the  system.  One  tenth  of  all  the  blood  goes 
to  this  important  organ.  If  the  quantity  or  qualify  be  materially 
lessened  or  changed,  great  disturbance  of  the  brain  follows.  A  large 
loss  of  blood  occasions  dizziness  and  fainting.  If  an  atmosphere 
charged  with  too  much  carbonic  acid  gas  be  breathed,  as  in  a  deep 
well,  the  blood  is  not  vitalized  in  the  lungs,  so  as  to  sustain  the  brain, 
and  unconsciousness  soon  follows.  If  the  air  be  vitiated  in  any  way, 
or  have  its  oxygen  extracted,  as  in  la.gt  assemblies,  where  it  is 
breathed  over  several  times,  it  becomr^s  unfit  to  support  the  brain,  and 
the  result  is  languid  feelings,  inability  to  apply  the  mind,  headache, 
fainting,  hysterics,  and  other  nervous  manifestations. 

Yentilation.  —  This  shows  the  great  necessity  of  having  dwellings, 
churches,  and  school-houses  well  ventilated. 

Were  a  good  system  of  ventilation  adopted  in  all  our  churches, 
ministers  would  seldom  preach  to  sleeping  audiences.  A  congrega- 
tion sitting  in  one  of  our  places  of  public  worship,  where  the  air  in  a 
single  afternoon  is  as  many  times  used  over  as  the  minister's  sermons 
are  in  a  lifetime,  can  neither  hear  with  attention,  nor  comprehend  with 
clearness. 


m 


68 


HTOIENE. 


In  our  schooKhouses,  the  ventilation  is  quite  as  bad,  and  the  conse- 
quencea  worse,  because  they  are  occupied  six  hours  in  the  day  instead 
of  three,  and  six  days  in  the  week  in  place  of  one.  In  the  small  school- 
houses  which  our  children  filled  to  overflowing  in  former  years,  in 
which  there  was  no  ventilation,  unless  they  happened  to  be  blessed 
with  an  old-fashioned  chimney  and  fire-place,  the  effects  upon  the 
nervous  system  of  the  children  was  deplorable.  Many  of  the  dis- 
eases which  afllict  the  present  generation  of  men  and  women,  had 
their  origin  in  the  bad  air  of  those  crowded  nurseries  of  education. 

Our  dwellings  were  partly  ventilated  in  olden  time,  when  the  oiwn 
fire-place  received  the  "  back-log,"  tlie  "  top-stick,"  the  "  fore-stick," 
and  other  sticks  to  match  ;  but  since  we  have  been  warmed  by  the 
stove  and  the  furnace,  we  have  known  little  of  the  luxury  of  pure  air 
at  the  domestic  hearth. 

l^eed  of  Exercise  for  the  Brain.  —  Health  requires  that  the  brain 
should  be  properly  occupied  with  vigorous  thought,  Tl\e  same  rea- 
sons may  be  given  for  this  as  for  the  exercise  of  the  mi  scles.  It  is 
governed  by  the  same  laws  which  apply  to  other  parts  of  the  system. 
Use  improves  its  strength  and  vigor,  —  idleness  causes  it  to  grow 
feeble.  Of  course  the  labor  it  is  put  to  should  be  only  reasonable  in 
amount,  and  should  not  be  too  long  continued  at  any  one  time. 
With  the  weakening  of  the  brain,  the  whole  bodily  forces,  and  indeed 
the  whole  mental  and  moral  character,  fall  into  feebleness  and  decay. 
It  is  a  great  mistake  to  suppose  that  the  cultivation  and  even  vigorous 
use  of  the  mind,  impaits  health.and  shortens  life.  Just  the  opposite 
is  true.  Many  of  the  most  eminently  intellectual  men,  who  have 
worked  their  brains  hard  all  their  lives,  have  been  distinguished  for 
long  life. 

Bad  Effects  of  Change  in  Circnnistanees.  —  No  class  of  persons 
suffer  more  from  nervous  diseases  and  general  ill  health,  than  those 
who,  having  worked  hard  in  early  life,  with  little  or  no  cultivation  of 
the  mind,  are  suddenly  raised  to  wealth,  and  immediately  drop  all 
exercise,  and  fall  into  habits  of  indolence  and  luxury.  The  condition 
of  such  persons  would  be  much  less  pitiable,  did  they  take  up  books 
when  they  lay  by  the  hoe  or  the  broom.  But  they  seldom  do  this. 
Many  a  woman,  in  early  life,  has  felt  the  glow  of  health  in  every 
limb,  and  a  thrill  of  pleasure,  too,  while  scrubbing  the  floor  upon  her 
hands  and  knees,  who  has,  in  subsequent  years,  reclined  »n  misery 
upon  her  damask-covered  lounge,  and  wondered  that  she  could  not 
have  the  health  of  other  days.  Let  her  cultivate  her  brain,  live  tem- 
perately, and  exercise  in  the  open  air,  and  life  may  again  have  real 
pleasures  for  her. 

Discretion  in  EYercisiun^  tlie  Brain.  —  In  exercising  the  brain  we 
must  use  discretion.  We  must  not  sit  down  in  the  morning,  and  ply 
it  with  work  during  the  whole  day,  without  rest.  This  would  soon 
bring  upon  it. disease,  or  premature  decay.  It  should  be  worked  only 
until  it  begins  to  show  symptoms  of  fatigue.  Then  it  should  be  per- 
mitted to  rest ;  or,  what  is  better,  be  turned  to  some  new  subject,  of 


HYGIENE. 


59 


a  lighttT,  or  a  different  character.     This  often  rests  the  brain  better 
than  to  entirely  sustpend  its  action. 

Overworkiiup  the  Brain  In  Cliildliooil.  —  Grout  care  should  be  used 
not  to  exorcise  the  bruin  too  much  in  early  life.  Like  other  parts  of 
the  systoiii,  it  is  tender  in  childhood,  and  will  not  boar  prolonged  ex- 
ertion. As  a  general  thing,  children  are  put  to  school  too  early,  and 
made  to  work  their  brains  too  hard.  Great  mischief  arises  from  this 
tiource.  Cliildron  are  born  with  larger  brains  now  than  formerly;  and 
it  is  no  uncommon  thing  to  see  upon  a  child  of  ton  years,  a  head 
e{|nal  in  size  to  that  of  an  adult.  Children  run  to  brain.  I^rooocity 
ill  d(!Vol()|)ment  of  brain  and  mind  is  conunon.  The  results  of  stim- 
uiatiiig  and  hastening  the  unfolding  of  such  minds  are  deplorable. 
Ill  such  cliildron,  the  brain  should  bo  the  last  thing  to  be  cultivated. 
We  need  not  urge  its  growth.  It  will  come  for\vard  fast  enough  in 
spite  of  us.  Our  oliiof  aim  should  ho  to  harden  and  fortify  the  general 
constitution,  so  that  the  noble  brain  which  it  is  required  to  bear  up 
and  sustain,  may  long  be  its  crown  and  glory. 

Yet  parents  are  proud  of  their  precocious  children,  and  often  reverse 
this  rule.  They  do  it  thoughtlessly,  and  would  be  terribly  startled, 
could  they  suddenly  look  into  the  future,  and  see  the  results  of  their 
folly.  Could  they  do  so,  they  would  see  inflammation  and  softening  of 
the  brain,  epiloj)sy,  insanity,  paralysis,  apoplexy,  with  all  the  horrors 
of  undescribed  and  indescribable  nervous  affections,  which,  though 
without  a  name,  have  a  terrible  reality. 

Old  People's  Bniins.  —  Persons  in  advanced  life  should  be  particu- 
larly careful  not  to  overwork  the  brain.  In  middle  life  it  recovers 
easily  from  great  fatigue.  In  the  decline  of  life,  its  powers  of  recov- 
ery are  feeble.  A  single  exhaustion  may  cause  its  fatal  collapse.  Old 
age  should  be  distinguished  for  gentleness  and  moderation.  The 
journey  of  the  down-liill  of  life  should  be  made  by  short  and  easy 
stages,  through  regions  of  diversified  beauty. 

A  Supiily  of  B1(NmI.  —  Every  part  of  the  system,  when  hard  at  work, 
needs  and  must  have  a  very  largt;  supply  of  pure  blood.  Without 
this,  it  is  torpid  and  inactive.  To  cause  the  blood  to  flow  to  any 
particular  part,  it  must  "be  exorcised.  The  lumberman,  when  in  the 
forest  in  extreme  cold  weather,  stamps  his  foot  violently  upon  the 
ground,  or  boats  them  against  a  log,  and  whips  his  hands  around  his 
body;  and  in  this  way  makes  them  rod  and  warm  with  a  now  supply 
of  blood.  The  stomach,  when  it  has  received  a  supply  of  food,  be- 
gins earnestly  to  turn  it  over;  and  by  this  exorcise,  and  the  stimulus 
which  the  food  supplies,  it  invites  large  ({uantities  of  blood  to  its 
vessels,  and  thus  increases  its  power  to  work.  But  just  in  |)roportion 
that  it  draws  the  vital  current  to  ilself,  and  augments  its  own  vital, 
force,  it  diminishes  the  blood  in  other  organs,  and,  for  the  time  being, 
unfits  them  for  work.  The  same  may  be  said  of  tne  brain  and  all 
other  working  organs. 

From  this  it  follows  that  only  one  organ,  or  set  of  organs,  can  work 
effectively  at  the  same  time,  and  that  it  is  improper  to  put  the  brain 
to  hard  work  immediately  after  a  full  meal,  bt^cause  the  stomach  then 


■^\f 


60 


HTOIENB. 


wants  the  blood  to  enable  it  to  digest  the  food ;  and  if  the  blood  be 
called  off  to  the  brain,  digestion  will  stop.  Nor  should  the  stomach 
be  loaded  with  food  directly  after  long  and  hard  thinking;  for  the 
brain  will  yield  up  the  blood  to  it  only  after  its  own  excitement  has 
had  time  to  subside. 


Sympathetic  Nervous  System. 

The  object  of  this  system  seems  to  be  to  bind  all  parts  of  the  body 
together,  and  to  combine  and  harmonize  their  actions.  It  takes  cure 
that  no  part  of  the  system  acts  in  such  a  way  as  to  injure  any  other 
part  It  exerts  a  controlling  influence  over  digestion,  nutrition,  al> 
sorption,  the  circulation,  etc.  These  are  natural  processes  which 
need  to  go  on  while  the  brain  is  asleep  and  cannot  attend  to  them. 
The  nervous  system,  of  which  I  speak,  presides  over  all  those  func- 
tions which  are  called  involuntary,  —  so  called  because  no  act  of  tlie 
will  is  needed  for  their  performance.  Secretion,  absorption,  digestion, 
and  the  circulation  of  the  blood,  all  have  to  go  on  while  we  sleep,  a» 
well  as  while  we  wake.  Were  an  act  of  the  will  necessary  to  their 
performance,  as  in  walking,  eating,  conversing,  etc.,  then  they  would 
have  to  cease  the  moment  ihe  brain  fell  asleep,  and  death  would  be 
the  result. 

The  sympathetic  nerves  apprize  each  part  of  the  system  of  the 
condition  and  Wants  of  every  other  part.  When  the  lungs  are  in- 
flamed, the  stomach  seems  to  be  aware  of  it,  and  will  receive  no  food, 
because  this  would  aggravate  the  disease  of  the  neighboring  organs. 
Well  would  it  be  if  human  beings  would  exercise  a  like  forbearance, 
and  abstain  from  those  acts  of  self-gratification  which  they  know  wili 
injure  their  neighbors. 

Effects  of  IVervous  Diseases.  —  Before  closing  these  observations,  1 
wish  to  add  a  few  words  respecting  the  terrible  effects  of  nervous  dis- 
eases which  characterize  the  present  time. 

That  they  are  far  more  numerous  and  afflictive  than  in  former 
years,  must  be  apparent  to  the  most  careless  observer.  They  are 
nothing  more  nor  less  than  the  price  we  pay  for  a  high  civilization, 
and  especially  for  our  republicanism.  Among  us,  every  man  feels  hh  | 
individuality,  and  has  a  motive  for  thinking  and  doing  his  best . 
Thought  and  action  are  here  unfettered  ;  and  if  the  race  is  not  to 
the  swift,  nor  the  battle  to  the  strong,  every  man  acts  as  though  he 
thought  it  was.  The  great  excitement  which  the  struggle  for  wealth 
kindles  and  inflames,  deranges  and  shatters  the  nervous  system  to  a 
shocking  degree. 

And  wealth,  when  obtained,  does  its  full  share  to  weaken  the  nerves.  I 
It  brings  with  it  high  living,  indolence,  loss  of  energy,  dissipation,  and 
a  weakening  of  the  whole  moral  and  physical  powers.     It  need  not  | 
do  this;  but,  in  most  cases,  it  does. 

The  result  is,  that,  at  least,  every  other  person  has  some  nervous  I 
disease,  which  makes  life  a  misery  rather  than  a  blessing.     The  brain 
and  nerves  are  too  much  developed  in  comparison  with  the  develop- 1 


1  ■  ■  ■■^■;.:V- 


inoiit  of  the  muscles.  Half  our  boys  and  girls  have  heads  as  large 
as  men  and  women.  It  is  common  to  see  a  boy  or  a  girl  at  ten  talk- 
ing and  acting  like  a  man  or  woman.  I  do  not  mean  by  this,  that 
they  imperfectly  imitate  the  actions  of  older  persons.  It  seems  to  be 
natural  to  them.  Their  brains  are  prematurely  developed,  and  their 
acts  and  thoughts  have  the  maturity  of  adult  life. 

What  Is  ComiiiK? —  What  will  be  the  result  of  this  state  of  things, 
no  man  can  predict.  I  sometimes  think  the  race  will  break  down; 
that  that  wliic^h  was  intended  to  be  its  ornament  and  strength,  will  be 
its  destruction.  I  hope  not.  Yet  there  is  danger  of  it.  Nothing  c  in 
save  us  but  the  wisdom  to  adopt  such  means  as  will  develop  all  parts 
of  the  system  alike.  No  race  of  men  can  stand  for  many  generations 
such  a  strain  upon  the  nervous  system,  unless  better  means  are  adopted 
to  counterbalance  its  evil  effects  than  are  now  used  in  the  United 
States.  We  have  got  to  pause  in  our  swift  career,  and  look  after  our 
health,  or  we  shall  become  a  nation  of  maniacs.  No  proof  is  needed 
of  what  is  here  said.  There  is  scarce  a  man  or  a  woman  but  has 
jn  their  own  person  the  foreshadowing  evidence  of  our  impending 
(loom. 

Hopeful  Considerations.  —  It  is  proper  to  say  the  considerations 
here  presented,  terrible  as  they  are,  are  mitigated  in  some  measure  by 
others  of  a  more  hopeful  character. 

Physiology  and  the  laws  of  life  are  now  better  understood  than  at 
any  former  period.  These  subjects  are  getting  into  our  common 
K-tiools,  and  are  engaging  the  attention  of  our  youth.  Declining 
health  has  already  made  us  think  more  of  the  means  of  preserving 
it,  —  such  as  diet,  exercise,  bathing,  travelling,  and  amusement  To 
encourage  and  intensify  this  hopeful  direction  of  the  public  mind,  I 
propose  to  devote  a  few  pages  to  these  subjects. 

Food  and  Digestion. 

From  the  earliest  dawn  of  existence  to  the  last  moment  of  life,  our 
bodies  are  constantly  changing.  Old  particles  of  matter,  when  they 
are  worn  out,  leave  their  places  and  are  thrown  out  of  the  system. 
Were  this  the  whole  of  the  matter,  our  bodies  would  soon  waste 
away,  and  that  would  be  the  end  of  us.  But  as  fast  as  the  old  mate- 
rials are  thrown  away,  new  ones  take  their  places ;  and  it  is  solely 
out  of  our  food  that  these  new  materials  are  formed. 

In  order  that  the  food  may  be  well  digested,  it  must  first  be  broken , 
into  small  particles  in  the  mouth.  The  act  of  chewing  it,  is  called  nias- 
tication.  During  this  act,  if  it  be  well  performed,  a  large  quantity  of 
spittle,  called  saliva,  flows  out  of  a  number  of  glands,  called  salivary 
glands,  and  mixes  w'ith  the  food,  forming  with  it  a  soft  mass.  Tr.  this 
condition,  it  is  thrown  backward  into  the  top  of  the  throat,  called  the 
pharynx.  Here,  a  little  cartilage,  called  the  epiglottis,  drops  down 
upon  the  opening  into  the  top  of  the  windpipe,  and  prevents  its  en- 
trance into  the  breath  passage ;  and  it  is  pushed  along  into  the  gullet, 
a  tube  which  runs  down  behind  the  windpipe  and  lungs,  and  which 


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I-  ■    ' 

I     I 


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X'i 


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I'       I- 


'■  'm 


T- 


62 


HYGIENE. 


physlrinDs  call  tin-  (rsophagUH.  Ilrre  a  succt'ssion  of  musfular  bands, 
III  circulitr  sluipc,  contract  u|H)ii  it,  one  ul'tcr  uiiuther,  and  furcu  it 
down  into  the  stoinacli. 

It  is  important  tliat  two  tliriif^rt  ^'llolJl(^  be  secured  while  the  food  is 
in  the  mouth,  namely,  that  it  sh«)ul(i  be  reduced  to  a  ^ood  deforce  of 
Bnoncss  by  chewing,  and  that  a  proper  amount  of  saliva  should  be 
mixed  with  it.  If  the  chewing  wore  not  necessary,  teeth  would  not 
have  been  given  us  ;  and  the  salivary  glands  would  certainly  not  Irnvo 
been  put  in  the  vicinity  of  the  mouth,  if  the  mixing  of  water  with  our 
food  would  servo  the  purposes  of  digestion  as  well. 

Eating  too  Rapidly. — The  Americans  have  fallen  intQ  a  pernicious 
error  in  eating  their  food  too  rapidly.  Time  is  not  given  to  chew  it 
sufficiently  to  excite  a  full  flow  of  saliva  ;  and  as  it  cannot  be  swal- 
lowed in  a  dry  state,  it  is  not  uncommon  to  see  persons  taking  a  sip 
of  water  after  every  second  mouthful  to  enable  them  to  force  it  into 
the  stomach.  It  ib  -i  habit  we  Americans  have  of  cheating  ourselves 
both  of  the  pleasures  j\nd  the  benefits  of  eating ;  for  the  only  real 
pleasure  of  eatuig  arises  from  the  flavor  of  food  while  retained  in  the  , 
mouth,  and  the  only  benefit  we  cun  derive  comes  in  consequence  of 
its  proper  digestion. 

The  food  when  received  into  th(^  stomach  is  in  the  same  condition 
as  when  taken  into  the  mouth,  except  that  it  is,  or  should  be,  ground 
fine  by  the  teeth,  and  well  mixed  with  saliva. 

The  GuKtrie  Jiikr. —  The  stomach,  like  the  mouth,  the  windpipe, 
and  the  gullet,  is  lined  by  a  mucous  membrane.  The  chief  office  of 
this  membrane  is  to  secrete,  or  take  out  of  the  blood,  a  fluid  which 
we  call  gastric  juice,  which  means  stomach  juice ;  for  the  Greek  name 
of  stomach  is  yaaryp  (gaster).  This  fluid  has  not  much  smell  or 
i^ste,  and  looks  like  spring  water.  It  has  a  powerful  effect  upon  food, 
which,  when  mixed  with  it,  soon  undergoes  an  important  change, 
whiv^h  is  apparent  to  the  taste,  the  smell,  and  the  sight.  What  the 
nature  of  the  gastric  juice  is,  or  how  it  produces  its  effect  upon  food, 
is  not  certainly  known. 

Too  Mucii  Cold  Water  at  Meals. — There  are  some  interesting  facts 
connected  with  the  formation  of  this  fluid,  of  which  it  is  important 
that  every  person  should  be  apprized. 

Its  quantity  and  quality  depend  on  the  amount  and  healthfulness 
of  the  blood  which  flows  to  the  stomach  during  the  first  stage  of 
digestion.  It  is,  therefore,  injurious  to  drink  large  quantities  of  very 
cold  water  with,  'or  immediately  after,  our  meals ;  as  this  will  chill 
the  stomach,  and  repel  the  blood  from  its  vessels,  so  that  but  little  of 
the  juice  can  be  formed.     Digestion,  in  such  case,  must  be  imperfect. 

Tliis  Fluid  not  Secreted  Without  Limit.  —  This  fluid  does  not  flow 
into  the  stomach  continuously,  but  only  when  we  swallow  food,  and 
then,  not  as  long  as  we  please  to  eat,  but  merely  till  we  have  taken 
what  the  system  requires.  If,  in  the  amount  we  take,  we  go  beyond 
the  wants  of  nature,  there  will  not  be  fluid  enough  formed  to  dissolve 
it,  and  the  whole  will  be  imperfectly  digested,  and  be  a  source  of  in- 


HYGIENE. 


63 


jury  rather  thai'  bnicfit.     Thin  should  teacli  \in  to  be  carrfiil  that  our 
food  he  only  reasonable  in  amount. 

!\ot  S^rreted  in  SickllCHS. —  When  v/e  are  sick,  the  gastri(r  jiiice  in 
either  not  formed  at  all,  or  only  in  small  <|uantities.  Whatever  may 
be  our  feelings  of  lassitude,  and  however  much  we  may  appear  to 
aeed  food,  at  smrh  times,  it  is  useless  to  taki  ,t,  for  it  eannot  be  di- 
gested, and  will  only  aggravate  our  tlisease.  If  the  illness  l)e  only 
slight,  the  fluid  will  bo  formed  to  some  extent,  and  food  uiay  be  taken 
ill  proportion. 

Us  SvvirtUm  Fjiyored  by  riicerfiiliiess. —  A  eheerful  disposition,  and 
a  happy,  livefy  frame  of  mind,  are  highly  favorable  to  the  production 
of  the  gastric  juice;  while  melancholy,  and  anger,  and  grief,  and 
intense  thought  of  business  at  the  hour  of  nn-als,  greatly  hinder  ita 
natural  flow. 
This  .should  loach  us  to  go  to  our  mculs  Avith  light  hearts,  and  to 

I  make  tl^o  family  board  a  place  of  cheerful  conversation,  and  of  a  light 
and  joyous  play  upon  the  mirthful  feelings  of  all  present.  Should 
any  of  the  family  circle  be  in  the  habit  of  using  vinegar  as  a  condi- 
ment, we  should  never  be  guilty  of  compelling  them  to  extract  it  from 
our  faces.  A  vinegar  face  is  not  easily  excused  anywhere  ;  at  the 
table  it  is  unpardonable.  A  single  countenance  of  this  description 
will  throw  a  gloom  over  a  tableful  of  naturally  cheerful  persons  ;  and 
if  habitually  present  at  the  board,  may  finally  spoil  the  digestion  of 

[half  a  dozen,  and  entail  dyspepsia  upon  them  for  life. 

The  s(  machs  of  the  sick  pour  out  but  very  little , of  this  fluid,  and 

I  they  I.  n  ♦  ke  but  a  small  amount  of  food.  It  is  cruel  to  deprive  them 
of  the  povvers  of  digesting  that  little  by  treating  them  harshly,  and 
filling  them  with  gloomy  and  desponding  feelings.  I  therefore  repeat 
the  substtince  of  the  advice  given  on  a  previous  page  :  Deal  gently 

[with  the  sick. 

How  all  tlii»  is  Kiio^vn. — As  the  stomach  is  wholly  concealed  from 
view,  the  reader  will  very  naturally  ask  how  it  is  known  that  the  gas- 
I  trie  juice  is  poured  into  it  in  certain  states  of  the  mind,  etc.,  and  with- 
held in  others.    It  certainly  could  not  have  been  so  accurately  known, 
I  had  it  not  been  for  an  accident  which  opened  the  living  and  working 
stomach  to  the  inspection  of  Dr.  Beaumont,  a  United  States  Surgeon. 
K  young  man  by  the  name  of  Alexis  St.  Martin,  a  Canadian  by  birth, 
but  then  in  the  State  of  Michigan,  had  a  large  part  of  his  side  torn  away, 
and  a  hole  of  considerable  size  made  into  his  stomach,  by  the  acci. 
I  dental  discharge  of  a  gun.     To  the  surprise  of  his  surgeon,  St.  Martin 
I  recovered  J  and  the  edges  of  the  wound  in  the  stomach  refused  to 
i  grow  together,  preferring  rather  to  fasten  themselves  to  the  borders  of 
the  breach  in  the  side,  thus  leaving  the  passage  open.     A  kind  of  cur- 
tain grew  down  over  this,  which  prevented  the  food  from  falling  out. 
1  Dr.  Beaumont,  taking  advantage  of  this  state  of  things,  instituted  a 
j  series  of  valuable  experiments,  by  lifting  the  curtain,  and  insertuig 
various  articles  of  food,  and  witnessing  the  process  of  digestion. 

■oTcment  of  the  StomaclL — The  presence  of  food  in  the  stomach 


ill 


i\ 


i!- 


.'t'-.l 


|-;i 


Ui  .■  t 


*i 


t','' 


64 


HTOIENB. 


causes  its  muscular  coat  to  contract  and  throw  it  about  from  side  to 
side,  mixing  it  thoroughly  with  the  gastric  juice,  and  reducing  it  to  a 
pulpy  mass,  called  chyme.  This,  as  fast  as  it  is  properly  prepored, 
pjisHfs  through  the  pylorcs  into  the  upper  bowel,  or  duodenum^  called 
also  the  second  stomach. 

Chyme.  —  A  certain  witty  professor  of  anatomy  and  physiology,  is 
in  the  habit  of  asking  his  class  if  they  ever  saw  any  chyme;  and 
when  they  -^nswer  no,  as  they  often  do,  he  calls  their  attention  to 
what  they  occasionally  see  in  the  morning,  upon  the  sidewalks,  where 
drunken  men  have  held  themselves  up  by  lamp-posts,  and  left  ihe 
contents  of  their  stomachs. 

The  pylorus,  or  opening  into  the  bowel,  has  a  very  singular  and 
wise  instinct,  which  is  worthy  of  remark.  When  a  piece  of  food, 
which  has  not  been  digested,  attempts  to  pass  into  the  bowel,  the 
moment  it  touches  the  inii«r  surface  of  this  orifice,  it  is  instantly 
thrown  back  by  an  ene-getic  contraction  ;  though  a  portion  of  well- 
|)repared  chyme  touching  the  same  opening  immediately  after,  is 
allowed  to  pass  on  unchallenged. 

Chyle.  —  The  chyme,  when  it  reaches  the  duodenum,  seems  to  cause 
the  liver  to  secrete  bile,  and  the  pancreas  to  produce  the  pancreatic 
>nice.  These  two  fluids  are  conveyed  into  the  upper  portion  of  the 
second  stomach,  and  are  there  mixed  with  the  chyme,  and  cause  it  to 
separate  into  a  delicate,  white  fluid,  called  cAy/e,  and  a  residuum, 
which,  being  worthless,  is  pushed  onward,  and  thrown  out  of  the 
body. 

Bile  in  the  Stomach. —  Most  persons  suppose  that  bile  is  generally 
found  in  the  stomach;  but  this  is  a  mistake.  It  is  thrown  up  by 
vomiting,  because  in  that  act,  the  action  both  of  the  first  and  the 
second  stomach  is  reversed,  and  the  bile  is  forced  up  from  the  duodes 
num,  —  taking  a  direction  the  opposite  of  its  usual  course. 

Destination  of  the  Chyle,  —  The  chyle  being  separated  from  the 
dregs,  is  pushed  onward  in  its  course 
by  the  worm-like  motion  of  the  in- 
t'istine  ;  and  as  it  passes  along,  it  is 
gradually  sucked  up  by  thousands 
of  very  small  vessels,  whose  mouths 
open  upon  the  inner  siirface  of  the 
bowel.  These  little  vt^ssels  are  called 
lacleals,  from  the  Latin  word  laCy 
which  means  milk,  because  they 
drink  this  white,  milky  fluid.  Fig- 
ure Gl  shows  a  .•section  of  the  siT\all 
bowel,  turned  inside  dut,  and  covered 
with  the  villi,  or  root-like  filaments, 
closely  set  upon  its  surface,  for  ab- 
sorbing the  chyle,  and  at  the  bottom 
of  which,  the  lacteals  t-ake  their  rise. 

In  these  lacteals,  and  in  the  mesenteric  glands,  the  chyle  in  gmdo- 


Fia.  61. 


HYGIENE. 


65 


ally  changed,  so  as  to  approach  nearer  and  nearer  io  the   nature 
Fio,  63.  ^^  the   blood ;   but  precisely  what  the 

change  is,  or  how  it  is  effected,  i  ■  not 
known.  Several  men  have  published 
their  theories  upon  these  points,  and 
the  writer  has  opinions  upon  them ; 
but  it  is  not  wortli  while  to  trouble 
the  reader  with  them.  It  is  sufficient 
to  say  that  (he  fluid  is  carried  by  the 
lacteals  to  the  thoracic  duct,  through 
which  it  is  conveyed  into  a  large  vein 
at  the  lower  part  of  the  neck,  where  it 
\a  poured  into  the  blood,  and  becomes, 
after  going  through  the  lungs  and  ex- 
periencing another  and  a  vital  change, 
the  material  out  of  which  our  bodies 
are  daily  and  hourly  new-created. 

Figure  62  gives  a  general  idea  of 
the  stomach,  bowels,  etc. :  9,  being  the 
stomach;  10,  10,  the  liver:  1,  the  gall 
bladder;  2,  the  duct  which  conveys  the 
bile  to  4,  which  is  the  duodenum ;  3,  is 
the  pancreas ;  5,  the  oesophagus ;  A, 
the  duodenum  ;  B,  the  bowels ;  C,  the 
junction  of. the  small  intestines  with 
the  colon  ;  D,  the  appendix  vermifor- 
mis ;  E,  the  ctecum ;  F,  the  ascending 
colon  ;  (i,  the  transverse  colon  ;  H|  the 

(If'ftcending  colon  ;  I,  the  sigmoid  flexure  ;  J,  the  rectum. 

Nature  and  Destination  of  Food. 

The  food  which  man  requires  for  his  support  and  development  is 
of  +WO  kinds,  the  inorganic,  and  the  organic.  The  first  of  these  em- 
braccs  f^ertain  mineral  substances,  as  common  salt,  sulphur,  phospho- 
ms,  iron,  :ind  lime,  either  in  combination  or  separate. 

These  art:  not  generally  reckoned  as  aliments,  and  yet  no  human 
being  can  live  witiiouc  them,  lik  their  absence,  the  body  decays,  dis- 
intf'gratcs,  and  oerishes.  Conm-'On  salt  is  composed  of  muriatic  acid 
and  soda.  Th'J  first  is  an  impt>rtunt  ingredient  in  the  g,..stric  juice, 
mid  the  latter  promotes  the  si-cretion  of  bile.  Sulphur  is  found  in 
wv<>raS  of  the  tissues,  particularly  ii5  the  muscles.  Phosphorus  united 
to  fatty  matter,  is  highly  honored  in  forming  a  portion  of  the  brain 
and  nerves,  and  is  also  combined  with  oxygen  and  lime  to  make  the 
•'arthy  or  hard  part  of  bones. 

Found  in  FimmI.  —  'I'hese  articles  it  is  not  necessary  often  to  intro- 
•luce  into  tin-  systcMii  in  a  separate  state.  They  arc  contained,  in 
liirger  or  smaller  proportions,  in  most  articles  of  fiK>d ;  and  man  always 
•^utfers,  as  all  animals  do,  from  their  absence,     ('ommon  salt  is  found 

9 


ir^r 


f 


1     I 

HI 


1 


(','■■■ !  ■ 


Pi, 


I"'  ./■ 


66 


hygiene; 


in  the  flesh  of  animals,  in  milk,  and  in  eggs.  It  is  not  very  abundant 
in  plants ;  and  we  all  know  how  eagerly  domestic  animals  devour  it 
when  it  is  given  to  them,  and  how  constantly  wild  cattle  resort  to  the 
salt  springs,  which,  in  the  great  "West,  are  called  "  buffalo  licks." 
Lime  exists  in  nearly  all  animal  and  vegetable  substances.  In  wheat 
flour  we  get  it  in  combination  with  phosplioric  acid,  that  is,  as  phois- 
phate  of  lime.  Lime  exists,  too,  in  ihcj  state  of  carbonate  and  sul- 
phate, in  all  hard  water.  Iron  is  found  in  the  yolk  of  eggs,  in  milk, 
in  anim«l  flesh,  in  potatoes,  pears,  cabbages,  nnistard,  and  other  arti- 
cles. Svlphur  we  get  in  flesh,  eggs,  and  milk  ;  and,  as  sulphate  of 
lime,  in  pring  and  river  water.  Phosphorus  is  derived  from  eggs  and 
milk ;  a  id  flesh,  bread,  fniits,  and  busies  of  grain,  commonly  called 
bran,  contain  even  a  larger  proportion  than  we  need  in  our  diet 

Orjpiiiic  Food. —  The  organic  elements  of  man's  food,  which  in  bulk 
embrace  almost  the  whole  of  it,  remain  to  be  considered.  In  the 
animal  economy  they  serve  two  great  purposes.  A  part  of  the  arti- 
cles which  compose  them  are  blood-formers,  out  of  which  all  the 
tissues  are  made, — the  other  part  produce  fat,  which  serves  to  warm 
the  body  by  being  burned  with  oxygen.  These  articles  are  derived 
partly  from  the  vegetable  and  partly  from  the  animal  kingdom. 


-  For  convenience,  these  articles  may 
For  the  first, 


Fio.  68. 


Divided  into  Four  Groups. 

be  divided  into  four  groups, 
fiugar  stands  as  a  type.  We  therefore  call 
it  the  saccharine  group.  It  embraces  starch, 
gum,  and  the  fibre  of  wood.  These  arti- 
cles may  all  be  converted  into  sugar  by  a 
simple  chemical  process.  Figure  63  gives  a 
microscopic  view  of  the  granules  of  stdrch. 

The  second  grovp  we  call  the  olea^iiKms. 
It  is  composed  of  oily  substances,  from 
whatever  source  derived,  whether  the  ani- 
mal or  the  vegetable  world. 

The  third  fi^royp  is  the  albuminous.  A 
good  type  of  it  is  the  white  of  egg. 

'i'\ie  fourth  is  the  gelatinous.,  ox  jelly  group. 

First  iinii  Second  Gronps,  Supporters  of  Respiration. — The  articles 
composing  the  first  and  8«'cond  groups  are  analogous  in  composition, 
all  containing  oxt/g-en,  hydrogen,  and  carbon.  They  are  what  Liebig 
calls  supporters  of  respiration  ;  the  meaning  of  which  is,  in  nio'o 
comprehensible  terms,  that  they  are  supporters  of  combustion.  They 
are  the  fuel  which  warms  us.  They  keep  the  fires  going,  from  whici 
arises  all  the  heat  we  have  in  our  bodies.  But  they  are  destitute  of 
nitrogen,  and,  on  this  account,  they  are  not  blood-formers,  and  cannot 
be  worked  into  flesh.     Hence,  man  caiuiot  live  on  them. 

The  food  articles  embract^d  in  the  third  and  fourth  groups,  also 
contain  oxygen,  hydrogen,  and  carbon  ;  and  to  these  they  add  nitro- 
gen. This  fourth  component  part,  which  forms  only  a  small  portion 
of  them,  gives  them,  for  some  reason  never  explained,  the  peculiar 


ri^ 


,;t, 


HYGIENE. 


67 


qualify  of  prodnring  blootl  and  flesh.     Thoy  are  the  raw  materials, 
out.  of  which  our  btKlies  are  n'consfrutrted  from  day  to  day. 

Feed  a  man  ev«*r  so  largely  u|:k)u  sugar,  starch,  gum,  and  oils,  and 
he  will  starve  as  certainly  as  if  he  were  allowed  nothing  but  water. 

Names  of  Tno  firejit  Divisions  of  F<kmI.  —  The  jx)s.session  or  non- 
possession  of  nitrogen,  then,  is  what  distinguishes  from  each  other 
the  two  great  classes  of  food-articles.  Those  which  eontain  nitrogen 
have  b<»en  called  nifrog-enized,  and  those  which  are  destitute  of  it, 
non-^nitro^enized  compounds.  As  nitrogen  is  often  called  azote,  the 
fonner  class  are  more  frequently  named  azofized ;  the  latter,  now- 
azotized. 

Let  the  reader  now  fix  it  in  his  mind  that  the  azotized  articles  of 
foot!  produce  blood  and  flesh;  the  non-azotized,  heat ;  and  he  will 
have  the  key  to  understand  much  of  what  is  to  be  said,  and  likewise 
to  unlock  many  of  the  mysteries  of  diet. 

Natritimi  Tablet  —  Taking  human  milk  as  the  standard,  and  ex- 
pres.sing  the  amount  of  nitrogen  it  contains  by  100,  the  following 
table  shows  the  relative  amount  of  nitrogen  in  the  principal  flesh- 
producing  articles  of  food,  and  consequently  their  power  of  fonning 

the  tissues : 


Rice, 
Kye, 
Com, 
Barley, 
Oats, 
[  Wheat, 


VEGETABLE. 

81  Potatoes, 84 

-  106  Turnips, 106 

126  Carrots, 150 

-  126  Peas,  -        -        -      .  -         ,  239 
138  Beans, 320 

-144 


ANIMAL. 

I  Human  Milk,          -        -        -        -  100  White  of  Egg,        -        -        -        -  846 

Cows' Milk,         ....  237  Herring. 910 

I  Oyster,                     ...        -  806  Haddock,        -        -        -        -        -  816 

lYolk  of  Eggs,      -        -        -        "  805  Pigeon, 756 

[Cheese,          ....       331-447  Lamb, 833 

lEel, 428  Mutton, 862 

iPork-Ham, 807  Veal, !)11 

[Salmon, 610  Beef, 942 

Otlier  Standards  of  Talne.  —  We  must  not.  infer  that  those  articles 
trhich  have  most  nitrogen  are  necessarily  best  adapted  for  human 
lift  because  they  are  the  most  effective  blood-producers.  In  deciding 
value  of  an  article  for  food,  other  thingu  are  to  be  looked  at  b«?- 
Hde  its  nutritive  qualities.  Those  which  are  poor  in  nitrogen,  are 
i(!h  in  carbon  and  hydrogen,  and  are  well  fitted  to  serve  the  double 
purpost'  of  nourishing  and  warming  the  btxly  at  the  same  time.  Th>^ 
Rtness  of  an  article  for  diet,  depends  very  much  upon  the  ease  or 
iilficulty  with  which  it  is  digested  and  assimilated.  If  an  article, 
laving  a  great  deal  of  nitrogen,  and  being  very  nutritive,  is  with 
jreat  dilficulty  redu<!ed  in  the  stomach  by  the  digestive  process,  it 


h,!l 

■■ '.  ''A 

Mil 


■t'i\ 


m 


■■V 


)  .  •■' 


m 


HYGIENE. 


may  be  much  less  denirable  for  focxl  than  one  which  i»  digested  and 
Hs.<imilated  eanily,  but  is  much  poorer  in  nutritive  qualities. 

Heat-i^eneratlns^  Food  Articles.  —  The  reader  has  before  him  the 
principal  blood  and  tissue-forming  food  articles.  Thoee  which  we 
reckon  as  fuel,  or  heat-generators,  are  chiefly  oils,  sugar,  starch,  farina, 
sago,  arrow-root,  tapioca,  gums,  etc.  These  are  less  essential  than  the 
others ;  for  the  blood-forming  articles  have  within  them  the  elementti, 
out  of  which  fat  is  formed  in  the  process  of  assimilation ;  for  many 
of  them  contain  starch ;  and  this,  in  the  human  organism,  is  changed 
into  fat.  The  amonnt  of  starch  in  some  of  these  articles  is  as  fol* 
lows : 

Wheat  flour,  good  quality,  100,  contains  65  to  66  parts  in  100  pure  starch. 

Wheat, 

Barley  ineal, 

Barley, 

Rye,  -        -        - 

Buckwheat,  - 

Indian  Com, 

Rice,    -        -        - 

Peas,         .        .        - 

White  Beans, 

In  the  Nutritive  Food  Articles,  there  is  a  fixed  relation  existing  be- 
tween the  elements  of  the  tissue-formers  and  the  heat-producers, 
which  they  contain.  Out  of  a  few  of  them  Baron  Liebig  has  con- 
structed the  following  table : 


108 

(t 

53  "  56 

II 

tt 

119 

n 

64  "  65 

tt 

t( 

130 

It 

37  "  87 

It 

K 

111 

(( 

44  "  47 

It 

tt 

108 

<( 

43  "  44 

tt 

t( 

138 

l( 

65  "  66 

It 

ft 

171 

It 

85  "  86 

ti 

II 

tt 

69 

It 

38  "  39 

M 

tt 

It 

59 

tt 

37  "  38 

(( 

It 

II 

For  ever)'  ten  parts  of  blood  and  tissue-formers  there  are,  — 

In  Barley,  10 

In  Rice,  10 

In  White  potatoes,  10 
In  Blue  potatoes,     10 


In  Wheat  flour. 

10 

46 

In  Ilye  meal, 

10     - 

-       57 

In  Oatmeal, 

10 

50 

In  Buckwheat, 

10     - 

•     ISO 

57 
123 

8S 
130 


Diet  a  Complex  Sabjeet. —  From  the  facts  and  tables  now  presented, 
it  appears  that  the  question  of  diet  is  one  of  complexity ;  and  that 
the  determination  of  its  several  points,  require  that  a  number  of  things 
ithould  be  taken  into  the  account.  First,  in  deciding  the  usefulneus 
of  any  article,  we  may  inquire  respecting 

Its  Digestibility. —  If  an  article  be  not  digestible,  it  is  of  little  con- 
sequence how  much  or  how  little  albumen,  starch,  or  nitrogen  it  may 
contain.  The  first  and  most  important  inquiry  respecting  it  is,  is  it 
(tiffestible  ?  If  not,  it  is  to  be  rejected ;  for,  whatever  other  qualities 
it  may  have,  it  can  only  injure  the  stomach,  and  embarrass  the  whole 
system. 

'J'he  following  table  will  be  useful  to  the  reader,  though  I  do  not  | 
set  it  down  as  reliable  in  all  cases.  There  is  often  a  great  diflfercnce 
ill  the  ease  with  which  different  stomachs  will  digest  the  same  iooi 
Many  stomachs  are  afflicted  with  what  is  called  an  idiosyncrasy,— > 
habit,  peculiar  to  itself,  of  rejecting,  or  refusing  to  digest,  some  one, 
or  more,  articles  which  are  acceptable  to  all  other  stomachs.     Thii  | 


HYGIENE. 


69 


table  shows  the  length  of  time  required  for  digesting  the  several  arti- 
cles in  the  stomach  of  St  Martin,  as  shown  by  the  experiments  of 
Dr.  Beaumont : 


Articles. 


Rice 

Pi(^8  feet,  soused  .... 

Tripe,  soused 

Trout,  salmon,  fresh .  . 
It        It  ti 

Apples,  sweet,  mellow 

Venison,  steak 

Sago 

Apples,  sour,  mellow 
Cabbage,  with  vinegar 
CodHsh,  cured,  dry .  . 

E<rgs,  fresh 

Liver,  beef's  fresh. .  . 

Milk 

Tapioca 

Milk 

Turkey,  wild 


"        domesticated 
Potatoes,  Irish 
Parsnips. 


with 


Pig,  sucking. 
Meat    ha.shed 

vegetables f 

Lamb,  fresh 

Goose 

Cake,  sponge    

Cabbage-head 

Beans,  i>od 

'^.(stanl 

Chicken,  full-grown  . 
Apples,  sour,  hani  .  . 

Oysters,  fresh 

Hiuss,  striped,  fresh.  . 
Bi'cf,  fresh,  lean,  rare 

"     steak 

Corn  cake 

Dumpling,  apple.  .  .  . 

Kg'.'i*,  fnisli 

Mutton,  fre&hi 


PreparatlonR. 


Boiled  .... 

Boiled  .... 

Boiled  .  .  .  . 

Boiled 

Fried 

Riivt 

Broiled.  .  .  . 

Boiled 

Raw 

2 

Raw 

2 

Boiled 

2 

Raw 

2 

Broiled. .  .  . 

2 

Boiled 

2 

Boiled 

2 

Raw 

2 

Roasted  .  .  . 

2 

Boiled 

2 

Roasted  .  .  . 

2 

Baked  

2 

Boiled 

2 

Roasted  .  .  . 

2 

Warmed.  . 

Broiled.  .  . 
Roasted  .  . 
Baked  .  .  . 

Riiw 

Boiled  .  .  . 
Baked  .  .  . 
Fricsisseed 

Raw 

Raw 

Broiled.  .  . 
Roa.sted  .  . 
Broiled.  .  . 
Baked  .  . . 
lioiU^d  .  .  . 
Boiled  soft 
Broiled.  . 
Boiled  .  .  . 


Time. 


h.  m. 


30 
SO 
30 
35 
45 


15 
18 
25 
30 
30 
30 
30 

2  30 


30 
30 
30 
30 
30 

4.T 

45 
50 
55 


Artielea. 


Pork,  recently  salted 

Soup,  chicken 

Oysters,  fresh 

Pork,  nscently  salted 

Pork  steak 

Corn  bread 

Mutton,  fresh 

Carrot,  orange 

Sausage,  fresh 

Beef,  fresh,  lean,  dry 
Bread  wheat,  fresh.  . 

Butter 

Cheese,  old,  strong .  . 
Eggs,  fresh 


PreparationB. 


Time. 


ti.  m. 


Flounder,  fresh. . .  . 

Oysters,  fresh 

Potatoes,  Irish  .... 

Soup,  mutton 

"     oyster 

Turnip,  flat 

Beets 

Corn,  green,  and  beans 
Beef,  fresh,  lean . .  . 
Fowls,  domestic  .  .  . 


Veal,  frtish 

Soup,   beef,  vegeta- ) 
bles,  an<l  bread  .  .  J 

Salmon,  salted 

Heart,  animal 

lieef,  old,  hard,  salted 
Pork,  recently  salted 
Cabbage,  witli  vin»'gar 

Ducks,  wild 

Pork,  recently  salted 

Suet,  mutton 

Veal,  fresh 

:Pork,  fat  and  lean  .  . 
Suet,  beef,  fresh  •  ■  .  . 
iTendon i  Boiled 


Raw 

3  — 

Boiled 

3  — 

Roasted  .  . . 

3  15 

Broiled.  .  .  . 

3  15 

Bniled 

3  15 

Baked  

3  16 

Roasted  .  .  . 

3  15 

Boiled 

3  15 

Broiled.  .  .  . 

3  20 

Roasted  .  .  . 

3  SO 

Bake«l 

3  SO 

Melted 

3  30 

Raw 

S  SO 

Hani  boiled 

3  30 

Frie<l 

3  30 

Fried 

3  30 

Stewed.  .  .  . 

S  SO 

Boiled 

3  30 

Boiled 

3  SO 

Boiled 

3  30 

Boiled 

3  30 

Boiled 

3  45 

Boiled 

3  45 

Fried 

4  - 

Boiled 

4  — 

Itoasted  .  .  . 

4  — 

Broiled.  .  .  . 

4  — 

Boiled  . 

Boiled  . 
Fric.l .  . 
lioilcd  . 
Fri(Ml .  . 
Boiled  . 
Roasti'd 
Boiled  . 
Boiled  . 
Fried .  . 
Roasted 
Boiled  . 


4  — 


15 
15 
30 
30 
•t  30 


30 
30 


t)  15 
5  SO 
r,  30 


This  table  may  be  considered  as  giving  a  gptn'ral  idoa  of  ihv  rela- 
tive digestibility  of  the  food-articles  contained  in  it.  If  not  fotmd 
exactly  right  in  each  individual  case,  it  can  be  rectified  by  experience. 
The  experience  o*"  no  other  individual's  stomach  will  ever  be  found 
precisely  like  that  of  St.  Martin's,  —  though  in  its  general  features,  it 
may  be  suiHcicntly  similar  to  make  his  valuable.  The  general  prin- 
ciples of  conduct  may  be  learned  from  the  experience  of  others.  The 
particular  application  must  come  from  our  own  experience  and  reason. 

OifestlUllty  Influenced  by  Amount. — The  rapidity  with  which  any 


'  ir'-f^ 


r^  ;■..(; 


,  H 


i     '■»■'- 


ii 


|:-^l.    mII 


article  is  digested  will  vary  with  the  amount  taken.  A  larger  quan< 
tity  than  is  called  for  by  the  wants  of  the  system,  will  be  digested 
more  slowly  than  the  proper  amount ;  while,  on  the  other  hand,  an 
insufficient  supply  begets  an  inability  to  reduce  in  the  stomach  even 
the  small  quantity  taken.  We  may  err  in  taking  too  little  food  ait 
well  as  in  taking  too  much  ;  though  the  former  error  is  much  le»s 
likely  to  occur  than  the  latter. 

Chooslii<i^  Food  ill  III  Health.  —  But  in  deciding  the  kind  and 
amovni  of  food,  we  must  be  guided  not  only  by  its  digestibility,  but 
by  the  state  of  the  health. 

If  we  find  the  stomach  apparently  in  good  working  condition,  capa- 
ble of  dissolving  proju'rly  whatever  is  submitted  to  its  action,  and 
yet  we  are  for  some  cause  losing  flesh  and  strength,  we  should  resort 
not  only  to  the  most  nut.-itious  of  the  albuminous  group  of  the  azo- 
tized  artii  les,  but  likewise  to  the  oleaginous  group  of  the  non-azotizeiL 
We  wan^.  a  great  amount  of  imtriment,  and  we  need  oils  to  make  fat. 
This  is  the  kind  of  ,food  generally  wanted  in  constitutional  consump- 
tion. 

In  fevers,  but  little  food  can  be  disposed  of  at  best ;  and  that  little 
must  be  chosen  with  reference  to  its  mildness  and  its  unstimulating 
(|ualities.  Generally  the  farinaceous  or  starchy  articles  are  most  suit- 
able, because  they  have  no  stimulating  and  irritating  qualities,  and 
especially  because  they  furnish  fuel  to  be  burned  with  oxygen,  and 
thus  take  the  place  cf  the  animal  tissues,  which  are  being  rapidly 
c'onsumed  with  this  devouring  element.  In  fever,' oxygen  is  literally 
burning  up  the  body.  In  this  state  of  the  syst^'m,  this  element  ao 
quires,  by  some  means,  a  singular  affinity  for  the  tissues;  and,  uniti  .g 
with  them  rapidly,  forms  a  true  combustion.  The  physician  who 
throws  to  this  devouring  agent  some  of  the  mild,  non-azotized  articles 
which  oH'er  it  stronger  affinities  than  it  finds  in  the  tissues,  is  as  wise 
as  he  who  tosses  his  dog  to  a  hungry  lion  to  avoid  being  devoured 
hims<>lf. 

Exercise  to  be  CoiLsidereil.  —  In  deciding  the  diet,  the  amount  of 
exercise  is  not  less  important  to  be  considered  than  the  health.  The 
farmer,  who  works  in  the  open  air,  and  uses  his  muscles  a  great  deal, 
wants  considerably  more  nutritive,  as  well  as  more  combustive,  food 
than  one  who  leads  a  sedentary  life.  Of  course  there  is  a  great  deal 
more  waste  of  the  tissues,  and  he  requires  more  of  the  flesh-forming 
articles ;  and  as  he  breathes  deeper,  and  tak'js  in  more  oxygen,  he 
needs  more  of  the  supporters  of  respiration,  —  the  sugars,  oils,  and 
starchy  aliments. 

Beans.  —  By  ttirning  to  the  table  which  shows  the  amount  of  nitro- 
gen in  the  different  food-articles,  the  reader  will  see  that  beans  are 
rich  in  this  <?lement.  They  are,  therefore,  excellent  food  for  working 
men,  who  are  obliged  to  make  great  use  of  their  muscles.  Our 
fathers,  who  broke  and  subdued  the  rocky  soil  of  New  England, 
showed  wisdom  even  in  their  instincts  in  taking  so  large  a  portion  of 
their  aliment  from  the  bean,  —  especially  as  they  oiled  it  with  the  fat 


HYGIENE. 


71 


of  pork.  But  for  the  hard-working  student,  who  daily  makes  heavy 
drafts  upon  his  brain  and  nervous  system,  btians  and  peas  are  an  im- 
proper diet.  They  contain  no  phosphorus,  in  the  shape  of  phosphate 
of  lime  ;  and  no  brain  can  work  hard  without  a  due  supply  of  phos- 
phorus, which  forms  a  part  of  its  substance. 

Unbolted  Wheat  Flour.  —  For  the  man  who  uses  his  brain  a  great 
deal,  there  is  no  other  one  article  of  food  equal  to  bread  made  from 
unbolted  wheat  flonr.  Fine  wheat  flour  is  little  better  for  him  than 
beans,  because  the  miller  has  robbed  it  of  much  of  the  phosphorus, 
which  is  found  cliiefly  in  the  hull  or  bran. 

I  mention  only  two  or  three  articles  of  food  as  specimens.  By 
looking  over  the  tables  furnished,  and  reasoning  upon  the  whole  in 
the  way  I  have  done  upon  these  few,  the  reader  can  give  every  article 
something  like  its  proper  value  in  most  circumstances. 

Climnte. —  If  health  and  exercise  should  influence  us  in  choosing 
the  kind  and  the  amount  of  food,  climate  must  do  so  quite  as  much. 

In  the  frigid  climate  of  high  latitudes,  it  is  necessary  that  a  great 
deal  of  heat  be  produced  in  the  botly,  in  order  to  avoid  perishing  with 
cold.  There  is  no  mystery  now,  as  there  once  was,  about  the  produc- 
tion of  this  heat.  It  comes  from  the  burning  of  carbon  and  other  sub- 
stances in  the  body,  where  they  unite  with  oxygen,  and  make  just  as 
real  a  fire  as  that  wliich  warms  our  houses.  Oils,  sugar,  starch,  gums, 
etc,  are  largely  com|X)sed  of  carbon,  and  readily  unite  with  oxygen 
in  the  body.  This  is  the  reason  why  they  are  reckoned  as  fuel,  and 
are  called  supporters  of  combustion.  And  for  this  reason,  they  require  to 
be  largely  consumed  in  very  cold  climates.  The  instincts  of  men  seem 
to  lead  to  the  same  conclusion,  for  the  dwellers  in  all  high  latitudes, 
consume  great  quantities  of  oils  and  fats.  The  aniount  of  train  oil, 
tallow,  the  fat  of  seals  and  other  animals,  devoured  by  the  Laplanders, 
Kamtschatkians,  and  other  northern  people,  is  truly  wonderful. 

In  hot  countries,  the  fundamental  rule  for  preserving  the  health,  is 
to  keep  the  body  cool.  Without  observing  this  rule,  the  strongest  will 
often  fall  victims  to  the  climate  in  low  latitudes.  But  to  keep  cool, 
of  course  all  the  heat-producing  articles  of  food  should  be  avoided. 
Particularly  all  alcoholic  drinks,  which  are  powerful  supporters  of 
combustion,  should  be  rejected.  Rice,  and  the  various  fruits  form  the 
most  suitable  articles  of  diet. 

The  great  sacrifice  of  life  which  we  have  witnessed  the  last  few 
years  among  the  emigrants  to  California,  has  been  the  result  chiefly 
of  using  ardent  spirits  and  heat-producing  food  while  crossing  the 
Isthmus,  which,  to  a  northern  constitution,  is  much  like  a  vast  oven, 
heated  to  a  temperature  suitable  for  baking  bread.  There  are  few 
persons,  vith  tolecable  health  and  strength,  but  would  safely  endure 
the  ordeal  of  the  Isthmian  passage,  if  they  would  live  light  for  a  few 
days  before  starting ;  and  during  the  passage,  take  only  an  abstemious 
vegetable  and  fruit  diet. 

Kiiyard  Taylor's  Opinion.  —  The  distiuf.uished  traveller.  Bayard 
Taylor,  re|X)rts  that  while  spending  a  few  days  in  a  heated  part  of 


p? 

•'luRi 

1 

'•  vi  ?MI 

^"!'<^-1 

i 

■  . .! 

■1 

I.'    : 


Iv'  '■■l' 


h 


72 


HYGIENE. 


i 


I 


Africa,  he  lived,  as  the  inhabitants  did,  pretty  much  entirely  upon  the 
flesh  of  well-fatted  sheep ;  and  that  he  enjoyed,  meantime,  excellent 
health  and  strength.  From  this  he  concludes  that  animal  food  is  as 
suitable  in  hot  climates  as  in  cold. 

It  is  a  pitAT  a  man  of  such  excellent  parts  as  Mr.  Taylor,  should 
allow  himself  to  rear  so  tall  a  structure  upon  so  narrow  a  foundation. 
That  he  could  live  on  flesh  in  so  hot  a  region,  and  not  be  made  sick, 
only  proves  that  he  has  a  fine  constitution,  and  that  his  health  is  not 
easily  disturbed ;  and  when  he  attempts  from  his  limited  experience 
of  a  few  days,  to  reason  against  the  established  facts  of  science,  and 
against  the  well-attested  Taws  of  life,  he  does  it  evidently  without 
reflecting  that  he  is  in  a  field  of  thought  which  he  has  never  had  oc- 
casion to  cultivate. 

The  great  Jewish  Lawgiver  doubtless  had  a  reason  for  prohibiting 
pork  to  the  Jews.  Whatever  that  reason  was,  the  prohibition  had  a 
wise  bearing  upon  the  health  of  the  people.  Palestine  has  a  hot 
climate,  in  which  pork-fat  is  an  improper  diet. 

More  Fat  in  Winter.  —  It  follows  from  what  has  been  said,  that  a 
more  fatty  as  well  as  stimulating  diet  is  needed  in  winter  than  in 
summer.  But  the  change  should  be  made  gradually.  When  cold 
weather  approaches,  the  food  should  become  more  nutritious  and 
warming  by  little  and  little.  The  exercise  should  likewise  be  in- 
creased. 

Even  the  lower  animals  act  upon  this  plan.  In  the  fall,  squirrels 
eat  nuts,  which  are  full  of  oil,  and  grow  fat  upon  them. 

The  instincts  of  men  move  in  the  same  direction.  It  is  in  the  fall 
that  the  hog,  the  ox,  and  the  poultry  are  killed ;  and  in  the  winter 
that  they  are  largely  feasted  upon  and  enjoyed.  Upon  such  food, 
combined  with  various  sorts  of  starch, -man  fattens  ;  and  a  good  sup- 
ply of  fat,  deposited  in  the  cells,  is  equal,  in  keeping  out  cold,  to  a 
layer  of  cotton  batting,  —  to  say  nothing  of  the  fire  cept  up  within 
the  body  by  the  burning  of  such  fuel.  As  hot  weath  i  comes  on,  we 
gradually  lay  aside  these  fattening  articles  (or  ought  to),  and  return  to 
the  watery  vegetables  and  fruits,  such  as  squash,  string  beans,  straw- 
berries, currants,  etc. 

Few  of  us,  I  apprehend,  would  sufler  from  heat  in  summer,  if  we 
could  persuade  ourselves  to  abandon  stimulating  and  fire-producing 
food,  and  confine  ourselves  pretty  much  to  a  cooling  and  succulent 
diet.  Diarrhoeas  in  sujnmer  are  not  induced  by  eating  whoh^sorne 
vpgetables,  but  by  combining  them  with  large  quantities  of  animal 
^od. 

Tlie  State  of  the  Hind.  —  This  should  by  no  means  be  overlooked 
in  choosing  the  kind  and  the  amount  of  food.  If  we  have  lost 
I'riends,  or  heard  desponding  news,  or  experienced  calamities  of  any 
kind,  we  must  during  the  first  hours  of  the  shock,  or  even  during  the 
first  days,  if  the  affliction  be  heavy,  partake  very  sparingly  of  food. 
The  stomach  is  in  no  condition  to  receive  it.  The  brain  lies  prostrate 
under  the  stroke,  and  the  stomach,  in  sympathy  with  it,  asks  for  a  day 
of  sorrow  and  fasting.     Disturb  it  not. 


I     '!     'il 


HYGIENE. 


73 


Hett-prodoclnf  Food  Incompfttlble  with  Excitement  —  It  is  follv 
to  take  heat-producing  aliment  when  laboring  for  days  under  high 
excitements.  During  political  campaigns,  when  the  blood  of  poli- 
ticians is  at  the  boiling  point,  the  diet  should  be  unstimulating, — 
containing  very  little  animal  flesh,  and  not  nluch  combustive  food. 
Many  a  man  has  died  of  apoplexy,  or  of  heart  disease,  by  putting  on 
the  steam  when  his  blood  was  up.  Whenever  we  have  a  day  oi  un- 
common excitement  to  pass  through,  we  should  always  begin  and 
end  it  with  an  unusual  degree  of  abstinence  as  to  the  amount  of 
food  taken,  and  with  special  care  that  the  articles  be  of  the  lightest 
kind. 

Anner  Demands  Abstinence.  —  Anger  is  a  passion  which  especially 
unfits  the  stomach  for  doing  much  work.  If  it  occur  often,  or  be 
protracted,  but  little  food  should  be  taken.  Those  who  indulge  it, 
have  a  double  cause  for  abstinence.  Both  their  folly  and  their  stom- 
achs call  for  a  fast 

Food  Adapted  to  Diflferent  Periods  of  Life. —  Food  must  vary  in 
different  periods  of  life.  The  infant  needs  a  fattening  diet ;  and  this 
has  been  supplied  in  the  milk  of  the  mother,  which  contains  more 
buifer  (the  fattening  portion)  than  the  milk  of  any  other  animal.  But 
as  fhe  infant  has  much  less  exercise  than  the  young  of  animals,  its  flesh 
is  not  wasted,  and  it  does  not  require  so  much  azotized  food,  that  is, 
the  reader  will  remember,  food  with  nitrogen  in  it.  Accordingly,  it 
will  be  seen  by  looking  at  the  table  on  page  67,  that  human  milk  has 
much  less  of  this  element  than  that  of  the  cow.  As  the  child  grows 
up,  and  begins  to  take  active  exercise,  indoors  and  out,  it  wants  more 
solid  food,  and  teeth  make  their  appearance  to  masticate  or  chew  it. 

In  Youtli  and  Himliood,  the  great  amount  of  exercise  usually  taken, 
calls  for  larger  supplies  of  azotized  aliment,  —  beef,  mutton,  pork, 
fowl,  fish,  wheat  flour,  corn-meal,  rye-meal,  potatoes,  turnips,  peas, 
beans,  etc.  This  is  the  working  part  of  life,  when  the  tissues  are 
rapidly  wasted  by  action,  and  the  Jksh-fornmig  alimeiUs  are  wanted 
to  keep  them  good. 

In  01(1  Ag;e,  the  exercise  is  diminished,  the  blood  circulatt^s  more 
slowly,  and  the  body  grows  cold.  Now  is  the  time  to  resort  to  non. 
azotized  food,  —  oils,  fats,  the  various  kinds  of  starch,  sugar,  and  the 
like.  These  will  furnish  fuel  to  warm  the  sluggish  blood,  and  will 
invest  the  body  with  fat,  which  will  serve  the  purpose  both  of  a  cush- 
ion and  a  garment  Wine,  beer,  porter,  and  distilled  spirits  are  never 
needed  by  young  persons  in  health ;  but  the  aged  are  frequency  bene- 
fited by  them,  if  taken  in  small  quantities.  They  are  chiefly  com- 
posted of  oxygen,  hydrogen  and  carbon,  and  are  properly  ranked  with 
the  supporters  of  combustion.  They  are  likewise  stimulant,  and  add 
to  the  comfort  of  the  old  by  quickening  their  circulation.  Like  tea 
and  coffee,  they  diminish  the  waste  of  the  body,  and  thereby  lessen 
the  demand  for  food. 

The  smallest  amount  of  aliment  upon  which  a  healthy  adult  person 
ever  lived  for  any  length  of  time,  was  twelve  ounces  a  day.     Upon 


I  j 


1 


74 


HYGIENE. 


this  small  daily  allowance,  Lewis  Cornaro,  a  noble  Venetian,  Bub- 
sisted  in  perfect  health,  during  the  protracted  |M!riod  of  fifty-eight 
years.  'Hiis  he  was  able  to  do  only  by  adding  daily  to  his  food 
about  twelve  ounces  of  light  wines.  I  shall  have  occasion  to  refer  to 
this  case  again. 

Goat  of  Food. 

One  other  consideration  must  ever  influence  the  great  majority  of 
men  in  selecting  their  food.  1  mean  its  cost.  It  is  a  matter  of  great 
importance  to  the  juior,  to  know  what  kinds  of  food  tiu'v  eiin  subsist 
upon  with  least  expiMise.  For  the  last  few  years  provisions  have  been 
BO  high,  that  jiersons  in  p(M)r  circumstances  greatly  need  advice  iti 
this  matter.  Let  me  «'ndeavor  to  furnish  some  informiition  which 
shall  be  of  service  to  the  reader. 

Nilk  is  supplied  by  nature  to  be  our  first  food,  and  is  a  good  type 
of  all  alimentary  substances.     It  contains  vm.M. 

curd,  which  has  nitrogen,  and  is  equivalent 
to  albumen  and  fibrine,  and  represents  the 
blood-formers.  It  has  butter  and  sugar. 
These  represent  the  heat-formers.  It  has 
salts,  which  contain  potash,  soda,  phospho- 1 
rus,  etc.  Figure  64  is  a  microscopic  view 
of  good  milk ;  Figure  65,  of  poor  milk ;  and ' 
Figure  66,  of  milk  adulterated  with  calf's 
brains. 

Food  will  be  valuable  in  proportion  as 
it  combines,  in  due  proportion,  the  articles 
contained  in  the  four  groups,  represented  by  albumen,  fat,  svgar,  and 
sails. 

Fio.  66.  Fio.  as. 


Albuminous  Group. —  Albumen,  fibrine,  casein,  gluten,  and  lugu- 
min,  all  enter  into  the  substance  of  animal  and  vegetable  bodies,  and 
are  all  composed  of  the  same  elements,  namely,  48  parts  carbon ;  36 
of  hydrogen  ;  14  of  oxygen ;  and  6  of  nitrogen.  In  containing  nitro- 
gen they  all  differ  from  the  other  three  groups.  Albumen  being  a 
good  type  of  them,  they  are  called  albuminous  compounds.     Albu- 


IlYfJIKNK. 


75 


men  forms  a  large  portion  of  the  »crum,  or  colorless  part  of  the  blood. 
It  is  tlic  leading  principle  in  alimentation.  It  is  worked  up  into  the 
tissues  of  our  bodies.  It  forms  our  muscles,  our  membranes,  a  por- 
tion of  our  nerves,  etc.  It  is  the  bricks  of  which  the  house  we  live 
in  is  made.  All  the  articles,  therefore,  which  are  chemically  consti- 
tuted like  it,  may  well  be  termed  albuminous. 

These  IxKlies,  consisting  of  the  four  organic  elemettts  named  above, 
have  been  called  (/vulcrnari/  conif/ouiuls.  Beside  these  elemt^nts,  they 
have  a  minute  portion  of  sulphur  and  phosphorus.  It  has  been  as- 
sumed that  these  compounds  contain  a  eouunon  principle  called  pro- 
leine ;  and  hence  they  have  been  called  proleintu'eous  comftourids.  It 
is  doubtful  whether  such  a  principle  can  be  obtained. 

All)uriien  is  a  very  unstable  compound,  —  tending  strongly  to  de- 
composition. This  is  owing  to  the  complexify  of  its  composition, 
and  to  its  union  with  the  fickle  element,  nitrogen,  which  forms  chemi- 
cal compacts  reluctantly,  and  breaks  them  without  reuiorse.  Sub- 
stances which  coagulate  or  fix  albumen  in  an  insoluble  compound, 
or  preserve  the  tissues  of  the  body,  which  are  made  from  it,  from 
decomposition  or  putrefaction,  are  called  antiseptics. 

Futfy  Oroiip.  —  The  next  group,  represented  by  fat,  perforn  »^ery 
important  olliees  in  tlu*  system,  —  the  most  important  of  which,  is  a 
union  with  albumen  in  the  formation  of  cells.  All  animal  and  vege- 
table life  begins  with  the  cell, —  the  tiny  cup,  with  which  nature  dips 
all  the  streams  of  life  out  of  the  great  fountain  of  inorganic  matter. 
No  cell  is  formed  without  a  minute  particle  of  oil.  The  |)ortion  not 
used  in  forming  cells,  is  either  burned  as  fuel,  to  keep  us  warm,  by 
uniting  with  oxygen,  or  it  is  stored  away  in  the  cellular  tissues,  adcling 
to  the  bulk  of  tlie  person.  If,  then,  the  very  beginnings  of  liie  are 
dependent  upon  fat,  it  is  of  great  importance  as  an  article  of  diet.  So 
necessary  is  it  in  the  economy  of  life,  that  when  not  taken  in  the 
food,  it  is  formed  out  of  albumen  in  the  processes  of  assimilation. 

Tlie  Starch  anil  Kuitur  firoup,  composed  of  several  kinds  of  sugar, 
gum,  etc.,  is  never  used  in  forming  the  tissues,  but  they  perform  im- 
portant offictes  in  the  changes  going  on  within  the  human  organism. 
Thus,  sugar  of  milk  is  decomposed,  and  forms  lactic  acid,  so  cailed 
from  being  found  in  sour  milk.  This  acid  plays  a  very  im|K)rtant 
part  in  the  process  of  nutrition. 

Pure  starch  is  a  snow-white  powder,  having  a  glistening  aspect.  It 
is  composed  of  grains  from  jjij  to  gf^j^  of  an  inch  in  diameter  in  the 
different  grains ;  being  largest  in  the  potato,  and  smallest  in  wheat 
When  examined  with  the  microscope,  they  appear  as  in  Figure  63. 

The  Salts  Oroup  are  sulRciently  spoken  of  in  another  place. 

A  wise  philosopher  in  ancient  time  said,  "  I  do  not  live  to  eat  and 
drink  ;  I  eat  and  drink  to  live."  If  we  intend  to  cat  io  live,  we  must 
combine,  in  our  food,  the  four  groups  above  explained  ;  and  if  we 
would  live  at  as  small  expense  as  possible,  we  must  take  those  articles 
which  are  low  in  price,  and  rich  in  nutritive  matter.  The  following 
table  will  help  the  reader  make  his  selections : 


i 


■,^- 


w 
■Mr 


,.  ri" 


i'.^'   r, 


Thble  of  the  rdative  value  of  artieleii  of  food  arranged  according  lo  their  proportione  of 
nvUriml  matter  in  each  of  the  four  groups  of  dementi  concerned  in  vital  change: 


In  100  pounds  of 


Grainh. 

Wheat 

Barley  .... 

Oatfl 

Rye 

Indian  Com 

Buckwheat. 

Rice 

Pod  Plants. 

Beans 

Peas 

Roots. 

Potato 

Turnip  .... 

Carrot 


Beet  (mansold  wurtzel). 


Long  re( 
Short  red  . 
Sugar  beet 

Parsnip.  .  .  .  , 
Lkaf. 

Cabbage ... 


Mkal. 

Wheat  flour 


Rye  meal 


Barley  meal 
Oat  meal.  .  . 
Wheat  bran 


la 


4 


1 

a 


15 
15 
16 
12 
14 
15 
13 

14 
14 

75 
88 
8ft 
85 
85 
85 
85 
80 


10.33 


14.50 

14 
14 
13.1 


15 

15 

20 

10  to  20 

6 
25 

8 

8  to  11 
9 

4 

2 

3 

2 
3.03 
3.31 

2 

li 


4.63 


55 


10  to  19 
12  to  15 
14  to  19 
10  to  15 
12 

8 

7 

24  to  28 
24 

2.0 

1.5 

1.5 

2 

0.48 

0.26 

2.5 

SO  to  35 


9.70 


8.97 

14 
18 
19.3 


2to4 

2  to  3 
5to  7 

3  to  4 
5  to  9 

0.4 
0.7 

2  to  3 
2.1 

0.3 
0.3 
0.4 


0.35 


2 
6 
4.7 


I 


55 
60 
60 
60 
70 
50 
75 

40 
50 

18 

9 

10 

11 

10.86 
12.46 
13 
16 


68  Starch 
5.85  Sugar 
4.12  Gum 
66..54  Stch 
2.56  Sugar 
9.40  Gum 

68 

62 
.6 


2 
3 
4 
2 

li 
4 

04 

8 

3 

ItolJ 

i  to  4-5 

1^  to  2 

i  tol 

U 
.75 


2 
2 
7.3 


'I'he  following  tables  have  an  admirably 
economy  in  food : 


practical  bearing  upon 


100  Iba. 


Barley, 

Beans, 

Beets, 

Buckwheat, .  .  .  . 

Carrots, 

Com, 

Oats, 

Peas, 

Potatoes, 

Turnips  (field), . 
Do.  (Swedish), . 
Wheat  Flour,  . 
Wheat  Bran,  .  . 

Cheese,* 

Cheese,'!' 


Muscle- forrniug 

Elements, 

in  lbs. 


•  Whole  milk. 


t  Skim-milk 


14 
26 

2 

8 

li 
12 
17 
24 

2 

11 
18 
28 
45 


Fat-forming 

Elements, 

in  lbs. 


64 
42 
12 
54 
10 
77 
66 
52 
19 

9 
12 
79 

6 
27 

6 


KelHtivv  I'rouor 
tiou  of  eacii, 
in  IbH. 

1  to  44 
1  to  ll 
1  to  6 
1  to6| 
1  to6| 
1  to  64 
1  to4 
1  to  2| 
1  to  94 
1  to  6 
1  to  54 
1  to  7 
1  toi 
1  to  1 
1  to| 


lIuRkr,  or 

Wo«)dy  flbre, 

in  Ibg. 

"15 

10 

(?) 
25 

S 

6 

20 
8 

4 
2 
2 

55 


3S^ 


HYOIEinL 


ArtMM. 

Barley, 

Beans, 

Corn, 

OaU 

Peas, 

Potatoes, 

Turnips, 

Flour  ffine), .  .  .  . 
Flour  (unbolted). 


Cost. 


tl  &0  per  bu. 


50 

1  10  •♦ 
68  •' 

2  00  " 
1  50  " 

60  " 
13  Owporbbl. 

11  00  « 


HiiMle-praduetiig 
RlMoraU. 


8.4 

16.6 

6.7 

S.3 

14.S 

1.6 

1.3 

83.0 

24.8 


TbT 


77 

Cost  oriliMelc-prodiMh 
iiiK  Ktommils. 


18o.  per  lb. 

lAo. 

16ic. 

ISc. 

I4c. 

94c. 

410. 

54c. 

44c. 


u 
tt 


These  tables  will  well  repay  study,  for  their  practical  use  will  Have 
many  dollan)  to  the  poor.  Ijct  it  be  remembered  that  producing 
muscle  is  the  Hame  thing  as  producing  strength,  or  labor  jMwer. 
Bearing  this  in  mind,  the  following  table  will  be  very  interesting: 

One  pound  of  labor-power  from  Potatoes  costs  94c.  per  lb. 

"      Fine  Flour,      54c.      " 


<t 

Ik 

tt 

tt 

It 

it 

tt     ■ 

tt 

M 

tt 

tt 

tt 

(i 

tl 

•t 

tt 

11 

l« 

tt 

tl 

M 

tt 

tt 

tt 

M 

tt 

tl 

tt 

«1 

tt 

tt 

tt 

Uunlmltud  do.  44c. 

tt 

Turnips, 

41c. 

It 

Barley, 

18c. 

It 

Corn, 

17c. 

tt 

Beans, 

15c. 

tl 

Peas, 

14c. 

It 

Oats, 

13c. 

It 

Heats  are  omitted  in  the  table.  So  far  as  their  imtritive  qualities 
arc  concerned,  it  is  of  little  consequence  which  are  taken.  Some  are 
more  digestible  than  others,  and  this  consideration  should  influence 
those  with  weak  stomachs  in  selecting.  Every  person,  of  course, 
knows  their  relative  cheapnes.s. 

Among  the  vegetables  given  in  the  table,  there  is  a  wider  range  for 
choice.     Let  us  consider  them  in  course. 

Wheat.  —  In  thi.s,  the  four  groups  are  represented  in  excellent  pro- 
portion. When  not  deprived  of  the  bran,  it  is  perhaps  the  very  best 
supporter  of  animal  life.  So  high  have  been  the  regards  of  men  for 
it^  and  so  generously  have  they  awarded  to  it  their  acknowledgments, 
that  its  product,  bread,  has  been  everywhere  called  "  the  staff  of  life." 
It  is  unfortunately  held  at  a  high  price.  My  hope  is  that  the  immense 
prairies  at  the  West,  adapted  to  its  culture,  will  yet  furnish  it  in  such 
profusion  as  to  bring  it  within  the  means  of  all. 

Barley.  —  This  has  the  four  groups  represented  in  nearly  the  same 
proportions  as  wheat.  It  is,  therefore,  nearly  as  valuable  an  alimen- 
tary grain.  Unfortunately  it  is  not  so  toothsome  as  wheat,  and  can 
never  be  so  popular  an  article  of  diet.  The  Scotch,  however,  feed 
upon  it  with  apparent  relish,  and  doubtless  think  it  strange  that  for- 
eign palates  are  not  better  pleased  with  it. 

Oats.  —  This  grain,  strange  to  say,  has  more  albuminous,  or  nutri- 
tive matter,  more  fat,  more  starch,  and  more  salts  than  wheat  In 
uniting  a  large  quantity  of  the  four  alimentary  groups,  it  surpasses 
every  other  vegetable  substance.     In  albumen,  it  is  not  quite  as  rich 


•■.  'I. 


■  i 


■'■S 


Ml 


.c'  <  il 


)l 


ar.  pea»  and  bcanH,  au<i  in  starch  il,  falls  a  trifl<>  below  fine  wheat 
flour ;  but.  in  fat.  it  is  cxeefdi'd  only  t»y  Indian  corn.  'I'his  grain  is 
likewise  eonsoeried  Ipr^ely  by  the  ScotAth,  —  a  people  whose  claims  to 
shrewd  connnon  s«'i»se  are  well  supported  by,  as  their  hardy  eoiisti- 
tntion.-i  vindicate,  the  chi  lee.  This  grain  might  well  be  pertnitted  to 
lake  the  place  of  riee.  Jt  aftords  several  times  as  much  nutriment, 
while  it  costs  only  aluMit  one-iifth  as  much.  There  is  good  reason 
why  the  horse  should  thriv(>  Uj)oti  oats.  Most  stable-ket'pers  think 
their  i)(»rsrs  will  do  more  work  upon  torn-meal,  but  this  nujst  be  a 
mistake.  In  using  oats  ftir  horse-feeding,  a  large  portion  of  the  nu- 
triioeut  is  lost  by  not  g-riudin^  +hem. 

Ryt'.  —  This  ia  also  a  grain  of  considerable  nutritive  value.  It  is 
msKij  cheaper  than  wheat;  and  rye  meal  has  long  been  a  standard 
arricle  of  diet  in  Xew  Knghuid,  —  pf.i-licularly  in  connectiorj  with 
Indian  meal,  as  •'  brown  bread."  It  is  us<'fnl  for  relieving  costivencss, 
in  Ih'   form  of  "hasty-pudding,''  with  molassesj. 

Iiid!iin  <'oni.  -  This  staple  article  of  American  produce  needs  no 
praise  from  me.  It  is  tiomparativeiy  cheap,  nutritive,  arid  wholeaoiric. 
It  abounds  in  fat  and  starch,  and  has  a  fair  amount  of  albumen, 
though  not  as  much  as  the  oat,  the  barley,  or  the  wheat.  In  salts,  it 
is  rather  deficient.  Indiiui  corn  is  strictly  an  Amerit^an  plant,  and  is 
perhaps  the  most  j)opular  grain  in  the  country.  It  has  emphatically 
a.  national  reputation,  and  is  perhaps  work(xl  n|)  into  more  savory 
dishes  than  any  other.  At  the  Soiith  it  is  an  institution.  It  is  there 
made  intti  lax;  cake,  corn  cake,  batter  cakes,  batter  bread,  mudins,  corn 
pone,  et<;.  At  the  North,  we  have  jonny  cake,  Indian  and  pumpkin 
cake,  baked  Indian  pudding,  boiled  Indian  pudding,  beside  the  well- 
known  rye  and  Indian  bread,  and  other-  preparations,  CJive  an  i;i- 
genions  Southern  or  Northern  housewife  a  few  simple  adjuncts,  sut-h 
ab  lard,  milk,  sugiir,  eggs,  cream  of  tartar,  and  soda,  and  she  will 
make  a  pretty  respectable  larder  frcna  this  single  grain.  If  mola.-ses 
be  substituted  for  sugar,  and  a.  little  stewed  pumpkin  be  thrown  in 
by  way  of  garniture,  we  may  have  several  preparations  which  are 
very  nourishing  as  well  as  clu-ap. 

ilUf^Kwheilf. —  Poor  in  nutritive  matter,  fat,  starch,  and  sugfir,  buT 
tolerably  well  supplied  with  salts.  It  will  do  very  well  for  batu  i 
ctjkes  in  winter.  Whi'U  brought  smoking  up^^n  the  table,  and  servi-o 
with  sugar  or  mola-sHcrt  and  i)urter,  these  'lakcii  are  a  luxury,  in  which 
the  rich  may  indulge  if  dtey  choose  ;  but  for  the  poor,  the  amount  (J. 
nourishment  they  afford  is  too  small  for  their  corft. 

Jllee.  —  Much  lik;  buckwheat,  except  that  it  has  more  fat,  s  gar, 
and  s'arch,  and  less  salts.  As  an  article  of  diet,  it  has  had  too  liigii 
areputalion.  Those  who  would  live  on  small  means  cannot  afford  it. 
Boiled  in  plain  vater,  it  is  excellent  for  a  rela.xed  state  of  tlu'  bowels ; 
and  this  is  about  all  the  comme.idation  to  which  it  is  entitled. 

IkuJiS.  —  The  richest  in  nutritive  matter  of  all  vegttable  substan- 
ces, except  cabbage  and  oats.     They  have  more  albumen  than  wheat, 


IlVr.iKNE. 


79 


or  I'orn,  or  barloy, or  oats;  but  in  fat  and  starch,  iliry  are  lowor  in 
the  scale.  Add  to  thciri  salt  pork",  and  the  liighcst  of  all  nutrient 
compounds  is  obtained.  During  not  less  than  four  generations,  pork 
;uu!  l)eans,  as  the  principal  dii't,  nourished  an  iron-sided  rac«'  of  nieii 
ill  New  I^jngland,  Bean-porridge  was  like  honey  U|K)n  the  tongue  of 
the  f«)unilers  of  N«nv  England  institutions.  They  ate  it  morning, 
)u>oM,  and  night;  and  thanked  God  for  it  every  time.  And  well  they 
ji;i^ht  thank  Him;  for,  with  Indian  corn,  it  furnished  them  with  a 
dirt  better  adapted  to  their  condition  than  any  other. 

IViis. —  Not  quite  as  rich  as  beans  in  albumen,  but  more  rich  in 
starch  ;  of  about  the  same  value  on  the  whole.  The  Canadian  French 
III  liowcr  Canada,  feed  on  peas  to  about  the  same  extent  that  the 
New  Kiiglanders  did  on  bv,'ans.  Pea-soup,  as  prepared  by  the  best 
i«)oks  among  them,  is  a  dish  of  great  nutritive  .  rcellence ;  and,  in 
my  judgment,  more  palatable  than  bean-soup. 

Tlie  Potato.  —  Three-quarters  of  this  root  is  water,  and  it  is  poor 
in  all  the  elements  of  nutrition.  It  is  a  palatable  article,  and  most 
|)<Tst)ns  are  nuich  attached  to  it.  As  bulk  is  of  some  consequence  in 
food,  the  potato  is  not  without  value;  but  should  the  disease  with 
which  it  has  been  tormented  for  several  years,  finally  exterminate  it, 
the  loss  to  the  world  would  not  be  so  great  as  many  suppose.  Men 
do  not  often  live  entirely  upon  jwtatoes, — not  even  in  Ireland.  Milk, 
butter-milk,  and  especially  cabbage,  are  united  with  them. 

T»niip8,  Carrots,  Beets,  Piirsuips.  —  These  are  much  alike,  —  being 
all  |KX>r  in  nutritive  qualities.  They  serve  to  please  the  palate  by 
furnishing  a  variety ;  but  in  our  city  markets,  they  are  expensive,  and 
do  not  furnish  an  economical  diet. 

Cabbage. —  It  is  interesting  to  observe  how  the  instincts  of  me« 
have  in  all  ages  led  them  to  select  those  articles  of  diet  which  their 
circumstances  have  demanded.  The  poverty  of  the  Irish  has  led 
th(?m  \o  subsist  largely  upon  the  potato, —  a  root  which  the  soil  of 
their  country  yields  profusely.  But  as  this  root  has  but  little  nutritive 
matter,  necessity  required  that  it  should  be  united  with  some  other 
vegetable.  The  natural  instinct  selected  the  cabbage ;  and  when 
cheviiieal  science  came,  at  length,  to  pass  judgment  upon  the  correct- 
ness of  this  instinc:t,  it  turns  out  that  the  cabbage  is  the  richest  in 
albumen  of  any  known  vegetable.  -The  cabbage,  then,  is  the  natural 
eoinplement  of  the  potato;  and  the  Irish  had  the  sagacity,  without 
K'iiujce,  to  bring  the  two  tog(!ther.  It  is  said  the  Irish  have  a  dish 
iiain<'d  "kohl-cannon,"  consisting  of  boiled  and  mashed  potatoes  and 
cabbage,  seasoned  with  pork  fat,  pepper,  and  salt,,  and  that  it  is  a 
truly  savory  dish.  It  certainly  is  a  nourishing,  and  a  cheap  one.  The 
ambassador  who  was  sent  to  tamper  with  the  patriotism  of  a  Roman 
who  had  dined  on  beans,  was  asked  if  he  was  silly  enough  to  think 
^o\i\  and  silver  could  bribe  a  man,  who  was  satisfied  with  so  plain  a 
lure,  and  desired  no  other.  We  come  tt)  the  eonelnsion,  then,  that 
Ijcan  porridge,  pea  soup,  suet  pudding,  swe<'leiied  with  molasses,  oat 
meal,  and  barley  bread,  with  "  kohl-cannon  "  for  those  who  can  digest 


dO 


HYGIENE. 


it,  will  furnish,  for  hard-working  men,  the  most  substantial  diet^  at  the 
smallest  possible  ex|)ense.  To  render  these  dishes  savory,  and  to 
make  the  table  on  which  they  are  spread  an  inviting  board,  the  deft 
housewife  must  empioy  her  best  skill  in  serving  them.  With  the 
thousand  "  fixings,"  with  which  a  New  England  matron  knows  how  to 
garnish  them  (or  would  know  how  if  they  came  within  her  culinary 
operations),  they  are  well  fitted  to  leave  savory  impressions  u[K)n 
tongues  which  would  praise  them  to  the  end  of  life.  J  speak  of  the»« 
articles  as  furnishing  a  cheap  diet  for  working  men.  The  indolent, 
the  sedentary,  and  the  effeminate  from  various  causes,  could  not 
digest  them. 

The  Amoant  of  Food  Taken. 

We  have  already  explained  that  this  should  be  governed,  in  part, 
by  the  amount  of  exercise  taken,  by  the  condition  of  the  health,  by 
the  state  of  the  mind,  by  the  climate,  by  the  season,  etc.  It  temuins 
to  add  a  few  words,  in  a  general  way,  respecting  the  absolute  amount 
required  by  an  udult  man. 

It  is  plain  enough  that  most  men  eat  too  much.  We  come  very 
near,  in  this  country,  bi'ing  a  nation  of  gorniands.  A  principal  reason 
of  our  over-eating  is,  that  we  eat  so  fast.  Wiien  tlx;  food  is  well  and 
slowly  masticated  and  swallowed,  the  gastric  juice  has  time  to  mix 
with  it;  and  at  the  proper  moment,  the  apjwtite  ceases.  But  wlie/i 
our  food  is  bolted  rapidly,  n.*ture,  finding  her  laws  disregarded,  and 
all  her  purposes  frustrated,  stands  back,  and  lets  us  learn  to  stop,  too 
intc,  alas  I  from  a  sense  of  fulness  ni  a  stretched  and  abused  stomach. 

It  has  already  been  stated,  that  Lewis  Cornaro  lived  lifty-eight 
years,  namely,  from  the  age  of  forty-two  to  one  hnndretl,  on  twelve 
ounces  of  solid  food  a  day,  with  about  the  same  amount  of  light 
wines.  At  the  age  of  eighty-four,  he  wrote  a  book,  in  which  hi-. 
praises  "divine  temperance"  in  terms  which  are  sometimes  eloquent, 
and  often  enthusiastic.  Indeed  it  is  very  rare  that  a  man  at  that  age 
retains  such  clearness  of  intellect,  and  especially  such  freshness  of 
feeling  as  he  evinces  in  his  book.  Probably  but  few  could  live  on  tlie 
amount  of  food  which  he  found  sufficient.  Yet  it  is  said  the  distin- 
guished John  Wesley  lived  on  sixteen  ounces  a  day,  which,  as  he  Uwk 
no  wine,  and  had  to  derive  the  combustive  materials  for  warming  tin* 
body  from  the  food,  was  quite  as  scanty  a  fare  as  that  of  Cornaro. 
Ck)nsidering  that  he  led  a  most  extraordinarily  active  life,  both  of  body 
and  mind,  being  half  his  waking  hours  in  the  saddle,  and  preaching 
almost  daily,  this  is  probably  the  most  remarkable  case  of  abstemi- 
ousness on  record.  Jonathan  Edwards  did  not,  I  think,  exceed  the 
same  amount  of  food,  but  he  was  not  so  active  a  man. 

Putting  aside  such  exceptional  cases  as  these,  we  may  say  in  round 
numbers,  that  a  laboring  man  requires,  to  keep  him  in  health,  about 
two  to  two  and  a  half  pounds  of  solid  food  per  day.  For  minister.", 
lawyers,  doctors,  authors,  and  merchant.-,  one  pound  and  a  half  is 
amply  .'tuflicient.  The  amount  should  bt>  increased  a  little  by  a  se- 
lection from  sofue  of  the  fuel^rmers,  if  no  &>rmeuted  or  alcoholic- 


drinks  be 
is,  that  tl 
to  be  dri> 
nishes  no 
be  had  in 

Dyspepi 

health;  a 
of  a  pers( 
the  in  fori 
sfldoni  b( 
wh.'U.  am 
for  life  is 
it  cries  ft 
enjov  any 
niie":  To 
only  an  oi 


It  has 
subsi.st  oi 
staiieert. 
pliys!  ' 
tabit    ([.> 
that  aniiii 
duly  slim 
rhfKus,  eh 
shortens  I 
this  eoun 
any  othei 
is    not    SI 
enormcus 
cattle  rail 
the  demai 
ket  at  tv 
blood-fon 

Facts  a 
aione,  or 
8ub!<i-it  u| 
ati<.«,  iipo 
nothing, 
looking  a 
both  isjde! 


^1 


HYGIENE. 


81 


drinks  be  taken,  and  slightly  diminished  if  they  are  used.  The  reason 
is,  that  these  drinks  furnish  fuel  to  be  burned  in  breathing,  which  has 
to  be  driwn  fron:  the  food,  when  they  are  not  employed.  This  fur- 
nishes no  motive  for  using"  ardent  spirits  ;  for  there  is  fuel  enough  to 
be  hud  in  the  oils,  starches,  and  sugars. 

Dyspeptics.  —  It  is  said  that  dyspeptics  eat  more  than  persons  in 
health ;  and,  in  many  cases,  the  remark  may  be  true.  The  appetite 
of  a  person  sutTcring  from  this  disease  is  almost  always  morbid,  and 
the  information  it  gives  respecting  the  real  wants  of  the  system,  can 
st'idoin  be  trusted,  if  \vc  allow  a  diseased  stomach  to  dictate  to  us 
wli.'ii.  and  what,  and  how  much  we  shall  eat  and  drink,  our  misery 
for  life  is  a  foregone  question.  A  sick  stomach  is  like  a  spoiled  child, 
it  cries  for  what  it  should  not  have.  If  the  dyspeptic  will  live,  and 
i'iij(»v  any  amount  of  peace  and  comfort,  h^  must  follow  this  simple 
rule  :  To  eat  no  more  than  can  be  digested^  even  thovgh  the  amount  be 
only  an  ounce  a  day. 

Animal  and  Vegetable  Food. 

It  has  generally  been  supposed  that  it  was  intended  man  should 
subsist  on  a  mixed  diet,  consisting  of  both  animal  and  vegetable  sub- 
stanies.  Witliin  the  last  twenty-tlve  years,  however,  a  school  of 
|<iiys'  '  trixtrt  have  ap|)eared  in  this  country,  who  atiirm  that  a  vege- 
tablt  (  is  alone  coii.-iistent  with  \\\v  laws  of  health.  They  declare 
that  animal  footi  is  not  adapted  to  man's  organization,  —  that  it  un- 
duly stimulates  the  blood,  predisposes  to  fevers,  consumptions,  diar- 
rhoias,  choleras,  apoplexy,  and  nnnierons  other  diseases,  and  of  course 
shortens  life.  That  sucli  a  school  should  have  come  into  existence  in 
this  country,  where  animal  food  is  more  largely  consumed  than  in 
any  other  part  of  the  world,  in  proportion  to  the  number  of  people, 
is  Bot  surprising.  We  do,  undoubtedly,  eat  too  much  flesh.  S<? 
enormcns  is  the  ct)nsumption,  that  notwithstanding  the  vast  herds  of 
cattle  raised  in  all  our  agriculture'  states,  the  supply  is  not  equal  to 
the  demand  ;  and  beef,  for  two  yes.rs.  has  been  selling  in  Boston  mar- 
ket at  twen*^  cents  per  pound,-  ,it  least  twice  its  full  value  as  a 
blood-former. 

Facts  show  that  man  may  live  npon  llesh  alone,  upon  vegetables 
alone,  or  upon  flesh  kikJ  vef^^'tubies  combined.  Is  it  best  he  should 
subsist  upon  vegetables  only,  or  upon  a  mixed  diet?  A  mere  alllrm- 
atiije  upon  these  points  is  of  little  consnjueuee.  To  cite  facts  avails 
nothing.  Men  hav*'  a  way  of  making  their  own  atlirinations,  and  of 
looking  at  facts  with  eyes  which  soiin'tim«'s  see  dearly  enough  on 
both  Hides  of  them,  but  totally  ignore  their  existence. 

MjMi's  Mtriicfiii't'  Settle?!  Hie  ^m*Um\.  —  To  settle  this  matter,  we 
must  iipj:)eal  to  mnii's  organization.  His  stn^iure  will  tell  us  some- 
thing we  need  not  mistake.  All  the  worK)*  o(  God  show  design. 
Everythimg  he  has  njade  has  a  use,  and  i*  so  contrived  as  to  be 
adapted  »o  that  use.  Lions,  tigers,  and  otli»'r  annuals  for  example, 
which  f««d  on  flesh  alone,  l«iv^  a  shtrrl  second  stomach,  —  it  being 


t. 


m 


~         '.vl 


t.   I 


I    I 


'  'S\ 


^».:i 


..U 


w^ 


83 


HYGIENE. 


only  about  three  times  the  length  of  the  animal's  body.  Animals 
which  cat  no  flesh,  have  a  long  second  stomach,  —  that  of  the  sheep 
being  from  thirty  to  thirty-five  times  the  length  of  its  body.  A  very 
remarkable  diflerence  of  anatomical  structure  ! 

This  is  the  meaning  of  the  difference :  Vegetable  food  has  a  great 
deal  of  waste  matter  in  it.  Woody  fibre  makes  ijuite  an  item  in  its 
composition.  This  waste  portion  must  all  be  carefully  separated  from 
tiie  nutritive  part,  and  this  must  all  be  done  in  the  second  stomach- 
It  takes  time  to  do  it.  It  must  not  be  done  in  a  hurry.  The  nutritive 
materials  are  destined  to  build  a  living  structure,  whose  duration,  like 
that  of  all  other  fabrics,  will  depend  on  the  care  with  which  the  mate- 
rials are  selected  and  put  together.  The  second  stomach  of  the  sheep 
is  long,  that  there  may  be  ample  time  for  the  mixed  mass  of  chyme 
when  it  passes  out  of  the  first  stomach,  to  be  changed  to  chyle,  and 
then  to  be  carefully  separated  into  the  two  parts,  the  nseful  and  the 
useless.  Animal  food  is  in  its  composition  just  like  onr  own  flesh, — 
there  is  little  waste  matter,  and  not  much  time  is  recpured  for  its  sep- 
aration ;  hence,  the  second  stomach  of  flesh-eating  animals  is  short. 
Nearly  the  whole  alimentary  mass  is  quickly  taken  up  by  the  lacteals, 
and  there  is  no  occasion  for  its  travelling  through  a  long  second 
stomach. 

Man's  second  stomach  is  in  length  midway  between  that  of  the 
flesh-eating  and  the  vegetable-eating  animals.  If  there  be  design  in 
the  works  of  tiie  Creator,  «"id  if  that  design  in  the  structure  of  the 
flesh  and  vegetable-consuming  animals  has  now  been  correctly  inter- 
preted, it  is  plain  that  man  is  best  nourished  when  he  eats  both  kinds 
of  food.  The  structure  of  his  teeth,  and  the  motions  of  his  jaws 
(see  p.  30),  confirms  the  same  conclusion. 

Americans  Eat  too  Much  Meat. —  Yet,  as  I  have  said,  there  is  no 
doubt  the  Americans  eat  too  much  meat.  Sedt'ntary  |)erst)ns  require 
but  very  little.  Less  is  wanted  in  sunnner  than  in  winter,  —  in  warm 
climates  than  in  cold.  People  of  wealth,  whose  circumstances  im- 
pose no  bodily  hardshi|)s,  need  less  than  the  |)oor,  who  are  miuii 
exposed,  and  work  hard  ;  whereas,  they  consume  more.  Those  wlio 
do  not  labor  with  tiieir  hands,  should  never  taste  meat  mor«  than 
once  a  day. 

It  is  4)ainfully-amusing  (if  such  a  componml  word  is  admissil)|<) 
to  hear  a  nervous  female,  whose  sole  o\fr\  ise  c(-iisists  in  goMig  I  Dm 
the  parlor  to  the  kitchen  once  or  twirt-  a  d  ly,  ami  in  milking  a  luitt' 
5ihop|)ing  excursion  once  a  week,  ctMiiplain  that  she  cannot  niaiiituiir 
her  strength  imless  she  eats  freely  twice  a  day  of  meat,  and  takes  her 
free  potations  of  strong  colFee  and  wine, 

A  like  opinion  prevails  generally  among  the  feeble  who  Wf  not 
obliged  to  labor.  The  child  in  its  nojse's  arms,  must  dailv.  it  i* 
thought,  suc-k  a  piece  of  chicken  or  k»^'f  st«-iik  in  order  *o  rhnvf. 
Children  thus  fed,  have  ineir  bUnnl  eons^rantiy  inHained,  »«iu  jsiauU  a 
poor  chance  when  attacked  by  scrrlet  fever.  The  to^  laawc  or 
miss  who  attends  school,  complains  of  headache,  m»^  gTo>\i*  palo, 
feeble,  and  nervous.     The  books  arc  biained  and   oeuwa^  aside  for 


what  the  dishes  have  done.  The  doctor  is  called  in,  and  assured  that 
the  dear  child  can  eat  nothing  but  a  little  fat  broth,  a  custard,  or 
cake;  and  if  he  prescrilM*  a  <liet  of  |)lain  bread  and  milk,  he  is  be- 
lieved to  be  heartless,  and  his  |)rescription  is  not  followed. 

Tlie  Wrtlority  of  Nniikiiid  Eat  no  Flesh.  —  All  such  misguided  per- 
sons should  be  apprized  that  the  great  majority  of  mankind  eat  no  flesh, 
because  they  cannot  afford  it.  And  ttiey  do  not  appear  to  suffer  from 
its  loss.  Millions  of  Irish  do  not  taste  of  llesh  or  fish  from  one  month's 
end  to  another.  Potatoes,  oat  meal,  and  cabbage  constitute  their  chief 
diet  Rice,  poor  as  it  is  in  nourishment,  sustains,  when  combined  with 
vegetable  od,  millions  of  people  in  Asia.  The  Lazaroni  of  Napl»>s 
with  active  and  finely  moulded  forms,  live  oi:  bread  and  potatoes. 
These  facts  do  not  aflord  ground  for  altogether  rejecting  animal  food, 
any  more  than  Bayard  Taylor's  statement  respecting  whole  tribes  in 
Africa  who  live  upon  flesh,  furnishes  a  reason  for  excluding  vegetable 
aliment.  Man  may  live  and  enjoy  health  upon  either,  but  liL*  organ- 
ization implies  the  use  of  both. 

Proportions  of  Animal  and  Vegetable  Food. 

UroN  this  subject,  it  is  impossible  to  fix  any  absolute  rules.  This 
is  a  point  which  must  be  determined  by  the  temperament,  the  state 
of  the  health,  the  constitution,  etc.  Persons  of  a  scrofulous  hnbit, 
should  eat  freely  of  animal  food.  But  an  inflamed  stomach  should 
never  be  tormented  with  flesh.  Meat  is  stimulating,  and  will  l)e  al- 
most sure  to  do  mischief  when  there  is  heat  and  tenderness  at  the  pit 
of  the  stomach.  There  are  cases  of  inllammation  of  this  organ,  ia 
which  it  may  be  necessary  to  live  on  bn'ud  and  milk,  with  articles  of 
the  starch  ffroup,  for  months,  and  even  for  years. 

On  the  other  hand,  when  the  system  has  rim  low  fr<»ni  some  ex- 
hausting disease,  which  excites  no  feverish  action,  it  nuiy  be  necesary 
at  times,  to  take  a  diet  almost  exclusively  animal. 

It  is  absurd  to  talk  of  the  same  diet  as  adapted  to  all  pci>on»,  even 
when  in  health.  As  well  might  we  expect  one  shtx'  to  tit  every  f»*ot, 
or  one  coat  every  back,  or  one  color  every  eye,  or  one  dot-trine  every 
mind. 

Temperance  the  Wain  Tiling. —  After  all,  the  great  thiiu^  to  be 
aimed  at  is  temperance.  It  is  not  so  necessary  to  reject  one  article 
mill  use  another,  as  to  partake  of  all  with  inoileration.  "  1  di»  not 
live  to  eat  and  drink  ;  I  eat  and  drink  to  live,"  said  a  wise  pliiloso 
pher  of  the  olden  time.  One  would  think  the  moderns  had  reversed 
this  rule.  A  imnlern  table  has  the  ap|)earanee  of  being  spread  for  the 
i>ur|x>se  of  inducing  men  to  eat  all  their  stomachs  will  liold.  A  man 
wl'i)  can  dine  daily,  for  half  a  dozen  years,  ai  one  of  our  first  elatw- 
hoteis,  and  then  find  himself  free  of  tlys|)e|»r,ia,  and  all  other  diseases, 
must  have  a  fine  ctmstitution,  as  well  as  iiu>st  iiduurable  control  over 
Ms  ippetite.  Mr.  Aildi^on  said,  "  When  !  iM-hold  a  full  table  set  out 
in  all  its  magnifieeiu-*',  I  fancy  1  see  gout,  ch»)lic,  fevers,  and  lethargies 


'r 


ii  :■:'!!?§ 


/rrj 


84 


HYGIENE. 


lying  in  ambusoadc  among  the  dishes;"  to  which  he  adds,  with  much 
truth,  in  another  place,  "  Abstinence  starves  a  growing  distemper." 

Good  Results  of  Temperance.  —  A  temperate  diet  has  rrlways  been 
attended  with  excellent  results,  and  always  will  be.  There  are  times 
of  great  anxiety,  when  abstinence  should  be  pushed  to  the  extreme 
verge  of  endurance.  During  the  siege  of  Gibraltar,  Liord  Heath- 
field,  its  gallant  defender,  lived  eight  days  on  four  ounces  of  rice  per 
day.  Dr.  Franklin,  when  a  journeyman  printer,  livod  two  weeks  on 
bread  and  water,  at  the  rate  of  ten  pounds  of  bread  a  week,  and  waa 
stout  and  hearty.  Dr.  Jackson,  an  eminent  physician  in  the  British 
army,  says,  "  I  have  wandered  a  good  deal  about  the  world,  and  never 
followed  any  prescribed  rule  in  anything ;  my  health  has  been  tried 
in  all  ways ;  and  by  the  aids  of  temperance  and  hard  work,  I  have 
worn  out  two  armies,  in  two  wars,  and  probably  could  wear  out  an- 
other before  my  period  of  old  age  arrives." 

Lord  Bacon  was  right  in  the  opinion  that  intemperance  of  some 
kind  or  other  destroys  the  bulk  of  mankind,  and  that  life  may  be  sus- 
tained by  a  very  scanty  portion  of  nourishment.  Cornaro,  whom  I 
have  before  mentioned  as  having  lived  fifty-eight  years  on  twelve 
ounces  of  solid  food  a  day,  wrote  as  follows  respecting  himself  in  his 
eighty-fifth  year :  "  I  now  enjoy  a  vigorous  state  of  body  and  of  mind. 
I  mount  my  horse  from  the  level  ground ;  I  climb  steep  ascents  with 
eas(? ;  and  have  wrote  a  comedy  full  of  innocent  mirth  and  raillery. 
When  I  return  home,  either  from  private  business  or  from  the  senate, 
I  have  eleven  grand-children,  with  whose  education,  amusement  and 
songs,  I  am  greatly  delighted ;  and  I  frequently  sing  with  them,  for 
my  voice  is  clearer  and  stronger  now,  than  ever  it  was  in  my  youth, 
in  short,  I  am  in  all  respects  happy,  and  quite  a  stranger  to  the  dole- 
ful, morose,  dying  life  of  lame,  deaf,  and  blind  old  age,  worn  out  with 
intemperance."  Howard,  the  philanthropist,  fasted  one  day  in  the 
week  ;  and  Napoleon,  when  he  felt  his  system  unstrung,  suspended  hia 
meals,  and  took  exercise  on  horseback. 

Nothing  can  be  plainer  than  the  duty  of  fasting,  when  the  stomach, 
having  bevt\  overworked,  is  disinclined  to  receive  food.  Brutes  in- 
variably follow  this  suggestion  of  nature ;  they  never  eat  when  sick, 
—  probably  because  they  have  no  silly  nurses  to  coax  them  to  swal- 
low stimulating  aliments.  The  habit  of  putting  high-seasoned  food 
into  the  stomach  when  it  is  inflamed  and  feverish,  is  about  as  wise 
as  directing  streams  of  blue,  violet,  or  red  light  into  the  eye  when  it  is 
red  and  swollen  with  inflammation. 

Tea  and  Coffee. 

It  is  proper  before  closing  this  chapter  upon  diet,  that  something 
should  be  said  respecting  the  beverages  of  tea  and  cotl'ee. 

Some  twenty  years  ago,  more  or  less,  a  meeting  was  held  by  the 
leading  physicians  of  a  city  in  the  old  world,  in  which  the  merits  of 
tea  and  coffee  were  discussed.  In  this  discussion  each  man  first 
stated   his  experience  in  the   use  of  these   articles,  and  then  con- 


structed 

what  th( 

used  tea 

formly  it 

cofl'ee  sh 

and  fouii 

while  tea 

was  a  be 

—that  r 

them  to 

to  indiilf! 

from  eve 

The  d 

men  who 

miserably 

no  more 

daring  it 

ing  all  m 

The  tri 

of  the  efii 

waste  in 

are  used. 

persons,  I 

not  coflec 

neither. 

is  his  owi 

or  atnios 

iVoiii  exp( 

bilious  iii 

of  tea. 

are  tracer 


I'm  K  RE 

ol  it.     In 
wiiiler,  in 

itoiUiU'll, 

iTpellJiig 
ever  tnan 
either  in 
or  lakes ; 
poriodieal 
ill  nature 
none  mor 

PureU 

•)ofh  in  it 
I'ure  wall 
fluids  is 
will  be  a 
by  this  h 


/rr_ 


HYGIENE. 


85- 


Btructed  his  argument  according  to  that  experience.  The  amount  of 
what  the  reader  could  learn  ''rom  the  discussion  was,  that  Dr.  A.  had 
used  tea  all  his  life,  and  been  benefited  by  it,  while  cofi'ee  had  uni- 
formly injured  him ;  and  that  he  thought  tea  should  be  used,  while 
cofl'ee  should  be  rejected  ;  —  that  Dr.  B.  had  taken  coffee  at  breakfast, 
and  found  it  an  excellent  support  to  the  stomach  and  nervous  system, 
while  tea  had  disturbed  his  digestion  and  his  mind  ^  and  that  tlie  former 
was  a  beverage  of  excellent  (jualities,  while  the  latter  was  detestable; 
—  that  Dr.  C.  had  always  drank  both  tea  and  coffee,  and  recommended 
them  to  everybody; — and  that  Dr.  D.  had  himself  never  been  able 
to  indulge  either  tea  or  coffee,  and  would  have  them  both  expelled 
from  every  liousehold. 

The  discussion  was  not  creditable  to  the  learnetl  and  really  able 
men  who  participated  in  it.  The  arguments  were  all  based  upon  the 
miserably  narrow  basis  of  single  indiviilual  experiences.  They  were 
no  more  valid  than  that  of  the  man  who  should  hold  up  a  shoe,  de- 
claring it  fitted  his  foot  the  best  of  any  he  ever  had,  and  recommend- 
ing all  men  to  have  their  shoes  made  upon  the  same  last. 

The  truth  is,  there  is  but  one  thing  which  can  be  affirmed  universally 
of  the  eflect  of  tva  and  coffee.  They  both,  when  taken,  tend  to  prevent 
waste  in  the  body,  and,  consequenlly,  less  focMl  is  retpiired  when  they 
are  used.  This  may  be  affirmed  of  them  in  their  applicability  to  all 
persons,  but  nothing  further.  The  truth  is,  some  can  drink  tea  but 
not  cofl'ee,  and  sonie  coffee  but  not  tea  ;  some  can  use  both,  and  some 
neither.  Every  man's  susce[)tibility  to  the  elfects  of  these  Ix-verages 
is  his  own,  as  nmch  as  his  susceptil)ility  to  the  effects  of  light,  or  heat, 
or  atmospheric  changes ;  and  these  etfeet.-<,  j'aeli  person  nmst  learn 
from  ex|)erience.  Cofli'e  often  produces,  and  generally  aggravat«'s,  a 
bilious  habit,  —  an  effect  which  eaimot,  I  believe,  be  traced  to  the  use 
of  tea.  I  hava  no  doubt  but  that  many  cases  of  confirmed  dyspepsia 
are  traceable  to  the  use  of  coffee  alone. 

Water. 

I'nRRR  is  one  universal  beverage;  it  is  water.  All  men  are  fond 
ol  it.  In  sickness  and  in  health,  in  joy  and  sorrow,  in  sinuiiier  :tii<l 
winter,  in  coltl  climates  and  in  hot,  man  loves  and  drinks  water.  'I'ln' 
itoMiaeli,  abused  and  made  sick  by  stimulating  food  and  drinks,  iuid 
I'epelling  everything  else,  still  gratefully  opens  itself  to  water.  Wher- 
ever man  exists,  therefore,  or  wherever  he  should  exist,  wal»r  is  found 
either  in  the  form  of  springs,  or  running  brooks,  or  rivers,  or  ponds, 
or  lakes ;  and  even  where  it  is  not  found  in  some  of  these  forms,  it  is 
periodically  dropped  down  from  the  clouds.  As  there  is  nt)  elenient 
in  nature  more  necessary  for  man's  existence  than  water,  so  there  is 
none  more  universally  diffused. 

Pure  Wafer  EHseiitial  to  Health. —  But  water  varies  very  materially, 
l)t)th  in  its  physical  qualities,  and  in  its  adaptation  to  its  |)urposes. 
I'ure  water  is  as  essential  to  health  as  pure  air.  When  either  of  these 
fluids  iti  rendered  impure  by  mixture  with  foreign  matters,  disease 
will  be  a  freciuent  result,  '1  he  aneie?its  nmst  have  been  influenced 
by  this  fact,  or  they  would  not  have  incurred  such  heavy  expiMises  in 


i:V 


>..M 


'  I 


86 


HYGIENE. 


procuring  pure  water  from  great  distances.  The  strong  aqueducts 
through  which,  for  many  miles,  large  streams  of  water  are  at  this  day 
poured  into  fallen  Rome,  attest  the  freeness  of  the  expenditures  she 
made  for  this  purpose  in  the  day  of  her  renown.  We  may  pity  the 
ancient  Romans  for  being  governed  in  their  military  operations  by  the 
opinions  of  augurs  ant'  soothsayers,  and  certainly  these  things  were 
silly  enough ;  but  in  other  things,  at  first  view  equally  superstitious, 
they  showed  practical  wisdom.  Vetruvius  reports  that  in  selecting  the 
sites  of  their  cities,  they  inspected  the  livers  and  spleens  of  animals  to 
learn  the  salubrity  of  the  waters  and  the  alimentary  productions  of  the 
region.  The  size  and  condition  of  these  organs  do  in  fact  indicate 
the  nature  of  the  pasturage  and  the  qualities  of  the  wat(?r  with  which 
animals  are  supplied.  No  people  can  enjoy  good  health,  when  sub- 
jected to  the  double  influence  of  bad  water  and  impure  air. 

Division  of  Water. — The  simplest  division  of  water  is  into  two  kinds, 
soft  and  hard.  Rain,  river,  pond,  and  snow  water  is  soft :  well  and 
spring  water  is  generally  hard.  Soft  water  contains  but  little  impu- 
rities, and  when  used  for  washing,  forms  a  good  lather  with  soap. 
Hard  water  contains  at  least  one  of  the  salts  of  lime,  often  Uiore ; 
mixed  with  soap,  it  curdles  and  turns  white.  The  reason  of  this  is, 
that  the  oily  acids  of  the  soap  unite  with  the  lime,  and  form  a  com- 
pound which  the  water  will  not  dissolve.  Such  water  is  not  suitable 
for  domestic  purposes. 

Cliemical  Nature  of  Water.  —  Water  contains,  reckoning  the  ele- 
ments of  which  it  is  composed  in  volumes,  one  volume  of  hydrogen, 
and  half  a  volume  of  oxygen.  These  two  gases,  the  unlearned 
reader  will  please  to  remember,  are  highly  subtle  bodies,  not  visible  to 
the  eye ;  and  yet,  when  chemically  united,  they  form  a  lic^uid  which 
covers  two-thirds  the  entire  surface  of  the  globe,  —  floating  upon  its 
bosom  the  navies  and  merchant  ships  of  all  nations,  and,  by  its  un- 
measured depths,  and  vast  breadths,  and  sublime  movements,  fills  the 
thoughtful  mind  with  conceptions  of  creative  Power,  which  words 
never  attempt  to  oppress.  Should  the  two  gases  which  compose 
this  vast  body  of  water  cease  to  love  each  other,  and  fall  asunder, 
the  first  lighted  taper  would  set  the  world  on  fire,  and  not  a  living 
being  upon  its  surface  could  escape  destruction. 

Impurities  iu  Water,  —  It  is  not  surprising  that  a  fluid  with  as  great 
a  solvent  power  as  water,  should  often  dissolve  and  hold  in  .solu- 
tion a  great  many  impurities.  In  passing  along  through  the  earth, 
before  it  comes  up  in  springs  and  wells,  it  is  filtered  through  various 
mineral  earths,  and  becomes  contaminated  accordingly.  In  running 
through  beds  of  limestone,  it  takes  up  a  little  carbonate  of  lime. 
Salt  beds  impart  to  it  common  salt  (muriate  of  soda),  while  sulphur 
and  other  ores  tinge  it  with  salts  of  various  kinds. 

Water  from  the  wells  of  Boston,  formerly  used  by  the  inhabitants, 
was  largely  imj)regnated  with  common  salt,  and  other  mineral  substan- 
ces. So  marked  was  the  saline  taste,  from  this  cause,  that  the  New- 
Yorkers  and  Philadelphians  used  to  say  the  Bostouians,  when  visiting 
their  cities,  had  to  salt  their  water.  ' 


HYGIENE. 


87 


Cocliituflte  Water.  —  These  wells,  which  so  long  yiehled  up  brack- 
ish water  to  offend  the  palates  of  strangers,  are  now  abandoned,  and 
Boston  is  blessed  by  a  copious  stream  of  pure  soft  water,  drawn 
through  a  fine  aqueduct  from  Cochituate  Liike,  twenty  miles  distant 
This  water  is  distributed  to  about  every  house  and  shop  in  the  city. 

The  result  is,  that  the  health  of  the  citizens  has  been  materially 
improved.  Fevers,  particularly  thosti  of  the  typhoid  type,  have  dimin- 
ished, both  in  preval«;nce  and  fatality.  The  decaying  vegetable  and 
animal  matter,  so  nmch  of  which  gets  into  the  connnon  sewers,  and 
which,  in  former  years,  sent  up  poisonous  gases  to  attack  tin;  life  of 
the  citizens,  are  now  washed  away  by  the  soft  water,  which  is  daily 
and  hourly  dropping  through  the  sinks  of  all  the  dwellings  of  the 
city. 

Scliiiylkill  niul  Crotoii  Wrtters.  —  The  Schuylkill  water,  introduced 
into  Philadelphia,  and  the  Croton,  brought  from  quite  a  distance  to 
New  York,  are  both  good  waters  ;  though  neither,  as  chemical  analy- 
sis has  shown,  is  (juite  as  jmre  as  the  Cochituate,  of  Boston. 

Lead  Pljies.  —  In  each  of  these  three  cities,  water  is  conveyed 
through  the  dwellings  in  leaden  pipes,  —  a  practice  fraught  with  a 
danger  to  which  the  inhabitants  should  not  expose  themselves.  That 
lead  does  often  become  oxidized  and  impart  its  ])oisonous  properties 
to  water  when  long  in  contact  with  it,  is  a  well-known  fact.  Let  a 
number  of  persons  drink  every  morning  from  the  first  water  drawn 
from  the  pipes,  and  a  portion  of  them  will  be  attacked  with  some 
form  of  lead  disease.  The  pipes  should  be  emptied  every  morning, 
before  using  the  water  for  domestic  purposes ;  and  then,  it  is  true, 
•there  is  little  danger.  But  where  the  work  in  the  kitchen  is  done  by 
hired  persons,  who  have  no  appreciation  of  the  danger,  how  is  it  to 
be  known  whether  this  act  of  safety  is  always  carefully  performed  ? 
Water  pipes  should  certainly  be  made  of  some  other  material. 

Physical  and  Other  Properties  of  Water.  —  Good  water  is  without 
smell,  is  perfectly  clear,  and  in  the  mouth,  has  a  soft  and  lively  feel. 
When  poured  from  one  vessel  to  another,  it  should  give  out  air- 
bubbles.  Boiled  and  distilled  waters  have  a  vapid,  flat  taste.  This 
is  owing  to  their  containing  no  carbonic  acid  gas  or  atmospheric  air, 
—  these  being  driven  otf  in  the  act  of  boiling  and  distilling.  A  hun- 
dred cubic  inches  of  good  river  water  contains  about  2^  of  carbonic 
acid,  and  1^  of  common  air. 

Carbonic  acid  is  what  gives  to  mineral,  or  soda  water,  its  brisk 
and  even  pungent  taste.  Without  a  portion  of  this  acid  and  atmos- 
pheric air,  water  is  perfectly  insipid,  and  not  fit  to  be  used  as  a  bev- 
erage. Hence,  if  it  be  boiled  or  distilled  to  clear  it  of  earthy  matters, 
we  must  expose  a  large  surface  of  it  trf  the  air,  and  shake  it,  that  it 
may  re-absorb  from  the  atmosphere,  what  it  has  lost,  and  thus  recover 
its  taste. 

Rain  Water  is  tlie  Result  of  Distillation  on  a  large  scale,  and  wouid 
be  insipid,  like  other  distilled  water,  only  that,  after  being  distilled  ctl 


Jf 

1 

.LM. 

di      m 

I      :l 


i 


!>  ,, 


I      <1 


88 


iiygip:ne. 


from  the  waters  upon  the  surface  of  the  earth,  it  recovers*,  while  as- 
cending as  vapor,  the  carbonic,  acid  and  atmospheric  air. 

Fishes  breathe  air  as  well  as  land  animals,  and  hence,  lakes  upon 
the  tops  of  high  moimtains,  where  but  little  oxygen  can  be  absorbed 
into  the  water  from  the  air,  are  not  inhabited  by  the  tinny  tribes. 

Tlie  SnltiiesH  of  the  Oceiiii  is  simply  the  accumulation  of  the  saline 
substances  washed  out  of  the  bowels  of  the  earth. 

The  water  which  for  thousands  of  years  has  been  distilling  off  as 
vapor,  from  the  surface  of  the  ocean,  is  nearly  pure.  Being  carried 
by  the  winds  to  the  continents,  it  falls  as  rain,  sinks  into  the  earth,  is 
fdtered  through  mineral  substances,  comes  to  the  surfaces  in  springs, 
is  colh?cted  into  rivers,  and,  with  all  its  freight  of  mineral  salts,  is 
borne  back  to  the  ocean.  Everything  that  water  can  dissolve,  and 
carry  dt)wn  from  the  continents,  nnds  a  great  depository  in  the  ocean; 
and  as  this  has  no  outlet,  the  accumulation  must  go  on  without  limit. 
Rivers  which  flow  into  the  ocean,  contain  from  ten  to  fifty  grains  of 
salts  to  the  gallon,  —  composed  chiefly  of  common  salt,  sulphate  and 
carbonate  of  lime,  magnesia,  soda,  |wtash  and  iron  ;  and  these  are 
the  constituents  of  sea-water.  The  time  must  come,  in  the  history 
of  our  globe,  when  these  salts  will  render  the  water  of  the  ocean  so 
dense  that  a  man  caa  no  more  sink  in  it  than  a  cork  can  sink  in  fresh 
water. 

Cleaiisjii«ir  of  Ini|rare  Water.  —  Impure  waters  should  be  cleansed 
before  being  used  for  domestic  purposes.  Distillation  is  the  most 
perfect  method  of  purification.  Filtration  through  sand  is  a  good 
method.  It  removes  all  suspended  vegetable  or  animal  matter,  and 
all  living  animals.  Boiling  likewise  kills  all  animals,  ami  throws  to 
the  bottom  carbonate  of  lime.  It  is  this  which  constitutes  the  crust 
which  lines  tea-kettles  in  all  regions  where  limestone  exists. 

Settlers  in  a  new  country,  should  make  it  a  prime  object  to  find 
good  water.  This  is  of  great  moment.  Their  own  health,  and  the 
health  of  their  posterity  is  dependent  upon  it.  Any  soil,  good  or  bad, 
is  not  worth  half  price,  if  it  yield  impure  water. 

RensoiiH  for  Prizing  Water.  —  Finally,  we  ought  all  to  prize  water 
very  highly,  for  it  composes  nearly  eight-tenths  of  our  entire  bodies^  in- 
cluding our  flesh,  blood,  and  other  fluids.  Nay,  we  owe  to  it  the  very 
softness,  delicacy,  and  smoothness  of  our  persons.  Our  muscles,  nerves, 
blood-vessels,  glands,  cartilages,  etc.,  all  play  smoothly  upon  each  other 
in  consequence  of  water.  Take  all  the  water  out  of  us,  and  we  should 
be  dry  sticks  indeed.  All  our  comelinc&s  would  be  gone.  Nobody 
would  or  could  love  us.  We  should  be  walking  reeds,  shaken  and 
sported  with  by  every  wind.  Let  us  never  forget  how  much  we  are 
indebted  to  water. 

Exercise. 

Animal  life  is  conditioned  upon  exercise.     Without  it  health  can- 
not exist,  or  life  itself  be  continued  for  any  great  length  of  time. 


1  ^H 

Proper 

1    ^^m 

it.     It  ex 

the  motic 

1  ^H 

the  ccntr 

'  ■ 

nutrition 

H 

tions  and 

1 

A  disti 

sarv  to  th 

■ 

finest  tail 

■ 

for  wit  ho 

1  ^H 

energy;  i 

great  tale 

a  larger  h 

!    ^1 

The  ar 

1  ^H 

facilities  1 

■  H 

fetters  of 

1  ^H 

by  leapin 

fetters  of 

;  1 

Must  b 

1 

lar,  —  not 

morrow ; 

1 

with  intei 

'  1 

Must  be 

H 

some  pics 

:    ■ 

should  ca 

an  interci 

!  ^1 

pursuits. 

^^H 

to  a  solits- 

j  H 

HI  list  IK 

;  H 

to  produc 

'  H 

ercise,  esp 

'  H 

little. 

1  HB 

No  clot 

;  H 

ofl"  by  sitt 

H 

low  this  \ 

■ 

Xot  to 

B 

mediately 

R 

DJained. 

Hi 

muting,  wi 

H 

V  liat  tho!- 

H 

■ot  labor 

B 

Active 

H 

passive. 

^B 

etc.,  are  a 

^B 

passive. 

^v 

active  anc 

H 

A  few 

H 

practical  ' 

.  |i 

HYGIENE. 


89 


Proper  exercise  communicatcH  motion  to  every  part  Husceptible  of 
it  It  expaiuln  the  breast,  contracts  and  relaxes  the  muscleH,  quickens 
the  motion  of  the  bl<Hxl,  moves  afresh  all  the  other  fluids,  ami  stirs  to 
the  centre  the  whole  frame.  More  easy  and  perfect  digestion,  the 
nutrition  of  every  part,  and  the  proper  performance  of  all  the  secre- 
tions and  excretions,  are  the  results  of  such  exercise. 

A  distinguished  physician  said  :  "  I  know  not  which  is  most  neces- 
sary to  the  support  of  the  human  frame,  food  or  motion."  Some  of  the 
finest  talents  in  the  world  are  probably  lost  for  the  want  of  exercise ; 
for  without  it  the  mind  loses  its  keen  perception,  and  its  bounding 
energy  ;  its  power  of  application  and  its  general  scope.  If  men  of 
great  talents  wonid  give  attentiiin  to  exercise,  the  world  would  reap 
a  larger  harvest  from  their  written  thoughts. 

The  arrangements  of  nu)dcrn  society  have  very  mucrli  abridged  the 
facilities  for  taking  exercise  ;  but  if  Trenck  in  his  damp  prison,  with 
fetters  of  seventy  pounds  weight  upon  him,  could  preserve  his  health 
by  leaping  about  like;  a  lion,  most  |)ersons  could  do  as  much  with  the 
fetters  of  modern  society  upon  their  limbs. 

Must  be  Rejfular.  —  Exercise,  to  be  of  much  service,  must  be  regu- 
lar,—  not  taken  by  fits  and  starts,  —  a  good  deal  to-day  and  none  to- 
morrow ;  but  in  reasonable  measure  every  day.  Occnisional  ellorts, 
with  intervening  inactivity,  only  does  mischief. 

Must  be  Pleiisuruble. —  It  should  be  connected,  too,  if  possible,  with 
some  pleasing  occupation  or  pursuit.  The  movement  of  the  limbs 
should  carry  us  towards  some  place  or  end  in  which  the  mind  feels 
an  interest;  exercise  will  then  do  us  most  good.  Hence,  botanical 
pursuits,  the  cultivation  of  a  garden,  and  the  like,  are  often  preferable 
to  a  solitary  and  aimless  walk. 

Must  not  be  Excessive.  —  Exercise  should  never  be  carried  so  far  as 
to  produce  great  fatigue.  Extremes  are  injurious  ;  anil  too  nmch  ex- 
ercise, especially  by  a  sick  or  feeble  person,  may  be  as  injurious  as  too 
little. 

No  clothing  should  be  thrown  off  after  exercise,  nor  should  one  cool 
ofl'  by  sitting  in  a  draft  of  air.  Very  serious  consequences  often  fol- 
low this  practice. 

Xot  to  be  Tilken  After  Meals.  —  It  is  not  best  to  take  exercise  im- 
mediately after  meals.  The  reasons  for  this  caution  have  been  ex- 
plained. It  is  true  many  laboring  men  go  at  once  to  their  work  after 
eating,  without  apparent  injury.  Yet  they  are  strong,  and  can  endure 
X^liat  those  who  use  their  brains  chiefly  could  not.  And  even  they  do 
'ot  labor  as  easily  and  cheerfully  immediately  after  dinner. 

Active  and  Passive.  —  E\rreise  is  properly  divided  into  active  and 
passive.  Walking,  runni  ig,  !»>,.  ling,  dancing,  gardening,  various  sports, 
etc.,  are  active.  While  iai!i)t^,  swinging,  and  riding  in  carriages,  are 
passive.  Riding  on  hon  -bac'^  is  of  a  mixed  nature,  —  being  both 
active  and  passive. 

A  few  remarks  upon  these  several  kinds  of  exercise,  will  have  a 
practical  value  to  some  ot  the  readers  of  these  pages. 


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90 


HYC'ENE. 


Walkin<gf  is  one  of  the  most  gentle,  easy,  end  generally  one  of  the 
most  useful  of  the  active  exercises.  It  is  within  the  reach  of  all  who 
have  the  use  of  their  limbs,  and  is  indulged  at  the  expense  only  of  a 
little  shoe  leather.  To  make  it  agreeable,  the  face  is  only  to  be 
turned  to  some  favorite  locality,  and  the  mind  put  in  communion 
with  the  voices  of  nature. 

To  walk  v^'ith  the  best  advantage,  the  body  should  be  kept  upright, 
the  shoulders  thrown  back,  the  breast  projected  a  little  forward,  so  as 
to  give  the  lungs  full  play,  and  the  air  an  opportunity  to  descend  to 
the  bottom  of  them.  This  attitude  places  all  the  organs  of  the  body 
in  the  most  natural  position,  and  relieves  them  from  all  restraint. 
Walking  then  becomes  a  source  of  pleasure.  The  artist  who  bends 
over  his  pallet,  and  gets  into  a  cramped  j  osition,  is  by  this  kind  of 
walking  relieved,  and  his  body  kept  upright.  Females,  particularly 
of  the  wealthier  class,  are  much  more  apt  to  neglect  this  species  of 
exercise  than  males. 

It  is  not  so  in  England.  There  it  is  no  uncommon  thing  for  ladies 
of  high  rank  to  walk  ten  miles  a  day ;  and  they  do  it  in  shoes  of  suffi- 
cient thickness  to  protect  their  feet  from  all  dampness,  and  in  clothes 
large  enough  to  give  their  muscles  full  play.  As  a  consequence,  they 
enjoy  excellent  health,  and  in  many  cases,  even  retain  their  freshness 
and  beauty  to  old  age. 

A  master  of  one  of  the  vessels  of  our  navy  who  spent  some  time, 
lately,  in  the  British  Channel,  was  several  times  invited  to  spend  the 
evening  at  Lord  Hardwick's,  where  he  made  the  acquaintance  of  two 
daughters  of  his  lordship,  who,  in  the  drawing  room,  he  thought  the 
most  accomplished  ladies  he  ever  saw.  Yet  those  young  women,  on 
two  occasions,  in  company  with  other  friends,  walked  miles  to  visit 
his  vessel,  once  on  a  rainy  day,  clad  in  thick,  coarse  cloth  cloaks  which 
no  rain  could  penetrate,  and  caring  as  little  for  wet  weather  as  a 
couple  of  ducks. 

Cood  for  the  Studious. —  For  the  studious,  walking  is  a  most  capi- 
tal exercise.  It  varies  the  scenes  so  constantly,  and  brings  the  mind 
in  contact  with  so  many  objects,  that  the  monotony  of  in-door  life  is 
admirably  broken.  It  was  a  maxim  of  Plato,  that  "  he  is  truly  a  crip- 
ple, who*,  cultivating  his  mind  alone,  suffers  his  body  to  languish." 

Good  in  Cold  Weather.  —  Walking  is  valuable  in  cold  weather,  Iv- 
cause  it  exposes  one  to  the  cold  atmosphere,  and  hardens  the  pj'rsoii 
against  frosty  we  tther, —  a  consideration  of  great  consequence  iu 
countries  which  are  subject  to  extremes  of  cold. 

Ruimin^  and  Leaping  are  forms  of  exercise  which  should  be  in- 
dulged with  prudence  even  by  the  young  and  healthy.  For  the  feeble 
and  the  aged,  they  are  entirely  inadmissible.  Used  cautiously,  in  a 
system  of  regular  training,  they  may  help  raise  the  bodily  powers  to 
a  high  degree  of  agility  and  endurance.  The  North  American  Indian, 
who  is  bred  to  the  chase,  runs  with  surprising  swiftness,  and  for  en- 
durance is  scarcely  excelled  by  his  faithful  dog.  What  training  does 
for  the  Indian,  it  may  do  for  the  white  man,  who  may  chance  to  in- 
herit as  good  a  constitution. 


*■■■ 


HYGIENE. 


91 


The  Game  of  Ball  requires  very  active  running,  and  for  the  young, 
it  is  an  exceedingly  healthful  amusement.  It  fills  the  whole  frame 
with  a  bounding  spirit,  and  sets  the  currents  of  life  running  like 
swollen  brooks  after  heavy  rains. 

Gymnastics.  —  The  more  active  species  of  exercise  have  generally 
been  included  under  the  term  gymnastics.  Among  the  Greeks  and 
Romans,  feats  of  strength  and  endurance  were  supposed  to  confer 
honor.  For  this  reason,  and  because  war  was  a  laborious  calling,  re- 
(juiring  bodily  endurance  and  strength,  their  youth  were  trained  in 
the  most  active  exercises.  Gymnastic  games  were  with  them  at  once 
thp  school  of  health,  and  the  military  academy. 

In  England,  during  the  middle  ages,  acts  of  v.»arliament  and  royal 
proclamations  were  employed  to  regulate  and  foster  those  manly 
sports  and  exercises,  which  fitted  the  people  for  the  activity  required 
on  the  field  of  battle. 

Those  preparations  for  brutal  wars  would  be  unsuited  to  the  pres- 
ent state  of  the  world ;  but  the  capacity  for  endurance  which  these 
trainings  produced,  could  be  most  usefully  employed  in  the  laborious 
and  scientific  researches  which  modern  advancement  requires.  Very 
few  of  our  scientific  men  have  sufficient  hardness  of  frame  to  sus- 
tain them  in  their  laborious  studies. 

The  heart  diseases  which  prevail  so  extensively  are  the  result,  many 
of  them,  of  violent  exercise,  taken,  perhaps,  from  necessity,  and  prov- 
ing injurious  because  not  a  matter  of  every-day  practice.  Violent 
exercise,  more  than  any  other  kind,  jtnust  be  regular  in  order  to  be 
borne. 

Xeeded  by  Yonn^  Women.  —  Gymnastic  exercises,  and  calisthenics, 
are  particularly  needed  by  our  young  women,  to  give  them  something 
of  the  robustness  of  our  mothers,  two  generations  back.  For  the 
want  of  them,  they  are  dwindling  away,  and  becoming  almost  worth- 
ies? for  all  the  purposes  for  which  they  were  made. 

In  view  of  this  want,  I  camiot  but  express  my  gratification  here, 
that  a  high  school  for  young  ladies  is  now  open  in  this  city,  under  the 
care  of  the  Rev.  George  Gannett  and  his  lady,  in  which  a  large  and  suit- 
able room  is  set  apart  for  the  daily  practice  of  calisthenic  and  gym- 
nastic exercises,  suited  to  the  age  and  strength  of  each  pupil,  under 
the  instruction  of  an  experienced  teacher  of  their  own  sex.  I  cannot 
but  look  upon  this  school,  offering,  as  it  does,  the  highest  advantages 
for  a  complete  education  in  science  and  morals  also,  as  the  beginning 
of  better  things. 

Moderns  Physically  Inferior  to  the  Ancients.    Reason  for  it.  —  It  is 

evident  that  the  moderns  are  inferior  in  bodily  strength  to  the  aiicient 
Greeks  and  Romans.  Before  the  introduction  of  Christianity,  men 
knew  very  little  about  the  future,  and  therefore  strove  to  make  the 
most  of  the  present.  Hence,  they  took  measures  to  ensure  health  and 
long  life.  It  is  true  that  a  due  regard  to  the  welfare  of  the  future, 
need  not,  and  should  not,  prevent  a  care  for  the  present ;  but  from 
various  causes,  to  be  referred  to  on  a  subsequent  page,  such  has  been 
the  practice,  to  the  mt  .lifest  physical  injury  of  the  race. 


ill 


92 


HYGIENE 


Dancini^,  when  hedged  about  with  proper  restrictions  and  limita- 
tions, has  great  advantages  as  a  physical  trainer  of  the  young.  There 
are  very  few  forms  of  exercise  which  give  so  free  a  play  to  all  the 
muscles,  and  at  the  same  time  so  agreeably  interest  the  mind.  Begun 
in  early  life,  and  pursued  systematically,  dancing  imparts  a  grace  and 
ease  of  motion  which  nothing  else  can  give.  For  this  reason  alone, 
it  should  be  cultivated  as  an  art. 

Everyman  and  woman  is  oiten  placed  in  circumstances  in  life  where 
the  possession  of  an  easy  carriage  of  body,  and  an  unembarrassed 
manner,  would  be  prized  above  gold.  One's  personal  influence  in  the 
world  is  greatly  increased  by  an  easy,  graceful  manner.  We  all  know 
how  a  polite  manner  wins,  while  a  rough  and  uncouth  one  repels  us. 

Wnniiiig;  A$|^aiiist  Excess. —  While  dancing  has  many  things  to  re- 
commend it,  there  are  also  several  considerations  which  should  warn 
us  against  using  it  to  excess,  particularly  in  the  ball  saloons  of  fash- 
ionable life.  So  many  muscles  are  called  into  play,  the  breathing 
is  so  much  quickened,  and  the  air  breathed  is  often  so  impure,  tha' 
the  circulation  of  the  blood  is  hastened  almost  to  fever  excitement 
And  when  to  this  we  add  the  use  of  wines  and  cordials,  alternated 
with  ices  and  iced  drinks,  and  the  exposure,  on  returning  home  froin 
balls,  to  the  chill  night  air,  under  the  miserable  protection  of  insulfi- 
cient  clothing,  we  have  draw-backs  enough  to  abridge,  if  not  to  ainii- 
hilate  the  benefits  derived  from  this  otherwise  healthful  and  elegant 
exercise. 

But  then  it  will  be  said,  and  truly  enough,  that  those  are  the  abuses, 
not  the  uses  of  dancing.  To  these  abuses,  no  parent  should  permit 
the  health  of  a  child  to  be  exposed.  In  the  parlor  at  home,  in  con- 
nection with  a  lew  young  friends  gathered  in  to  spend  an  evening; 
or,  in  a  well-ventilated  hall,  under  the  instruction  of  a  master  of 
known  character  and  refinement,  dancing  is  of  high  utility,  and  much 
may  be  said  in  its  favor.  An  amusement  for  which  there  is  so  gen- 
eral a  fondness,  one  may  say,  passion,  must  be  fitted  to  meet  some 
want  of  the  animal  economy,  and  perhaps  of  man's  higher  nature. 

Grace  of  motion  gratifies  our  sense  of  the  beautiful,  and  in  its 
nature  is  allied  to  poetry.  Turning  away  from  the  abuses  of  dancing, 
let  the  reader  thankfully  use  it  as  one  of  the.  very  best  physical,  social, 
and  sesthetical  educators  of  youth. 

But  if  dancing  is  salutary,  it  is  only  when  every  limb  and  mnj^clc 
is  allowed  to  participate  naturally  and  without  restraint  in  the  general 
motion.  When  performed  in  a  dress  so  tight  as  to  restrain  all  free- 
dom, not  only  is  every  grace  destroyed,  but  injury  of  a  serious  char- 
acter may  be  the  result. 

The  CultiTfltion  of  a  Garden  is  also  a  species  of  exercise  highly 
conducive  to  health.  To  the  poor  it  should  have  a  double  attraction. 
It  is  not  only  i  healthful  exercise,  but  it  yields,  in  its  season,  many 
wholesome  vegetables,  the  price  of  which,  when  they  have  to  be  pur- 
chased, frequently  puts  them  beyond  the  reach  of  the  poor.  It  is 
pleasant  to  know  that  in  the  towns  of  Massachusetts,  where  shoes 
are  largely  manufactured,  most  of  the  workmen  own  small  pieces  of 


HYGIENE. 


93 


ground  which  they  cultivate  as  gardens,  —  deriving  health  both  from 
the  labor,  and  from  the  vegetables  raised.  This  is  one  of  the  kinda 
of  exercise  which  are  more  beneficial  from  having  an  end  in  view 
The  man  who  works  in  his  garden  derives  pleasure  from  the  im- 
provement he  is  making  upon  his  ground,  and  from  the  prospect  of 
advantage  to  himself  and  family. 

Other  Actire  Exercises.  —  To  the  exercises  already  spoken  of  may 
be  added  those  which  are  mostly  taken  indoors,  —  the  dumb-be]ls, 
jumping  the  rope,  the  battle-door,  etc.  They  may  be  resorted  to 
when  the  weather  is  stormy,  or  when  any  other  cause  may  prevent 
one  from  going  into  the  open  air.  Nevertheless,  as  promoters  of 
health,  they  are  inferior  to  those  exercises  which  take  one  out  under 
the  open  sky.  They  are  too  mechanical  in  their  nature,  and  have  too 
little  aim,  to  be  allowed  to  take  the  place  of  the  preceding. 

Passive  Exercises. 

Sailing.  —  This,  to  many  persons,  is  among  the  most  pleasurable 
and  exciting  of  the  passive  exercises.  But  the  excitement  arising 
from  the  motions  of  a  boat,  sometimes,  in  caf:a  of  timid  persons, 
degenerates  into  fear^  which  is  injurious.  You  ^  gentlemen  who 
manage  the  boat  upon  sailing  excursions,  should  never  put  on  too 
much  sail  in  a  brisk  wind,  and  torment  the  ladies  by  exciting  their 
fears,  as  their  own  amusement  may  be  in  this  way  purchased  at  the 
cost  of  others'  heolth,  —  a  result  far  enough  fronx  their  thoughts  or 
intentions,  but  not  the  less  real. 

Swinging. —  The  sick  may  sometimes  indulge  in  this  exercise,  when 
capable  of  enduring  no  other.  To  swing  gently  has  a  soothing  effect, 
and  often  allays  nervous  irritability  in  a  waj  v/hich  nothing  else  can. 
It  is  like  the  lullaby  motion  of  the  cradle.     It  calms  and  soothes. 

Nervous  children  and  grown  persons  in  feeble  health,  are  some- 
times, by  roguish  boys,  swung  too  high,  and  very  much  excited  and 
alarmed.  This  is  wrong.  It  may  do  great  injury.  Very  few  boy-s 
would  do  it  if  they  knew  the  evil  consequences.  Boys  and  girls  are 
generally  kind  hearted ;  and  though  they  may  like  to  hector  others, 
they  will  seldom  knowingly  injure  them  for  their  own  amusement. 

Carriage-Riding.  —  The  advantages  to  be  derived  from  this  species 
of  exercise  are  probably  rated  too  high.  For  feeble  persons,  just  re- 
covering from  illness,  who  cannot  endure  walking  or  riding  on  horse- 
back it  is  valuable,  particularly  if  taken  in  an  open  carriage.  But  for 
those  who  have  more  strength,  it  is  less  desirable  than  many  other  ex- 
ercises. True,  it  is  generally  an  agreeable  mode  of  locomotion,  and 
for  this  reason,  it  is  generally  more  serviceable  than  the  small  amount 
of  exercise  afforded  by  it  would  lead  one  to  supix)9e. 

Carriages  are  luxuries,  and  like  all  other  luxuries,  they  are  apt  to 
bring  on  debility,  and  perhaps  shorten  life.  A  man  is  apt  to  order 
his  carriage  to  the  door  at  the  time  when  increasing  wealth  enables 
him  to  retire  from  the  active  pursuits  of  life, — the  very  moment  when 


'■(■'■ 


I  i ; 


i*- 


ri?  .  M 


I  f 


94 


HYGIENE. 


he  is  most  in  need  of  some  exertion  to  take  the  plaee  of  that  to  which 
he  has  been  accustomed.  Yet  so  it  is,  hixury  comes  to  enfeeble,  at 
the  time  when  we  need  something  to  harden  us. 

Could  rich  men  be  persuaded  to  let  their  luxuries  consist,  in  part, 
in  doing  good,  and  like  Howard,  find  pleasure  in  travelling  on  foot  to 
visit  those  who  are  sick  and  in  prison,  they  would  be  surprised  to  see 
how  their  happiness  would  be  increased. 

Close  carriages  are  generally  used  by  the  wealthy.  They  at  best 
contain  but  little  air,  which  is  breathed  over  and  over,  and  becomes 
unfit  for  respiration.  The  windows  of  such  carriages  should  always 
be  open,  except  in  rainy  weather,  when  the  latticed  windows  only 
should  be  used. 

Riding;  iit  Sleighs  furnishes  an  agreeable  excitement,  and  may  be 
indulged  to  some  extent  with  advantage.  Yet  it  can  be  had  only  iu 
cold  weather,  and  persons  who  partake  of  its  pleasures,  should  be 
careful  to  wear  clothing  enough  to  protect  themselves  against  the 
frost.  This  is  the  more  necessary,  as  very  little  motion  is  communi- 
cated to  their  bodies  by  the  sleigh. 

Ilorse-Bdck  Riding;.  —  This  form  of  exercise  may  fairly  rank  next 
to  walking;  in  some  states  of  the  system,  it  is  preferable.  It  justly 
holds  a  high  rank  as  an  exercise  for  consumptive  persons.  Many  a 
man,  and  woman  too,  has  been  benefited  by  it  when  sutiering  from 
lung  disease.  For  those  who  have  hernia,,  or  falling  of  the  bou'el,  it 
is  not  proper,  as  the  most  serious  consequences  may  result  from  its 
use. 

Tlie  Horse  should  he  Owned.  —  A  feeble  man  who  rides  on  horse- 
back should,  if  possible,  own  his  horse  ;  for,  becoming  attached  to  him, 
as  he  generally  does,  he  will  be  able  to  ride  farther  than  upon  an  ani- 
mal in  which  he  feels  less  interest.  A  horse  is  a  noble  creature,  and  a 
man  who  loves  him,  will  sometimes  acquire  a  passion,  almost,  for 
being  upon  his  back,  and  witnessing  his  splendid  performances. 

Pleasurahle  Exercises  Most  Beneficial. —  Finally,  those  exercises  arc 
most  beneficial,  and  can  be  longest  endured,  in  which  W3  feel  the 
greatest  interest.  Place  before  even  a  feeble  man  some  desirable  ob- 
ject, and  he  will  endure  a  great  deal  to  reach  it ;  or  engage  the  miiul 
of  a  very  tired  person  in  something  which  greatlv  interests  it,  uiu' 
considerably  more  exertion  will  be  easily  borne.  This  is  well  iUn^- 
trated  by  the  story  told  by  Misa  Edgeworth  of  a  certain  father,  wiio 
had  taken  a  long  walk  with  his  little  son,  and  found  the  boy  app'ir- 
ently  unable  to  walk  further,  son'e  time  before  reaching  home.  "  Ilere." 
said  the  shrewd-minded  father,  *'  ride  on  my  gold-headed  cane."  Im- 
mediately the  little  fellow  was  astride  the  cane,  which  carried  him  as 
safely  home  as  the  freshest  horse. 

Rental  Co-operation  is  of  the  highest  importance  in  all  exercise. 
Men  who  are  paid  by  the  job,  work  with  far  more  spirit  than  tho.se 
who  are  paid  by  the  day.  One  would  dig  in  the  earth  with  very  litt!  - 
Mpirit,  if  he  had  no  motiv^or  doing  it ;  but  if  he  expected  with  evoi j 


HYGIENE. 


f)5 


shovelful  of  earth  to  bring  up  gold-dust,  he  would  not  only  work  with 
a  will,  but  would  endu.e  a  great  deal  more  labor.  From  these  consid- 
erations we  may  infer  that  those  farmers  and  manufacturers,  who  pay 
their  men  the  highest  wages,  make  the  most  money  on  their  work. 

The  best  time  for  takin<(  exercise  is  that  in  which  it  does  us  most 
good.  For  most  persons,  the  morning  hours  may  be  considered  most 
fevorable.  But  there  are  many  who  cannot  take  exercise  in  the  early 
morning,  without  suffering  from  it  through  the  whole  day.  Some  are 
able  to  walk  miles  in  the  afternoon,  who  would  be  made  sick  by  sim- 
ilar exertions  immediately  after  rising. 

Persons  often  injure  friends  who  have  this  peculiarity  of  constitu- 
tion, by  urging  them  out  in  the  morning.  They  do  it  from  good 
motives,  but  are,  nevertheless,  blameworthy  for  attempting  to  advise 
in  matters  which  they  do  not  understand. 

Rest  and  Sleep. 

Our  bodies  are  like  clocks  ;  they  run  down  and  are  wound  up  oncfj 
every  twenty-four  hours.  Were  they  obliged  to  work  on  uninter- 
ruptedly, they  would  wear  out  in  a  few  days.  It  is  a  merciful  prO' 
vision  that  periods  of  repose  are  allotted  to  us.  Everything  has  it'* 
proper  place.  Rest  is  not  less  a  luxury  after  exercise,  than  exercise 
is  after  rest.  They  both  confer  happiness  at  the  same  time  that  they 
promote  our  well-being. 

Sleeping  Rooms. —  The  largest  part  of  our  rest  is  taken  in  sleep. 
Of  course  the  kind  of  room  in  which  we  sleep  is  worthy  of  considera- 
tioii.  Hufeland  says :  "  It  must  not  be  forgotten  that  we  spend  a 
considerable  portion  of  our  lives  in  the  bed-chamber,  and  consequently 
that  its  healthiness  or  unhealthiness,  cannot  fail  to  have  a  very  im- 
portant influence  upon  our  physical  well-being."  It  should  at  least 
be  large.  That  is  of  prime  importance,  because,  during  the  several 
hours  that  we  are  in  bed,  we  need  to  breathe  a  great  deal  of  air,  and 
our  health  is  injured  when  we  are  obliged  to  breathe  it  several  times 
over.  We  should  at  least  pay  as  much  attention  to  the  size,  situa- 
tion, temperature,  and  cleanliness  of  the  room  we  occupy  during  the 
hours  of  repose,  as  to  the  parlors,  or  drawing-rrom,  or  any  other 
apartment.  And  yet  how  different  from  this  is  the  general  practice 
of  families.  The  smallest  room  in  the  house  is  commonly  set  apart 
for  the  bed  and  its  nightly  Occupants. 

The  sleeping-room  should  have  a  good  location,  so  as  to  be  dry 
It  should  be  kept  clean,  and  neither  be  too  hot  nor  too  cold.  A'  a 
more  important  still,  it  should  be  well  ventilated. 

One  bed,  occupied  by  two  persons,  is  as  much  as  should  ever  be 
allowed  in  a  single  room ;  though,  of  course,  two  beds  in  a  large 
room,  are  no  more  than  one  in  a  small  one.    Both  are  objectionable. 

Fire  in  Sleeping  Rooms. —  As  to  having  fire  in  a  sleeping  room, 
that  is  a  matter  to  be  determined  by  the  health  of  the  occupant 
Persons  who  have  poor  circulation,  and  are  feeble,  had  better  have  a 


!      •{ 


'  1 
i  f 

1  > 

m 

w    ......  .  _ 

1 

1 

96 


HYGIENE. 


little  fire  i»  the  bed-chamber,  in  cold  weather.     For  those  in  good 
health,  a  cold  room  is  preferable. 

Open  Windows  in  Sleepin^^  Rooms.  —  In  the  hot  weather  of  sum- 
mer, it  is  better  to  keep  the  windows  open  to  some  extent,  through 
the  night,  but  not  on  opposite  sides  of  the  room  so  as  to  make  a  draft 
across  the  bed. 

There  is  a  difference  of  opinion  as  to  the  safety  of  this  practice," 
but  the  experience  of  those  who  have  used  it  prudently  and  perseveft 
ingly,  has  generally  sanctioned  its  employment.  It  is  presumed  that 
night-air  is  made  to  be  breathed ;  and  if  we  breathe  it  habitually,  there 
is  no  good  reason  why  it  should  be  considered  hurtful.  At  all  events, 
we  have  got  to  do  one  of  three  things,  —  either  breathe  it,  or  be  poi- 
soned by  air  which  is  breathed  several  times  over,  or  use  very  large 
sleeping  rooms,  and  thus  lay  in  a  stock  to  last  over  night. 

An  Open  Firepluce  in  a  bed  chamber  will  do  much  towards  its  puri- 
fication. It  carries  off  foul  air.  But  many  persons  board  up  this 
outlet  as  if  bad  air  were  a  friend,  with  whom  they  could  not  think  of 
parting.  At  the  same  time,  they  will  carefully  close  all  windows  and 
doors,  as  if  fresh  air  were  an  enemy  not  to  be  let  in. 

Beds.  —  It  is  a  pleasant  thought  that  while  so  many  things  which 
injure  health  are  coming  into  fashion,  some  which  have  a  like  effect 
are  going  out.  Among  tlr^  injurious  things  which  are  silently  with- 
drawing, are  feather  beds. 

In  earlier  times,  a  bed  made  of  eider-down  was  thought  to  be  a 
great  luxury,  to  be  carefully  preserved,  and  handed  down  from  mothei 
to  daughter.  Beds  made  of  ht  ns'  feathers,  and  other  coarser  kii  ds, 
were  thought  to  be  only  fit  for  children.  With  «lue  deference  to  these 
earlier  judgments,  it  must  be  said  that  feather  beds,  whether  downy 
or  coarse,  are  not  even  fit  for  children.  They  are  composed  of  ani- 
mal matter,  and  by  a  slow  process  of  decay,  are  always,  when  stirred, 
sending  up  an  exhalation  which  it  is  not  healthful  to  breathe. 

By  their  softness,  too,  they  increase  the  general  tendency  to  effemi- 
nacy. In  warm  weather,  they  are  too  heating.  To  sink  down  into 
them,  and  lie  nearly  buried  all  night,  is  to  insure  a  feeling  of  lassitude 
and  debility  in  the  morning.  Only  the  strongest  persons  can  endure 
it  without  being  made  conscious  of  the  evil  effects. 

Beds  mnst  not  be  too  Hard.  —  On  the  other  hand,  it  is  almost 
equally  unwise  to  choose  a  bed  of  absolutely  unyielding  hardness. 
When  very  tired,  we  may  rest  even  upon  a  board;  but  sleep  will 
go  -''rally  be  more  sound  as  well  as  refreshing,  if  the  bed  be  some- 
what J  'elding.  The  hair  mattress  is  the  very  best  bed  yet  used.  It 
ia  healthful  and  easy.  No  person  once  accustomed  to  it,  will  ever 
return  to  feathers,  bi  summer,  it  is  a  luxury ;  in  winter,  it  is  suffi- 
ciently warm,  though  a  little  more  covering  is  needed  than  with 
feathers. 

Beddins:. —  In  hot  weather  linen  sheets  are  preferable  to  cotton, 
and  of  course  will  be  used  by  those  who  have  ample  means.     But 


HYGIENE. 


97 


cotton  ones  are  good  enough,  and  in  winter  are  decidedly  the  more 
desirable  of  the  two.  Cotton  is  best,  too,  for  those  who  sufler  with 
rheumatic  atiections.  For  external  covering,  comfortables  are  objec- 
tionable, becausf'  they  do  not  let  the  insensible  perspiration  pass  off 
as  freely  as  it  si'ould.  They  are  light,  however,  and  so  are  rose 
biaiiivcts,  which  have  the  additional  good  quality  of  being  povoua. 
We  should  sleep  under  as  few  clothes  as  possible,  consistently  with 
comfort. 

Xiftiit  Dress. —  The  flannel,  cotton,  linen,  or  silk,  vorn  n<?Kt  the 
skin  through  the  day,  should  always  be  replaced,  on  retiring/,  by  a 
suitable  night-dress.  This  should  be  of  the  same  material  wi  n  that 
wliich  is  taken  oH".  If  we  wear  flannel  through  the  day,  we  need  ii 
quite  as  much  at  night. 

Do  not  Cover  the  Face. —  The  practice  of  sleeping  with  t/ie  face 
entirely  covered  with  the  bed  clothes,  is  very  injurious.  It  coinpela 
one  to  breathe  the  air  over  several  times. 

Natiinil  Position  for  Sleep. —  The  most  natural  position  in  which 
t(i  sleep  is  upon  the  right  side.  This  afibrds  the  easiest  play  to  the 
internal  organs.  It  is  best,  howeve-,  to  learn  to  sleep  in  (Jiff«>rent 
positions,  and  to  change  occasionally  from  side  to  side.  U|on  the 
back  is  not  so  easy  a  position.  To  lie  in  this  way  obstructs  the  cir- 
culation of  the  blood,  by  the  pressure  of  the  stomach,  bowels,  etc., 
upon  the  large  blood  vessels  which  |)ass  down  and  up  in  front  of  the 
back  bone.  It.  is  very  tiresome  and  injurious  to  lie  with  the  hands 
above  the  hea  .' 

Amount  of  Slee|>.  —  The  average  amount  of  sleep  required  by  per- 
sons in  health,  is  from  seven  to  eight  hours.  Occasionally  we  find 
persons  who  get  along  very  well  with  six,  or  even  five  hours ;  while 
some,  even  in  health,  require  nine.  There  is  no  absolute  standard  for 
all  persons,  in  the  amount  of  sleep,  any  more  than  in  that  of  food.  It 
depends  on  the  temperament,  th^  constitution,  the  amount  of  exercise, 
and  the  exhausting  nature  of  the  mental  application. 

The  object  of  sleep  is  to  repair  the  ejiergies ;  the  extent  to  which 
they  are  wasted,  and  the  recuperative  powi?r  possessed,  will  measure 
the  amount  required. 

Late  Suppers.  —  These  are  a  bar  to  all  sound  and  healthful  sleep. 
The  last  meal  should  always  be  taken  at  least  three  hours  before  re- 
tiring, and  should  be  light.  During  sleep,  the  stomach  should  have  a 
chance  to  rest.  It  will  work  the  better  on  the  morrow.  Some  per- 
sons boast  that  they  can  sleep  perfectly  w^ell  after  a  heavy  supper. 
Perhaps  they  can;  but,  as  Franklin  has  wisely  suggested,  they  may 
by  and  by  "  have  a  fit  of  apoplexy,  and  sleep  till  dooms  day."  This 
will  be  sleeping  too  ivefl ! 

Preparation  for  Sleep.  —  Dr.  Franklin  left  behind  the  record  of  a 
wise  life,  as  well  as  many  excellent  moral  and  philosophical  direc- 
tions. A  good  conscience  was  his  prescription  for  quiet  sleep  and 
pleasant  dreams,  —  a  most  excellent  direction.     Sleep  is  promoted, 

13 


111  r 

i':  It 


ii 


llj- 


i 


98 


HYGIENE. 


too,  by  withdrawing  the  mincJ,  a  short  time  before  retiring,  from  al\ 
hard  study,  and  exciting  themes  of  conversation ;  and  turning  it  to 
calmer  subjects  of  reflection,  such  as  the  ...--al  attributes  of  God, — 
particularly  his  love  and  paternal  character. 

Objects  of  Clothing. 

The  clothes  we  wear  are  intended,  or  should  be  intended,  to  secure 
three  objects,  —  warmth  in  winter,  coolness  in  summer,  and  health  at 
all  times. 

It  has  already  been  shown  that  our  bodies  are.  warmed  by  their 
own  internal  fires.  In  the  lungs,  in  the  skin,  and  indeed  in  all  parts 
of  the  body,  oxygen  unites  with  carbon  and  other  combustible  mat- 
ters, producing  heat  in  the  same  way  that  it  is  produced  in  a  grate 
where  anthracite  coal  is  burned ;  and  as  our  temperature  always 
needs  to  be  kept  up  to  about  98*^  of  Farenheit,  it  follows  that  this 
combustion  must  always  be  going  on. 

Now,  the  atmosphere  which  surrounds  us  is  always  receiving  into 
itself  the  heat  which  comes  to  the  surface  of  our  bodies,  and  thus 
robbing  us  of  our  warmth.  In  summer,  the  atmosphere,  full  of  the 
rays  of  a  burning  sun,  may  impart  heat,  instead  of  taking  it  away; 
while  in  winter,  it  takes  more  than  it  gives,  and  would  cause  us  to 
perish  with  the  cold,  were  it  not  for  the  protection  afforded  by  our 
clothing. 

Clothes,  of  course,  have  no  power  to  manufacture  or  impart  heat. 
They  only  retain,  and  keep  in  contact  with  our  bodies,  that  which  is 
generated  within  us.  If  we  have  on  a  single  garment  which  is  made 
tight  at  the  bottom  and  top,  so  that  no  current  can  pass  up  or  down, 
there  will  be  a  layer  of  air  between  it  and  the  body,  which,  becoming 
immediately  heated,  and  being  retained  there,  helps  keep  us  warm,  or 
rather,  prevents  us  from  being  cold.  With  every  additional  garment 
put  over  this,  there  is  another  layer  of  heated  air,  adding  still  more 
impenetrable  guards  against  either  the  intrusion  of  cold,  or  the  escaj)e 
of  internal  heat. 

Bad  Conductors  of  Heat.  —  But,  that  our  clothes  may  thus  retain 
our  warmth,  and  prevent  its  dispersion,  they  umst  be  bad  conductors 
of  heat,  —  that  is,  they  must  not  readily  take  up  the  heat  and  convey 
it  away  from  the  body.  They  must  slowly  absorb  the  caloric  into 
their  own  substance,  and  then  retain  it  tenaciously. 

Linen,  which  is  so  universally  popular  in  temperate  climates,  as  an 
article  to  be  worn  next  the  skin,  is  unfortunately  a  good  conductor  of 
heat.     It  does  not  afford  a  warm  garment.     It  conducts  heat  rapidly 

away  from  the  body.  Hence  it  always  feels  cool 
to  the  touch.  It  is  really  no  colder  in  itself  than 
other  kinds  of  cloth,  but  it  is  solely  the  rapidity 
with  which  it  conducts  heat  away  from  the 
body,  that  gives  it  the  feeling  of  coldness.  It 
has  other  qualities  which  compensate,  in  some 


Fro.  67. 


measure,  for  this  defect.     The  fibres  of  which  it  is  composed,  are 


%f: 


HYGIENE. 


99 


Fio  08. 


roun«l  and  pliable,  whii-li  inako  linen  cloth  snuujtli  and  soft,  and  the 
soMsation.H  produced  by  it,  upon  th»!  s*l\in,  altoi^ether  agreeable.  Figure 
67  represents  a  fibre  of  linen,  as  it  appears  under  a  niieroscopt!  wliieh 
magnilies  it  155  times. 

Cotton  is  warmer  than  linen,  because  it  is  a  worse  cnmluctnr  of 
heat.  The  perfection  to  which  its  manufacture  has  been  carried, 
makes  it  almost  a  rival  of  linen  in  softness  and  ])liability.  It  do<^8 
not  absorb  as  much  moisture  as  linen,  and  therefore  better  retain* 
its  powers  as  a  non-conductor. 

But  then  the  libres  of  cotton  are  not  round  and  smooth,  like  those 
of  linen,  but  flat  and  spiral,  with  sharp  edges 
Figure  68  represents  two  of  its  fibres,  iiiagMilie. 
155  times.  This  renders  cotton  irritable  to  sonu; 
very  delicate  skins.  This  is  the  reason  why  linen 
is  better  than  cotton  for  binding  up  wounds, 
where  there  is  tenderness  of  the  surface. 

Silk  has  a  round  fibre,  like  linen,  which  is  even  softer  and  smaller. 
It  absorbs  less  moisture  than  cotton,  and  in  its  power  of  communi- 
cating warmth,  it  is  superior  to  both  the  preceding.  It  forms  the 
most  desirable  fabric  for  clothing  that  we  have  ;  but  its  cost  makes  it 
inaccessible  to  the  great  body  of  the  people,  except  as  a  holiday 
dress  for  the  ladies.  Its  culture  in  our  own  country,  if  once  exten- 
sively established,  would  be  a  source  of  national  wealth. 

The  Fibre  of  Wool  is  quite  rough,  almost  scaly,  and  highly  irritative 
to  delicate  skins.  Figure  69  shows  fibres  magni- 
fied 310  times.  It  is  not  possible  for  some  per- 
sons to  wear  it  next  the  skin.  But  where  this 
cannot  be  done  it  may  be  worn  outside  the  linen 
or  cotton;  and  being  a  good  non-conductor^  it  will 
in  this  way  preserve  the  warmth  of  the  body, 
without  either  irritating  the  skin,  or  disturbing 
its  electricity. 

Wool,  in  cold  climates,  is  one  of  the  very  best 

materials  of  which  clothes  can  be  made.    In  New  

England,  and,  indeed,  in  all  cold  and  temperate  regions,  it  should  be 
worn  by  delicate  persons,  in  the  form  of  thick  or  thin  garments,  al! 
the  year  round.  It  does  not  readily  absorb  moisture,  and  is  a  dry, 
warm,  and  wholesome  material  for  clothing. 

Hair.  —  Though  not  precisely  in  the  line  of  these  remarks,  hau  may 
as  well  be  introduced  here.  Wool  is  in  fact  hair.  Every  part  of  tne 
skin,  with  the  exception  of  that  upon  the  soles  of  the  feet,  and  the 
palms  of  the  hands,  is  intended  to  produce  hairs.  On  most  parts  of 
the  body,  they  are  short  and  fine,  hardly  rising  above  the  surface. 
Upon  the  head  and  the  face,  they  grow  to  considerable  length. 

Hair,  like  wool,  is  a  bad  conductor  of  heat ;  and,  as  growing  upon 
the  head  and  face,  is  doubtless  intended  for  some  useful  purpose. 
That  it  was  designed  as  a  warm  covering,  can  hardly  be  doubted. 
The  beard,  when  permitted  to  grow,  is  a  natural  respirator,  guarding 


Fio.  69. 


-m 


:     rlnf". 


rl! 


M 


■H: 

.\ .  ■' 

,'t 

M 

M 

ml 


100 


IIYOIKNE. 


the  lungs  against  cold  and  dust.  Mr.  Chadwick  noticed  that  black, 
smiths  who  allowed  their  beards  to  grow,  had  their  niustachioa  discol- 
ored by  iron  dust,  which  lodged  among  the  hairs,  and  very  justly  in- 
ferred that  the  dust  must  have  found  its  way  into  the  lungs,  and  done 
mischief,  had  it  not  been  arrested  by  this  natural  respirator. 

That  the  beard,  when  long,  does  ward  olt"  a  great  many  colds  and 
thvoat  ails,  is  too  well  known  to  be  denied,  it  has  required  moral 
courage  on  the  part  of  those  who  have  broken  away  from  the  univer- 
sal practice  of  shaving,  for  which  they  should  be  hon-  kio.  70. 
ored  rather  than  ridiculed.  For  those  who  do  not  suH'er 
from  throat  or  lung  complaints,  especially  if  they  are 
jetting  advanced  in  life,  it  may  not  be  thought  worth 
while  to  abandon  the  razor.  Vet  the  change  would  not 
be  regrettetl.  Figure  70  is  a  human  hair,  magnitied  250  times,  show- 
ing its  scaly  surface. 

The  Color  of  our  Clothiiijr  is  a  matter  of  some  moment.  The  dark 
colors  absorb  the  light,  the  sun's  rays,  and  heat,  much  more  than  the 
lighter  ones ;  and  as  those  bodies  which  absorb  heat  well,  are  like- 
wise good  radiators,  the  dark  colors  have  the  hig'hest  ratliatiriff  power. 
White  reflects  heat,  and  rays  '^f  light,  and  is  a  bad  absorber  and  bad 
radiator.  In  slimmer  it  prevents  the  sun's  rays  from  passing  inward 
to  heai;  the  body,  and  in  winter,  interrupts  the  heat  of  the  body  in  its 
passage  out.  In  summer,  it  makes  the  coolest  garment ;  in  winter, 
the  warmest  one.  These  facts  can  be  very  simply  illustrated,  by  lay- 
ing, side  by  tiide,  upon  the  snow,  when  the  sun  shines,  two  pieces  of 
cloth,  the  one  black,  the  other  white.  Lifting  them  up,  after  a  time, 
the  snow  will  be  found  considerably  me/ted  under  the  black  cloth,  but 
not  under  the  white. 

It  is  now  seen  that  the  object  of  clothing  is  not  to  impart  heat  to 
the  body,  but  to  prevent  its  loss ;  that  it  is  not  to  create  it,  but  to 
furnish  the  occasion  for  increasing  its  degree.  It  appears  further,  that 
clothing  protects  the  body  against  the  evil  effects  of  changes  of  tem- 
perature, and  that  white  garments,  by  reflecting,  instead  of  absorbing 
heat,  guard  it  against  the  heat  of  summer. 

Clothhi?  should  be  Porous. — All  articles  used  for  garments,  should 
be  porous,  and  permit  the  free  passage  of  insensible  perspiration.  The 
skin  receives  oxygen  through  its  pores,  and  gives  back  carbonic  acid. 
It  performs  a  sort  of  subordinate  respiration.  India  rubber  garments 
worn  next  to  it,  interrupts  this,  and  must  do  mischief.  Shoes  made 
of  th'.o  material,  soon  cause  the  feet  to  become  damp  and  cold.  The 
dampness  is  occasioned  by  the  insensible  perspiration,  which  cannot 
escape  through  the  rubber.  Such  shoes  worn  in  the  open  air,  should 
be  immediately  taken  off*  on  entering  the  house. 

Thin  Shoes.  —  The  defective  way  in  which  American  females  pro- 
tect their  feet  from  cold  and  wet,  is  a  sore  evil ;  and.  he  who  persuades 
them  to  adopt  a  wiser  fashion,  and  cover  their  feet  with  better  guards 
against  colds  and  consumptions,  will  deserve  the  gratitude  of  the 
nation.    We  are  in  many  things  too  fond  of  copying  foreign  fashions : 


1^  'A 


mm 


JOW- 


but  if  our  ladies  would,  in  this  matter,  follow  tho  excellent  example 
of  English  women,  they  would  live  longer,  and  leave  a  hardier  pos- 
terity behind  them. 

The  shoes  worn  by  our  females,  high  and  low,  rich  and  poor,  are 
not  thick  enough  to  walk  with  safety  upon  a  painted  floor,  hardly 
upon  a  carpet  in  an  unwarmed  room  ;  and  yet  tliey  walk  with  them 
upon  cold  brick  side-walks,  upon  damp  and  frozen  ground,  and  even 
in  mud. 

The  result  is,  that  they  sufTer  from  colds,  sore  throats,  pleurisies, 
lung  fevers,  sjippressions,  inllammations  of  the  womb,  and  many  oilier 
ailments,  which  in  early  life,  rob  them  of  their  freshness  and  beauty, 
of  their  health  and  comfort,  of  their  usefuhu-ss  to  tlicir  household  and 
the  world,  and  leave  them  helpless  in  the  arms  of  their  friends,  with 
a  patrimony  of  snflering  for  themselves  while  they  live,  and  a  legacy 
of  dis(!ase  to  hand  down  to  their  children.  Wo  ild  that  they  were  wi.,e 
in  season  I  Some,  to  their  honor  be  it  suii  have  already  adopted  a 
safer  course.     It  is  hoped  the  evil  will  be  gnulaully  corrected. 

IVever  afteiiipt  fo  iiioiihl  the  Form  by  IKess.  —  Parents  commit  a 
great  error  when  they  atti^mpt  to  rno'  '  i  the  iorms  of  their  children, 
particularly  their  daughters,  by  their  dress.  This  cannot  l)e  done. 
1.  i^  the  work  of  nature,  and  she  wants  nc  assistanc(^  in  it.  Tiii; 
great  object  of  dress  in  childhood  as  \yc11  as  in  adult  life,  is  to  pro- 
mote health.  Willi  litis,  there  is  not  much  ditliculty  in  |)reserving  tlie 
symmetry  ;  irillioiU  il,  deforuuty  is  almost  a  mailer  of  course. 

The  fact  cannot  be  too  often  repeated,  nor  too  seriousl)  urj.'ed  upon 
parents,  that  while  the  foundation  of  all  graceful  and  just  proportion 
of  the  ditlerent  parts  of  the  body  nuist  be  laid  in  inlancy,  it  cannot 
be  done  by  tight  bands,  and  ligatures  upon  the  chest,  and  loins,  and 
legs,  and  arms.  Upon  all  these  points,  the  garments  of  children 
should  set  easy,  leaving  the  muscles  at  liberty  to  assume  the  line 
swell  and  dev«'lopment  which  nothing  short  of  unconstrained  exercise 
can  give.  Could  infants  tell  all  the  horrors  they  suttL'r  from  the  re- 
straints put  upon  them  by  tight  dresses,  it  woukl  make  niany  a  moth- 
er's heart  bleed. 

In  these  brief  remarks,  the  principles  are  given  which  should  guide 
us  in  the  selection  of  our  clothing, 
able,  very  easily  to  fdl  up  the  outline. 


The  intelligent  reader  will  be 


Bathing  and  Cleanliness. 

Aristoti.k  calls  cleanlmess  one  of  the  half  virtues ;  and  Addiscu, 
in  the  Spectatt)r,  recommends  it  as  a  mark  of  politeness,  and  as  analo- 
gous to  purity  of.mind.  Both  in  the  Jewish  and  Mohanunedan  law,  it 
is  enforced  as  a  part  of  religious  duty.  Its  recpiirement  as  a  prerequi- 
site to  christian  communion,  would  l)e  wiser  tlian  the  demands  some- 
times made.  A  dirty  Christian  may  perhaps  be  found,  but  not  among 
those  who  mean  to  be  intelligent. 

The  importance  of  keeping  the  skin  clean  is  not  generally  appre- 
ciated.    The  motive  for  cleanliness  is  often  a  lower  antl  meaner  one 


■:3E=sB!r!;sn=!= 


than  should  be  allowed  to  have  place  in  the  mind.  Many  persons 
would  '  >e  mortified  to  have  their  hands,  or  face,  or  neck  dirty,  who  do 
not  wash  their  w'.iole  body  once  a  year.  That  they  may  appear  wet 
in  the  eyes  of  others,  is  the  only  motive  with  such  for  keeping  clean. 

Offices  of  the  Skin.  —  If  we  look  a  little  at  t!ie  offices  of  the  skin, 
we  shall  better  understand  the  need  of  keeping  it  clean. 

The  skin  is  not  merely  a  covering  to  protect  us  from  the  wealner. 
It  is  a  living  structure,  curiously  wrought,  with  a  large  extent  of  sur- 
face, and  having  important  duties  to  perform  in  the  animal  economy. 
Its  structure  is  more  particularly  explained  under  the  head  of  "  Anat- 
oiny"  and  "  Skin  Diseases."  It  has  been  already  said,  that  it  helps 
the  lungs  in  breathing.  It  does  many  other  things  on  which  the 
health  is  dependent,. 

Xumbcr  of  Perspiratory  Tubes. —  The  skin  performs  several  kinds 
of  secretion,  —  that  is,  it  separates  several  things  from  the  blood, — 
one  of  which  is  the  perspiration,  or  sweat.  The  sweat  is  formed  in 
small  glands,  situated  just  under  the  skin,  and  is  brought  to  the  surface 
in  small  ducts,  or  tubes,  like  the  hose  through  which  firemen  throw 
water.  These  little  tubes  are  spiral,  as  seen  in  cut  44,  and  run  ujv 
through  the  two  skins. 

These  spiral  canals  are  very  numerous,  covering  every  part  of  the 
human  frame,  —  there  being  about  2800  of  them  upon  every  square 
inch,  throughout  the  body  ;  and  as  a  man  of  ordinary  size,  has  about 
2500  square  inches  '^  surface,  the  number  of  tubes  in  the  skin  of  one 
man  is  seven  millions. 

The  mouths  of  these  tubes  are  called  the  pores  of  the  skin.  Each 
one  of  these  tubes  is  extended  just  below  the  skin  ;  and  there,  among 
the  cells  where  the  fat  is  deposited,  it,  or  rather  the  two  branches  into 
which  it  is  divideXi,  are  wound  into  a  coil,  called  the  suucriferons,  or 
sweat  gland.  These  ducts  are  each  about  a  quarter  of  an  inch  ;;• 
length,  wliich  makes  an  aggregate  length  of  tubing  in  the  human  skin 
of  about  tw^enty-eigl'.t  miles. 

Insensible  Perspiration. —  Through  each  of  these  seven  million  of 
quarter  inch  hose,  there  is  poured  out,  day  and  night,  as  long  as  a 
man  lives,  a  stream  of  sweat  in  the  form  of  vapor.  When  this  is 
thrown  oil"  very  rapidly,  as  happens  when  active  exercise  is  taken,  it 
accunmlates  in  drops,  and  is  called  sweat.  Ordinarily  it  does  not 
thus  accumulate  ;  it  is  then  called  insensible  perspiration,  —  not  being 
ircognized  by  the  senses. 

This  transpiration  may  be  proved  very  beautifully  by  inserting  the 
naked  arm  into  a  long  glass  jr.r,  and  closing  up  the  space  around  it 
at  the  mputh  so  that  no  air  can  get  in.  The  inside  of  the  glass  will 
Foon  be  covered  with  a  vapor,  which  will  grow  more  and  more  dense 
until  it  is  converted  into  drops.  Boerhaave  says :  "  If  the  piercing 
chill  of  winter  could  be  introduced  into  a  summer  assembly,  the 
insensible  perspiration  being  suddenly  condensed,  would  give  to  each 
person  the  appearance  of  a  heathen  deity,  wrapped  iu  bis  own  sepa- 
rate cloud." 


Now,  this  continual  exudation  of  sweat  through  these  millions  of 
tubes  is  for  a  wise  and  necessary  purpose.  It  is  to  take  out  of  the 
blood  and  other  Huids  various  salts,  which  would  do  mischief  if 
allowed  to  remain  longer,  and  particularly  carbonic  acid,  which  is 
poisonous, — the  same  matters,  in  fact,  which  are  thrown  out  by  the 
lungs.  The  skin,  in  truth,  is  a  kind  of  helper  of  the  lungs ;  and  a 
lady,  by  covering  herself  With  garments  which  have  no  pores,  and 
will  neither  admit  air  nor  let  off  insensible  perspiration,  may  be  stran- 
gled almost  as  certainly  as  by  putting  a  cord  around  her  neck,  and 
closing  her  windpipe.  Almost  twice  as  much  tiuiJ  passes  otV  through 
the  skin  as  through  the  lungs. 

Keep  the  Pores  0|ieii. —  It  is  obvious  from  what  has  now  been  said, 
that  the  pores  of  the  skin  should  be  kept  open  to  preserve  health. 
When  bathing  is  neglected,  and  the  under  garments  are  not  changed 
sufliciently  often,  the  insensible  perspiration  accujnulates  and  dries  up 
upon  the  skin,  mingling  with  the  oily  matter  secreted  by  the  oil  glands, 
and  with  the  shreds  of  the  scarf  skin,  and  forming  a  tenacious  gluey 
matter,  which  closes  up  the  pores.  By  this  misfortune,  that  large  quan- 
tity of  worn-out  matter  which  usually  goes  oil' with  the  fluid  through 
the  pores,  is  retained  to  poison  and  embarrass  the  living  current  of 
blood,  or  seek  an  outlet  through  lungs  or  kidneys  which  are  already 
burdened  with  quite  as  nmch  as  they  are  able  to  do.  How  impor- 
tant, then,  that  these  channels  through  which  the  body  is  purified, 
should  be  kept  open !  that  the  skin  should  be  kept  healthy  and  in 
working  order ! 

The  Bath,  the  Great  IMirifier.  —  But  this  can  only  be  done  by  daily 
washing.     The  bath  is  the  great  purifier  of  the  human  skin. 

The  antiquity  of  bathing  is  very  great.  The  practice  is  supposed 
to  reach  back  to  the  infancy  of  the  race,  or  certainly  to  a  very  early 
period.  The  inhabitants  of  middle  Asia  are  said  to  have  been  the 
first  to  use  the  bath  for  the  specific  purposes  of  purification  and 
health.  Domestic  baths  are  represented  as  having  been  used  by 
Diomed  and  Ulysses.  Andromache  prepared  warm  water  for  Hector 
on  his  return  from  battle.  Penelope  banished  sorrow  by  unguents 
and  baths. 

The  Baths  of  the  Wedes,  the  Persians,  and  tlie  AssjTians  were  much 
celebrated.  Alexander,  though  familiar  with  the  voluptuous  baths 
of  Greece  and  Macedon,  was  astonished  at  the  magnificence  of  those 
of  Dnrius. 

Itoman  Baths.-  — As  luxury  and  refinement  advanced,  the  means  of 
luxurious  bathing  were  multiplied,  until  establishments  were  built  by 
the  Romans,  the  very  remains  of  which  exttite  wonder  at  this  day. 
Among  these  are  the  ThernifB  of  Agiippa,  of  Nero,  of  Vespasian, 
of  Titus,  etc.  One  of  the  halls  of  the  building  constructed  for  baths 
by  Diocletian,  forms  at  this  day  the  church  of  the  Carthusians,  one 
of  the  most  magnificent  temples  in  Rome. 

IVuniber  and  Character.  —  According  to  Pliny,  baths  were  intro- 
duced into  Roni9  about  the  time  of  Pomjjey ;  their  first  erection  Dion 


:  1 

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II 

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i  t 


1  .1 


104 


HYGIENE. 


attributes  to  Maecenas.  Agrippa  increased  their  number  to  one 
hundred  and  seventy  ;  and  within  two  hundred  years  they  were  mul- 
tiplied to  about  eight  hundred.  These  establishments  were  so  vast 
that  one  writer  compares  them  to  provinces.  They  were  paved  either 
with  crystal,  or  mosaic,  or  plaster,  and  were  adorned  by  sculpture  and 
painting  to  the  very  highest  degree.  They  added  not  merely  to  the 
health  and  luxury  of  the  people,  but  contributed  to  their  culture  in 
the  highest  departments  of  art  and  taste. 

IVnnies  of  Biitlis.  —  To  the  apartment  of  their  dwelling  in  which 
•hey  washed  their  bodies  in  warm  or  hot  water,  the  Romans  gave  the 
iiiMie  of  balneum^  or  bath;  to  the  public  establishments,  that  of  balnea, 
or  baths.  The  apartment  which  held  the  vessels  was  called  vasariuni. 
hi  this  were  the  three  immense  vessels  which  contained  the  cold,  warm, 
and  hot  water.  There  were  instruments  of  bone,  ivory,  and  metal, 
for  scraping  the  skin,  with  a  groove  in  the  edge,  through  which  the 
impurities  of  the  skin  mi^-^ht  run  off. 

On  the  north  front  of  *^he  thermfB  was  a  reservoir  of  cold  water  • 
large  enough  for  swimming,  called  by  Pliny  the  younger,' baptisteium. 
In  the  centre  was  a  spacious  vestibule,  and  on  each  side,  warm,  cold, 
and  vapor  baths,  with  apartments  for  cooling,  dressing,  and  refresh- 
ments. There  was  the  fri<>'idaiiim,  a  vaulted  room,  a  cooling  room 
midway  between  the  warmer  and  the  open  air ;  the  tepidanum,  with 
a  temperature  widway  between  the  above  and  the  hot  bath  ;  and  the 
co/idarium,  or  the  vapor  bath. 

Then  there  was  the  room  where  the  body  was  rubbed  over  with  a 
great  immber  of  ointments  and  essences  of  the  most  precious  kinds ; 
and  another  in  wmch  it  was  sprinkled  over  With  powder  ;  and  also  a 
room  which  held  the  clothes,  in  which  the  bathers  undressed  and 
dressed  at  pleasure. 

All  these  apartments  were  double,  the  two  wings  being  appropri- 
ated to  the  sexes. 

Open  to  uU.  —  These  baths,  thus  numerous  and  magnificent,  were 
open  to  all  classes  of  the  people,  and  contributed  largely  to  the  gen- 
eral health  and  physical  endurance  for  which  the  Romans  were  con- 
spicuous. 

The  Bntli  ^'ejclerted  iinder  the  Chrisfijin  System. — When  Jesus  of 
Nazareth  came  into  the  world,  he  found  man's  nature  cultivated  in  a 
most  defective  way.  The  moral  element  had  sunk  down  to  the  low- 
est place,  while  the  physical  had  risen  to  the  highest, — just  the  reverse 
of  the  true  order  of  things.  This  Divine  Teacher  came,  not  to  re- 
commend a  neglect  of  the  body,  but  a  new  cure  for  the  imperishable 
part.  Mankind  were  for  the  first  time  systematically  taught  to  forgive 
injuries.  Prostrate  liberty,  and  degraded  woman,  became  the  wards 
of  Christianity. 

Unfortunately,  under  the  new  order  of  things,  the  lower  element 
of  man,  which  had  been  exalted  and  worshipped,  was  cast  down  and 
abused.  What  the  Pagan  had  pampered,  the  Christian  persecuted. 
The  body,  whi(;h  had  been  bathed,  and  scrubbed,  and  anointed,  and 


HYGIENE. 


105 


perfumed,  was  thenceforward,  in  consequence  of  the  improper  inter- 
pretation of  certain  texts,  scourged,  and  fasted,  and  clothed  in  rags. 
Thousands  believed,  and  thousands  do  to  this  day,  that  to  torment 
the  body  is  to  please  God.  Under  this  feeling,  the  public  and  private 
baths  were  neglected ;  and  to  this  day,  no  christian  nation  has  fully 
appreciated  the  necessity  of  cleanliness,  and  of  sanitary  measures  for 
the  maintenance  of  the  public  health.  To  a  considerable  extent,  the 
body  is  still  under  disabilities ;  still  the  subject  of  persecution  ;  and 
where  this  is  not  the  case,  it  is  too  often  regarded  only  as  a  loose  out- 
side garment,  to  be  thrown  over  the  traveller  to  the  celestial  city,  and 
is  expected  to  be  well  soiled  with  mud  and  dust.  The  teachings  of 
,lie  Great  Master  will  by  and  by  cease  to  be  perverted,  and  will  be 
applied  to  raise  up  man's  body,  as  they  have  raised  his  mental  and 
moral  nature,  and  will  make  a  well-developed  and  harmonious  being. 
In  the  mean  time,  it  is  the  duty  and  the  privilege  of  the  physician 
to  urge  a  return,  not  to  the  magnificence  of  the  ancient  regimen  for 
training  the  body,  but  to  its  real  efficiency  in  a  simpler  form. 

Cold  Batllillj^. —  Water  applied  to  the  skin  at  a  temperature  below 
75°  of  Farenheit,  is  called  a  cold  bath.  If  appl'ed  to  a  person  with 
sufficient  constitutional  energy  to  bear  it,  if  is  a  decided  and  very 
powerful  tonic.  By  this  is  meant  that  it  promotes  the  solidity,  com- 
pactness, and  strength  of  the  body. 

The  first  effi^'ct  of  the  application  of  cold  water  to  the  ski  i,  is  the 
sudden  contraction  of  all  its  vessels,  and  the  retreat  of  the  blood 
towards  the  internal  organs.  The  nervous  system,  feeling  the  shock, 
causes  the  heart  to  contract  witli  more  energy,  and  throw  the  blood 
back  with  new  force  to  the  surface. 

This  rushing  of  the  blood  back  to  the  skin,  is  called  a  reaction  ; 
and  when  it  occurs  with  some  energy,  it  is  an  evidence  that  the  sys- 
tem is  in  a  condition  to  be  much  benefited  by  the  cold  bath.  When 
this  does  not  take  place,  but  the  skin  looks  shrunken,  and  covered 
with  "goose  flesh,"^and  a  chilliness  is  felt  for  a  longer  or  shorter  time 
after  bathing,  then  the  inference  should  be,  either  that  the  water  has 
been  used  too  profusely,  or  that  the  bather  has  too  little  reactionary 
|)ower  for  this  form  of  the  bath.  -The  latter  conclusion  must  not  be 
iKicepted  until  cold  water  has  been  tried  with  all  possible  guards, — 
tiuch  as  beginning  with  tepid  water,  and  gradually  lowering  the  tem- 
perature ;  bathing  for  a  timt^,  at  least,  in  a  warm  room  ;  beginning 
the  practice  in  warm  weather  ;  and  applying  the  water  at  first  with  a 
Bponge,  out  of  which  most  of  it  has  been  pressed  by  the  hand.  With 
some  or  all  of  these  precautions,  most  persons  may  learn  to  use  the 
ex)ld  bath.  It  is  always  to  be  followed  by  brisk  rubbing  with  a  coarse 
towel  or  flesh-brush. 

The  Spondee  Bvitli.  —  A  wet  sponge  is  the  simplest,  as  well  as  the 
best  mode  of  applying  water  to  the  surface  of  the  body.  With 
persons  who  are  feeble,  a  part  only  of  the  body  should  be  exposed 
at  a  time,  —  which  part,  having  been  quickly  sponged  and  wiped 
dry,  should  be  covered,  and  another  part  exposed,  and  treated  in  a 
like  manner.     In  this  way,  all  parts  of  the  body  may  successively  be 


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subjected  to  the  bracing  influence  of  water  and  friction,  with  little 
risk,  even  to  the  most  delicate,  of  an  injurious  shock.  The  only  fur- 
niture required  for  carrying  out  this  simple  plan  of  bathing,  is  a 
eponge,  a  basin,  and  a  towel.  There  is  no  form  cf  bathing  so  uni- 
versally applicable  as  this,  or  so  generally  conducive  to  health. 

The  Shower  Bath  requires  a  brief  notice.  The  shock  to  the  nervous 
Bystem  produced  by  it,  is  much  greater  thaii  that  from  sponging 
Beside  the  sudden  application  of  coldness,  there  is  a  concussion  of 
the  skin  by  the  fall  of  the  water.  This  form  of  the  bath  is  excellent 
for  those  who  are  strong  and  full  of  vitality,  but  is  fraught  with  some 
danger  for  the  feeble  and  delicate.  This,  however,  depends  on  the 
judgment  with  which  it  is  used.  In  the  form  of  a  delicate  shower 
and  with  tepid  water,  the  frailest  body  might  bear  its  shock. 

The  Warm  Bath.  —  A  temperate  bath  ranges  from  75°  to  85° ;  a 
tepid  bath,  from  85°  to  95° ;  a  warm  bath,  from  95°  to  98°  ;  a  hot 
bath,  from  98°  to  105°.  A  warm  bath  is  of  the  same  temperature 
with  the  surface  of  the  body.  Of  course  it  produces  no  shock.  To 
those  who  are  past  the  meridian  of  life,  and  have  dry  skins,  and  begin 
to  be  emaciated,  the  warm  bath,  for  half  an  hour.  tvVice  a  week,  is 
eminently  serviceable  in  retarding  the  advances  of  age. 

It  is  a  mistake  to  suppose  the  warm  bath  is  enfeebling.  It  has  a 
soothing  and  tranquillizing  effect.  It  renders  the  pulse  a  little  slower, 
and  the  b-feathing  more  even.  If  the  bath  be  above  98°,  it  becomes 
a  hot  one,  and  the  pulse  is  quickened. 

The  temperature  of  the  warm  bath,  as  of  the  cold,  should  be  made 
to  range  up  and  down  according  to  the  vigor  of  frame,  and  the  circu- 
lation of  the  individual.  The  aged  and  the  infirm,  whose  hands  and 
feet  are  habitually  cold,  require  it  to  be  well  up  towards  the  point  of 
blood  heat.  The  pulse  should  not  be  made  to  beat  faster  by  it,  nor 
should  sensations  of  heat  or  fulress  be  induced  about  the  temples 
and  face. 

The  Vapor  Bath.  —  This  differs  from  the  warm  bath  in  being  ap- 
plied to  the  interior  as  well  as  to  the  exterior  of  the  body.     The 
warmth  is  inhaled  into  the  air  tubes  at  the  same  time  that  it  env^'l- 
ops  the  external  person.     The  first  sensation  of  the  vapor  batli  is 
oppression,  and  causes  some  difficulty  of  breathing ;  but  this  pussei 
of!"  as  soon  as  the  perspiration  begins  to  flow.      From  the  slciiin 
chamber,  the  bather  should  step  into  a  tepid  bath,  and  after  remain 
ing  a  short  time  in  this,  wipe  himself  thoroughly  with  dry  towels. 

Cold  Affusion  immediately  after  either  the  warm  or  the  vapor  bath, 
is  excellent.  In  Russia  it  is  common,  after  the  vapor  bath,  to  pour 
upon  the  head  of  the  bather,  a  bucket  of  warm  water,  then  one  of 
tepid,  and  lastly  one  of  cold ;  and  to  finish  with  giving  him  a  good 
towelling.  It  is  even  said  that  the  natives  leave  the  steam  and  the  hot 
bath,  and  roll  themselves  in  the  snow. 

No  danger  need  be  feared  from  cold  affusion  when  the  skin  is  red 
and  excited  by  the  warm  bath,  provided  the  nervous  frame  is  not  in 
a  depressed  condition.     If  the  body  is  chilled,  and  the  nerves  pros- 


trated by 
may  do  § 
water  app 
nothing  b 
tage  on  ri 
time  is  ai 
power  is  i 

Reactio 

importanc 
and  imprc 
motion  ol 
the  skin. 

Variou! 
it  by  a  kii 
attendanti 
warm  wa 
He  cracki 
then  plac 
seizes  you 
vertebrte, 
parts,  thei 
"This  pn 
hour,  aftei 
being."  1 
« If  life  b 
with  whic 
that,  in  th 
number  oi 

Tlie  Coi 

appliance! 
tion.  Fo 
the  bathei 
duces  pal) 
the  reacti( 

Restora 

tlie  bath  i 
among  ai 
s()\irce  of 
IH'ople  wi 
The  atter 
has  a  bit  < 
that  watt 
and  physi 
should  CO 
times  be  i 
A  peop 
very  natu 
clean  am 


HYGIENE. 


107 


trated  by  disease  or  fatigue,  the  application  of  cold  water  to  the  skin 
may  do  great  mischief,  and  should  in  no  case  be  hazarded.  Cold 
water  applied  to  a  hot  skin,  cannot  do  harm  ;  to  a  cold  skin,  it  can  do 
nothing  but  harm.  Hence,  the  cold  bath  may  be  used  with  advan- 
tage on  rising  in  the  morning,  while  the  body  is  warm.  Another  good 
time  is  at  ten  or  eleven  o'clock  in  the  forenoon,  when  the  nervous 
power  is  advancing  towards  its  height  for  the  day. 

Renctioii  Necessary. —  As  a  means  for  promoting  cleanliness,  the 
importance  of  the  bath  can  hardly  be  overstated.  For  tlie  support 
and  improvement  of  health,  it  is  equally  important.  But  for  the  pro- 
motion of  the  latter,  one  prerequisite  is  essential,  —  the  reaction  of 
tlie  skin. 

Various  means  are  resorted  to,  to  secure  this.  The  Hindoos  secure 
it  by  a  kind  of  shampooing,  thus  described  by  a  writer  :  "  One  of  the 
attendants  on  the  bath  extends  you  upon  a  bench,  sprinkles  you  with 
warm  water,  and  presses  the  whole  body  -in  an  adminible  manner^ 
He  cracks  the  joints  of  the  fingers,  and  of  all  the  extremities.  He 
then  places  you  upon  the  stomach,  pinches  you  over  the  kidneys, 
seizes  you  by  the  shoulders,  and  cracks  the  spine  by  agitating  all  the 
vertebrte,  strikes  some  powerful  blows  over  the  Heshy  and  muscular 
parts,  then  rubs  the  body  with  a  hair-glove  until  he  perspires,  etc." 
"This  process,"  says  the  writer,  "continues  for  three-quarters  of  an 
hour,  after  which  a  man  scarcely  knows  himself ;  he  feels  like  a  new 
being."  Sir  John  Sinclair  speaks  thus  of  the  luxury  of  the  process  : 
"If  life  be  nothing  but  a  brief  succession  of  our  ideas,  the  rapidity 
with  which  they  now  pass  over  the  mind  would  induce  one  to  believe 
that,  in  the  few  short  minutes  he  has  spent  in  the  bath,  he  has  lived  a 
number  of  years." 

Tlie  Course  Towel,  the  horsehair  glove,  and  the  flesh-brush  are  the 
appliances  commonly  used  for  stimulating  the  skin,  and  causing  reac- 
tion. For  tender  skins,  the  towel  is  sufficiently  rough.  With  this 
the  bather  should  rub  himself,  unless  he  is  weak  and  the  exertion  pro- 
duces palpitation.  The  muscular  exertion  necessary  for  this  will  help 
the  reaction. 

Restoration  of  the  Bath  desirable.  —  It  is  greatly  to  be  wished  that 
the  bath  might  be  restored  to  something  like  the  importance  it  held 
among  ancient  nations.  It  is  a  luxury,  a  means  of  health,  and  a 
source  of  purity  both  of  body  and  of  mind;  for  the  morals  of  any 
IH'ople  will  rise  where  the  use  of  the  bath  is  regular  and  habitual. 
The  attempt  to  cure  all  diseases  by  what  is  called  the  "  water-cure," 
has  a  bit  of  fanaticism  about  it,  which  will  cure  itself  in  time.  But 
that  water,  used  judiciously  in  the  form  of  baths,  is  a  potent  moral 
and  physical  renovator  of  the  race,  is  not  to  be  doubted  ;  and  this 
should  commend  it  to  all  sensible  people,  even  though  it  should  some- 
times be  abused  by  excess,  as  all  good  things  are. 

A  people  with  clean  hands,  and  clean  bodies,  and  clean  health,  will 
very  naturally  come  to  like  clean  streets  and  clean  cities,  and  finally, 
clean  consciences.     A  fondness  for  cleanliness  in  one  form,  almost 


3'  ' 


I,      I 


'     i 


I      ! 


t  1 


!,  '   ' 


I  ip 

!  I!' 


VA 


,5, 


i!il' 


III 


108 


HYGIENE. 


nece.ssarily  runs  into  a  like  fondness  for  it  in  other  forms,  until  the 
purifying  desire  pervades  the  whole  nature,  moral  as  well  as  physical. 

Air  and  Ventilation. 

Water  and  air  are  fluids.  Water  covers  two-thirds  the  surface  of 
the  globe,  having  a  depth,  in  some  places,  of  ^.*e  miles  or  more.  Air 
covers  not  merely  the  remaining  third  of  the  earth,  but  the  water  as 
well.  It  embraces  the  entire  globe,  pressing  alike  upon  land  and 
water,  and  having  a  depth  of  about  forUf-fwe  miles.  This  is  a  sea  of 
such  magnitude,  that  the  Atlantic  or  Pacific  shrinks  to  a  very  small 
lake  in  the  comparison. 

Man  has  his  residence,  and  walks  about  at  tiie  bottom  of  this 
ocean.  He  has  no  means  of  navigating  it,  and,  therefore,  never  rises 
to  its  surface  ;  but,  with  his  natural  eyes,  and  with  telescopes,  he  dis- 
covers objects  which  lie  millions  and  billions  of  iniles  beyond  it,  and 
even  acquires  much  exact  and  useful  information  respecting  them. 

This  vast  ocean  of  air  we  call  an  almosp/iere,  from  two  Greek 
words  signifying  vapor,  and  a  sphere,  —  it  being  an  immense  fluid- 
sphere,  or  globe. 

Pressure  of  the  Atmosphere. —  This  atmosphere  presses  upon  man 
and  upon  every  object  on  the  surface  of  the  earth,  with  a  force  ecjual 
to  fifteen  pounds  to  every  square  inch  ;  and  as  a  man  of  average  si/e 
has  a  surface  of  about  2500  square  inches,  the  air  in  which  he  livos, 
presses  upon  him  with  a  weight  of  eighteen  tons.  This  would  of 
course  crush  every  bone  in  his  body,  but  for  the  fluids  within  him 
which  establish  an  equilibrium,  and  leave  him  unoppressed. 

The  Philosophy  of  Brenthniii^  canijot  be  fully  explained  in  the  brief 
space  allotted  to  this  subject ;  it  is  enough  to  say,  that,  upon  the  at- 
tempt being  made  to  draw  in  the  breath,  the  muscles  of  the  breast 
draw  up  the  ribs,  the  diaphragm  or  midrifl'  at  the  same  time  contract- 
ing,—  the  whole  movement  being  such  as  to  create  a  vacuum  in  the 
lungs.     The  air,  pressing  upon  every  part  of  the  surface,  as  mentioned 


lungs 


being 


above,  instantly  rushes  in  and  fills  the  vacuum.     The 
filled,  the  contraction  of  the  muscles  of  the   belly  causes  the  dia- 
phragm, which  has  sunk  down  towards  a  plane,  to  rise  up  into  the 
form  of  an  umbrella,  and  squeeze  the  air  out  of  the  lungs. 

This  is  about  all  that  need  to  be  said  of  the  method  of  getting  the 
air  into  and  out  of  the  lungs.  The  whole  process  is  under  the  con- 
trol of  that  part  cf  the  nervous  system  called  tlie  medulla  obfungala, 
or  top  of  the  spinal  cord. 

Objects  of  Breathing. —  There  are  at  least  three  objects  to  be  ac- 
complitihed  by  breathing ;  the  renewal  of  the  blood  and  the  taking  of 
impurities  out  of  it ;  the  warming  of  the  body ;  and  the  finishing  up 
of  the  process  of  digestion,  and  the  change  of  chyle  into  imtritive 
blood. 

There  is  no  ^ood  reason  for  attempting  here  to  explain  the  last  of 
these  objects.  To  give  any  idea  of  the  first  two,  it  is  necessary  to 
furnish  a  very  brief  explanation  of  the  circulation  of  the  blood. 


HYGIENE. 


109 


Fio  71 


The  heart  is  double.  There  are  in  fact  two  hearts,  a  right  and  a 
left,  joined  together.  The  right  heart  receives*  the  blood  from  the 
veins,  and  forces  it  up  into  the  lungs,  whence  it  is  brought  back  to 
the  left  heart,  and  by  this  is  driven  through  the  arteries  into  every 
part  of  the  body.  When  received  into  the  lungs,  the  blood  is  of  a 
dark  purple  color,  and  is  loaded  with  carbonic  acid  and  some  other 
impurities.  It  has  also  been  deprived,  during  its  circulation  through 
the  body,  of  most  of  its  oxygen.  The  small,  delicate  vessels  which 
convey  this  dark  and  impure  blood  through  the  lungs,  pass  directly 
over  the  air  cells  ;  and  at  this  moment  the  carbonic  acid  and  water 
pass  through  the  blood  vessels  and  air  cells,  and  are  borne  from  the 

body  on  tiie  outgoing  breath ;  while  the  oxy- 
gen enters. the  blood  through  the  walls  of  the 
same  vessels ;  and  thi.s  exchange,  which  takes 
place  with  every  breath,  alters  the  blood  from 
a  dark  purple  to  a  scarlet  red.  Figure  71 
shows  at  1,  a  bronchial  tube  divided  into  three 
branches  ;  2,  2,  2,  are  air-cells  ;  3,  branches  of 
the  pulmonary  artery  winding  around  the  air- 
cells  with  the  dark  blood  to  be  reddened. 
That  carbonic  acid  and  water  are  borne  out  of  the  lungs  with  every 
breath,  may  be  easily  proved.  If  we  breathe  into  lime-water,  it  will 
become  white.  This  is  owing  to  the  carbonic  acid  in  the  breath 
uniting  with  the  lime,  and  producing  carbonate  of  lime.  Then,  if  we 
breathe  upon  a  piece  of  glass,  it  becomes  wet,  showing  that  there  is 
watery  vapor  in  the  breath.  That  the  blood  receives  oxygen  from 
the  air  we  breathe  is  proved  by  the  fact  that  the  ingoing  breath  has 
one-fourth  more  oxygen  in  it  than  the  outgoing. 

The  lungs,  then,  take  out  of  all  the  air  we  breathe,  one-fourth  of 
its  oxygen.  If  we  breathe  it  over  a  second,  a  third,  and  a  fourth  time, 
it  not  only  has  less  oxygen  each  time,  and  is  less  useful  for  the  pur- 
poses of  respiration,  but  it  becomes  positively  more  hurtful  by  reason 
of  the  poisonous  carbonic  acid  which,  at  every  outgoing  breath,  it 
carries  with  it  from  the  lungs. 

Effect  of  Sleeping;  in  a  Small  Room.  —  Now,  consider  the  effect  of 
sleeping  in  a  small  room,  seven  feet  by  nine,  not  furnished  with  the 
means  of  ventilation.  A  pair  of  lungs,  of  ordinary  size,  take  in,  at 
each  breath,  about  a  pint  of  air.  Out  of  this  air  one-fourth  of  its  oxy- 
gen is  extracted  ;  and  when  it  is  returned  from  the  lungs,  there  comes 
along  with  it  about  eight  or  nine  per  cent,  of  carbonic  acid.  As  it  is 
not  safe  to  breathe  air  containing  more  than  three  or  four  per  cent, 
of  this  gas,  the  pint  which  the  lungs  take  in  and  throw  out  at  each 
breath,  is  not  only  spoiled,  but  it  spoils  something  more  than  another 
pint  with  which  it  mingles;  and  as  the  breath  is  drawn  in  and  thrown 
out  about  eighteen  times  per  minute,  not  less  than  four  cubic  feet  of 
air  is  spoiled  m  that  time  by  one  pair  of  lungs.  This  is  two  hundred 
and  forty  feet  an  hour ;  and  in  eight  hours,  the  usual  time  spent  in 
the  sleeping  room,  it  amounts  to  one  thousand  nine  hundred  and 
twenty  cubic  feet.     During  the  hours  of  sleep,  theiefore,  one  pair  of 


;'ii!1'^ 


I  i, 


w 


110 


HYGIENE. 


lungs  SO  spoil  one  thousand  nine  hundred  and  twenty  cubic  feet  of 
air  that  it  is  positively  dangerous  to  breathe  it. 

In  a  room  seven  feet  by  ten,  and  eight  feet  high,  there  are  five  hun- 
dred and  sixty  cubic  feet  of  air,  a  little  more  than  one-quarter  the 
amount  spoiled  by  one  pair  of  lungs  during  sleeping  hours.  In  a 
room  of  this  size,  there  is  not  air  enough  to  last  one  person  three 
hours ;  and  yet  two  persons  often  remain  in  such  rooms  eight  or  nine 
hours. 

Why  then  do  they  not  perish  ?  Simply  because  no  room  is  entirely 
air  tight.  Fortunately,  all  our  rooms  are  so  made  that  some  foul  air 
will  get  out,  and  a  little  that  is  pure  will  find  its  way  in.  Were  it  not 
so,  no  man  who  closed  the  door  behind  him,  for  the  night,  in  a  small  bed- 
room, would  ever  see  a  return  of  day. 

Suppose  fifty  children  are  confined  in  an  unventilated  school-room, 
twenty  feet  by  thirty,  and  ten  feet  high.  These  children  will  spoil 
about  one  hundred  and  fifty  feet  of  air  in  one  minute,  or  nine  thou- 
sand feet  per  hour,  or  twenty-seven  thousand  feet  in  three  hours,  —  a 
usual  half  day's  session.  But  the  room  holds  only  six  thousand  cubic 
feet  of  air,  —  the  whole  of  which  these  children  would  spoil  in  forty 
minutes. 

These  simple  facts  show  the  absolute  necessity  of  ventilation.  Yet 
how  poorly  it  is  provided  for  in  our  sleeping  rooms,  our  sitting  rooms, 
our  school  houses,  our  churches,  our  court  houses,  our  halls  of  legis- 
lation, and  even  in  our  anatomical  and  medical-lecture  rooms ! 

In  sick-rooms,  ventilation  sliould  receive  special  attention. — Every 
disease  is  aggravated  by  the  breathing  of  bad  air.  Yet  It  is  common 
to  close  all  the  doors  and  windows  of  rooms  where  sick  persons  are 
confined,  lest  the  patients  should  take  cold.  This  is  a  bad  practice. 
The  sick  should  have  a  plenty  of  fresh  air.  Their  comfort  is  pro- 
moted by  it,  and  their  recovery  hastened. 

It  is  strange  that  human  beings  should  be  afraid  of  pure  air.  It  is 
their  friend  and  not  their  enemy.    Impure  air  only  should  be  shunned. 

The  supply  of  goo<l  air  ample.  —  There  is  no  necessity  for  breath- 
ing air  which  has  lost  a  part  of  its  oxygen,  and  acquired  a  portion  of 
carbonic  acid.  The  supply  of  good  air  is  ample.  An  ocean  of  it 
forty-five  miles  deep,  covering  the  whole  globe,  seems  a  pretty  plain 
intimation  that  it  is  not  to  be  sparingly  used.  When  men  retire 
within  their  dwellings,  and  attempt  to  shut  out  this  great  sea  of  air, 
they  show  about  as  much  wisdom  as  would  be  exhibited  by  fishes 
which  should  build  water-tight  huts  around  themselves  at  the  bottom 
of  the  ocean,  and  swim  about  continually  in  the  unchanged  water 
within.  Fiohes  can  only  live  in  glass  globes  when  the  water  is 
changed  every  day ;  and  if  the  ^ater  be  changed  half  a  dozen  times 
a  day,  they  cannot  be  as  healthy  as  when  swimming  in  the  great 
ocean. 

Cnltivatinji:  Trees. —  In  most  of  our  cities  there  is  almost  a  criminal 
neglect  of  the  cultivation  of  trees ;  yet  they  add  greatly  to  the  health, 
and  prolong  the  lives  of  the  citizens. 

The  leaves  of  a  tree  are  the  lungs  with  which  it  breathes ;  but  in* 


"I  'i 


HYGIENE. 


Ill 


Btead  of  extracting  oxygen  from  the  air,  and  giving  back  carbonic 
acid,  like  man,  it  takes  only  the  poisonous  carbonic  acid,  and  give» 
back  oxygen. 

Were  there  no  animals  on  the  globe,  the  vegetables  would  consume 
all  the  carbonic  acid,  and  die  for  want  of  breathing  material ;  on  the 
other  hand,  were  there  no  trees  or  other  vegetables,  the  animals  would 
in  time  so  far  exhaust  the  oxygen  as  to  perish  for  lack  of  it.  The  two 
together  keep  the  airliealthy  for  each. 

The  relation  of  plants  and  animals,  in  all  that  relates  to  their  pecu- 
liar actions  and  eftects,  is  a  complete  antagonism.  Their  movements 
are  in  contrary  dirtctions,  and  by  hostile  forces.  Their  opposing  ac- 
tions may  be  illustrated  thus : 


TnK  vEGETAnLK  PU0DUCE8  the  non- 
nitrogenized  substances,  sugar,  starch,  and 
gum. 

The  vegetable  decomposes  car- 
bonic acid,  water,  and  ammoniacal  salts. 

The  vegetable  disengages  oxygen. 

The  vegetable  absorbs  heat  and 
electricity. 

The  vegetable  is  a  de-oxidizer. 

The  vegetable  is  stationary. 


The  animal  consumes  the  non-ni- 
trogunized  substances,  sugar,  starch,  and 
gum. 

The  animal  produces  carbonic  acid, 
water,  and  ammoniacal  sahs. 

The  animal  absorbs  oxygen. 

The  animal  produces  heat  and  el- 
ectricity. 

The  animal  is  an  oxidizer. 

The  animal  is  locomotive. 


We  learn  from  the  facts  of  Geology  that  the  time  was  in  the  his- 
tory qf  our  globe,  when  lunged  animals  could  not  breathe  its  atmos- 
phere ;  it  was  too  much  loaded  with  carbonic  acid.  The  trees  then 
grew  with  a  rapidity  almost  inconceivable,  decomposing  the  poison- 
ous gas,  taking  to  themselves  the  carbon  and  setting  the  oxygen  free, 
and  lifting  up  their  brawny  arms  to  heaven  in  acts  of  thankfulness 
for  the  great  feast. 

At  length  the  noxious  gas  was  exhausted;  and  then,  pale  and  sickly, 
they  feebly  held  up  their  hands  for  help ;  and  God  sent  numberless 
tribes  of  warm-blooded  animals,  full  of  life  and  energy,  that  sported 
in  the  exhilarating  air,  and  destroyed  vast  forests,  thereby  reproducing 
carbonic  acid. 

These  simple  facts  should  teach  man  the  sanitary  importance  of 
trees  and  bushes ;  and  wherever  he  has  a  rod,  I  had  almost  said  a  foot 
of  ground  to  spare,  a  tree  should  be  planted  and  carefully  nursed. 
This  is  particularly  necessary  in  large  cities.  Every  narrow  street 
even  in  Boston,  should  be  lined  with  trees.  For  their  absence,  thou- 
sands of  men,  women,  and  children  have  died  sooner  than  they  other- 
wise would.  We  want  them  stretching  up  their  arms  to  all  our  win- 
dows to  give  us  oxygen,  and  to  take  to  themselves  the  carbonic  acid 
we  exhale. 

Tight  Di esses.  —  The  health  may  be  injured  by  not  breathing  air 
enough,  as  well  as  by  inhaling  that  which  is  impure.  It  is  therefore 
improper  to  compress  the  lungs  by  wearing  tight  dresses.  If  the  ribs 
are  held  down  by  the  dress,  but  little  air  can  get  into  the  lungs,  and 
only  a  small  amount  of  carbonic  acid  can  be  carried  out.  In  this 
event,  the  health  is  injured  in  two  ways ;  the  blood  is  not  vitalized  by 
oxygen  received,  and  it  is  poisoned  by  carbonic  acid  retained.        < 


:{■: 


't  :  I. 


1 1  ji 


■II.,' 


112 


HYGIENE. 


Tight  lacing  has  in  a  measure  gone  out  of  fashion  ;  yet  too  much 
of  it  for  the  best  (lovclopment  of  female  health  ia  yet  retn  ••»♦"'  As  a 
knowledge  of  physiology  and  the  laws  of  life,  and  a  bt'tier  judgment 
of  the  true  synunetry  of  the  female  form  prevail,  this  barbarous  cus- 
t(Mn  will  pass  out  of  use,  and  the  substantial  health,  and  real  beauty 
of  the  American  woman  will  together  rise  to  a  higher  standard. 

Fill  the  liin^s  well.  —  Persons  who  take  but  little  exercise  are  apt 
to  accjuire  the  habit  of  drawing  the  air  very  little  into  the  lower  part 
of  the  lungs.  This  should  be  counteracted  hj  taking  long  and  full 
inspirations  for  a  short  time,  every  day,  while  in  the  open  air.  This 
practice  would  get  the  lungs  in  the  habit  of  opening  to  the  air  (]uitt' 
down  io  their  base,  and  would  make  the  breathing  much  more  natural 
hiS  well  as  effectual  at  all  times.  In  the  case  of  young  persons,  it 
would  enlarge  the  capacity  of  the  chest,  and  add  to  the  brief  years 
ut  2ife.  Parents  should  \ee  to  it  that  their  children  spend  from  ten  to 
twenry-five  minutes  every  morning  inflating  their  lungs  with  pure  air. 

Travelling. 

It  is  true  that  many  persons  who  dwell  in  one  spot,  and  hardly 
move  from  it  all  their  lives,  live  to  old  age.  Yet  change  of  location 
for  a  short  time,  or  permanently,  does  promote  health,  and  protract 
life.  The  mind  tires  of  contemplating, one  set  of  objects  for  a  great 
length  of  time;  and  in  the  absence  of  all  stimulation,  it  sinks  into 
apathy,  and  imparts  no  energy  to  the  body.  The  physical  frame, 
partaking  of  the  ennui  of  the  mind,  droops.  This  is  doubly  true  when 
one  is  suffering  from  illness. 

Travelling  is  eminently  fitted  to  draw  the  thoughts  of  the  nervous 
and  feeble  from  themselves,  and  to  turn  them  with  interest  to  outward 
objects.  This  is  .of  great  importance.  It  is  better  than  stimulants 
and  tonics. 

The  nervous  system  has  great  power  over  the  health  ;  and  the 
pleasurable  sensations,  excited  by  visiting  new  places  and  scenes,  and 
conveyed  to  the  mind  through  the  nerves,  often  awaken  in  the  consti- 
tution, energies  which  are  essential  to  recovery. 

Travelling  places  a  man  in  entirely  new  circumstances.  It  sur- 
rounds him  with  novelties,  every  one  of  which  makes  a  demand  upoi. 
his  attention.  It  breaks  up  his  old  trains  of  thought,  which  have  been 
monotonous  so  long  that  they  have  grown  oppressive.  It  causes  the 
world  to  touch  him  at  a  thousand  new  points,  and  surprises  him  every 
day,  perhaps  every  hour,  with  a  view  of  the  false  relations  he  has 
sustained  to  it.  It  opens  to  him  new  depths  in  his  own  nature,  and 
causes  him  to  wonder  that  they  never  attracted  his  attention  before. 
It  opens  to  him  one  door  after  another,  leading  him  into  new  apart- 
ments of  knowledge  ;  and  as  the  world  grows,  he  finds  himself  grow- 
ing with  it,  until  his  whole  nature  dilates  and  beats  with  new  life. 

means  of  Travelling  Increased.  —  The  last  twenty-five  years  have 
greatly  increased  the  facilities  for  travelling.  Many  of  the  sick  may 
now  seek  health  in  distant  lands,  who,  had  their  circumstances  been 


HYQIENR. 


113 


similar  twenty  years  ago,  would  have  been  compelled  to  pine  at 
home.  The  cars  give  an  easy  journey  to  thousands  who  could  not 
have  borne  n  ride  in  the  old  stage  coach. 

thie  tiling  more  wanted. —  But  one  thing  is  wanted  to  bring  the 
means  of  travelling,  for  the  sick,  very  nearly  to  perfection  ;  it  is  a 
method  of  propelling  carriages  upon  common  roads,  by  some  cheap 
power,  which  can  never  be  exhausted,  and  which  shall  be  easily  man< 
a^vd  by  the  traveller  or  his  companion.  This  is  a  prominent  want  of 
the  present  hour ;  a  giant  discovery,  which,  at  a  smgle  stride,  would 
carry  the  world  forward  a  hundred  years,  and  which,  we  may  hope,  is 
11  the  womb  of  the  near  future.  The  power,  it  is  believed,  will  be 
(hctro-ma^netmn.  The  mode  of  applying  it,  when  discovered,  will 
be  simple,  yet  wonderful ;  and  the  results  to  the  sick,  beneficent  be- 
yond expression.  The  human  mind  cannot  conceive  the  advantages 
which  invalids  would  derive  from  such  a  mode  of  conveyance.  Jour- 
neys might  be  long  or  short ;  might  be  made  with  any  rate  of  speed 
which  the  strength  permitted.  The  morning  or  afternoon  stages 
might  be  discontinued  when  fatigue  demanded,  and  resumed  at  pleas- 
ure. Over  uninviting  regions  the  traveller  might  glide  swiftly,  and 
linger  where  nature  spreads  her  feasts  for  the  mind. 

The  best  Seasons  for  Travellinii^  are  spring  and  autumn.  Winter 
is  too  cold.  A  pleasurable  excursion  may  sometimes  be  made  in 
summer ;  but  in  general  the  season  is  too  hot  for  comfort.  In  chang- 
ing climate,  food,  water,  etc-,  in  the  sultry  season,  there  is  danger  of 
contracting  very  troublesome  bowel  complaints. 

Neans  of  Travelllna:  for  the  Poor.  —  There  is  one  painful  thought 
connected  with  travelling  as  a  means  of  health.  It  cannot  be  en- 
joyed by  the  poor.  When  sick  they  generally  have  the  careful 
attention  of  humane  physicians ;  they  receive  from  kind  neighbors 
little  delicacies  of  food  and  drink ;  they  are  watched  with  by  night, 
and  visited  by  day ;  but  though  suffermg  from  the  hard  routine  of  a 
laborious  life,  and  needing  diversion  and  recreat.'  ^  .  more  than  all 
else,  thev  cannot  travel.  They  have  not  the  means,  and  nobody 
thinks  of  supplying  them  for  such  a  purpose. 

This  is  a  channel  into  which  charity  ought  to  pour  some  of  its 
benevolent  streams.  In  large  cities  there  is  a  class  of  poor  females, 
who  sit  in  their  small  rooms  and  ply  the  needle  diligently  through 
the  whole  year,  and  who  run  down  every  summer  very  near  to  con- 
finement in  bed.  Two  or  three  weeks,  in  the  hot  season,  spent  in 
travelling  in  the  mountains  and  elsewhere,  would  bring  back  the  color 
to  the  pale  cheeks  of  such  persons,  and  save  them  many  years  both 
from  the  grave  and  from  the  almshouse.  No  millionnaire  could  make 
a  better  use  of  his  property  than  to  set  it  apart,  at  his  death,  for  the 
specific  purpose  of  enabling  the  poor  to  travel.  And  if  this  sugges- 
tion should  induce  one  rich  man  to  consecrate  his  wealth  to  the  God- 
like work  of  bestowing  health,  happiness,  and  intelligence  upon  the 
poor,  the  great  labor  of  preparing  this  book  will  not  have  been  en- 
dured in  vain. 

15 


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114 


HYGIENE, 


Amusements. 

That  which  engages  the  mind,  aiul  fit  the  same  time  impresses  it 
with  pleasurable  sensations,  is  a  sutruicntly  accurate  definition  of 
amusement.  Whatever  occupies  the  thoughts  and  senses  in  an 
agreeable  way,  and  employs  them  with  some  degree  of  intensity, 
comes  under  the  same  head. 

This  broad  and  general  definition  allows  us  to  regard  our  daily 
employments  as  amusements  when  they  engage  our  deep  attention, 
and  at  the  same  time  give  us  pleasure. 

The  term  amusements,  however,  in  the  more  popular  sense,  is  re- 
stricted to  those  sports,  games,  plays,  exhibitions,  entertaimnents,  etc., 
which  involve  a  suspension  of  our  daily  labors  and  are  properly  called 
diversions. 

When  nature  is  tired  and  worn  with  those  ocvere  and  exhausting 
toils  by  which  we  earn  our  bread,  amusements  turn  us  aside,  divert 
us,  engage  other  powers,  and  allow  our  tired  faculties  to  rest.  They 
are,  therefore,  of  very  great  importance.  Even  the  most  trifling 
amusements  may  have  the  highest  value.  Their  very  nature  and  ob- 
ject imply  that  they  will  be  valuable  just  in  proportion  as  they  divert 
and  rest  us.  And  just  in  proportion  as  they  do  these  things,  they 
give  us  health. 

One  other  thing  amusements  do  for  us,  which  must  not  be  forgot- 
ten ;  they  preserve  in  us,  in  middle  life,  and  even  in  old  age,  the  warm 
simplicity  of  childhood.  They  keep  us  young  in  our  dispositions  and 
feelings.  They  keep  us  in  harmony  with  nature,  and  consequently 
artless  and  truthful.  They  prevent  the  formalities  of  conventional 
life  from  stiffening  us  into  cold  and  repulsive  hypocrites. 

Selection  of  Aninsenienfs,  —  Of  course  the  same  amusements  are 
not  adapted  to  all  persons.  The  farmer  who  has  worked  his  nmscles 
all  day,  would  not  be  benefited  by  a  game  of  ball  in  the  evening; 
yet  there  are  few  games  more  suitable  for  the  student  who  has  bent 
for  many  hours  over  his  books.  Care  should  always  be  taken,  there- 
fore, that  amusements  or  sports  do  not  bear  upon  those  limbs  or  fac- 
ulties which  are  wearied  by  work. 

Amusements  improve  various  faculties.  —  To  one  who  has  a  tastt 

for  art ;  who  is  fond  of  works  of  genius  and  poetry,  theatrical  enter- 
tainments will  always  be  agreeable,  and  a  ^ource  of  gratification  and 
health.  I  know  these  exhibitions  are  objected  to  by  many  as  immoral 
and  hurtful,  but  more,  I  think,  from  habit  and  fashion,  than  upon  any 
solid  grounds  of  reason  or  religion.  They  certainly  appeal  to  a  high 
order  of  faculties  in  the  human  mind ;  and  to  those  who  are  fitted  to 
receive  them,  teach  lessons  of  great  moment.  Aven  the  lower  exhi- 
bitions of  comedy,  though  not  particularly  improving  to  the  mind,  are 
yet,  from  their  power  to  provoke  lauff/Uer,  among  the  most  powerful 
up-builders  of  health. 

Tlie  Games  of  Wliist,  Endure,  etc.,  engage  the  minds  of  the  players 
in  a  sort  of  mental  contest,  which  is  exciting,  agreeable,  and  health- 


HYGlKN'i; 


115 


imparting.  Thcso  games  make  us  wkilful  in  calculating  chances,  and 
judging  how  men  ought  to  act  under  certain  contingencies*.  They 
make  us  sharn  to  detect  and  turn  a>side  the  unseen  forces,  which  tend 
to  oppose  anu  destroy  our  success  in  life. 

I  hardly  need  say  that  money  or  other  property  should  never  be 
staked  upon  a  game  of  cards,  or  upon  any  other  game.  Gambling  is 
one  of  the  meanest  as  well  as  nu>st  destructive  things  in  which  men 
can  engage.  It  raises  the  hciilthfid  excitement  of  these  innocent 
amusements,  —  innocent  when  pro|)erly  pursued,  —  into  raging  i)!is- 
sions,  which,  when  defeat  comes,  as  coine  it  will,  sink  into  remorse 
and  bitterness  as  terrible  as  the  mind  can  conceive.  I  warn  young 
men  as  they  woiild  escape  the  pangs  of  a  hell  on  earth,  and  the  U)«s 
of  character,  happiness,  and  probably  health  for  life,  to  avoid  any 
8ucl'  abuse  of  cards. 

Chess,  Chequers,  etc.,  appeal  likewise  to  the  fondness  of  competi- 
tion, which  is  common  to  all  men.  But  they  cultivate  in  us  a  little 
more  of  the  mathematical  element.  As  they  require  yery  close  appli- 
cation of  the  mind,  they  are  not  suitable  for  persons  of  sedentary  em- 
ployments, or  whose  daily  avocations  require  a  constant  use  of  the 
mind.  Such  persons  should  choose  lighter  and  more  active  arause- 
ments. 

Lij^hter  Aniliseiiieiits. —  Beside  these  higher  amusements,  there  are 
a  great  number  of  lighter  and  more  childish  ones,  which  should  not 
be  overlooked. 

Some  of  these  are  merely  physical,  involving  a  trial  of  strength, 
tleetness,  action,  etc.,  as  the  games  of  ball,  cricket,  etc.  Others  are 
domestic  in  their  nature,  involving  mirth,  and  various  other  of  the 
lighter  excitements,  as  blind-man's  bufT,  puss  in  the  corner,  hole  in  the 
wall,  fox  and  geese,  hunt  the  slipper,  hurly-burly,  roll  the  platter,  etc. 

In  fashionable  American  households,  these  simple  domestic  plays 
have  in  a  great  measure,  gone  out  of  use,  —  being  deemed  vulgar,  and 
below  the  dignity  of  ladies  and  gentremen.  I  am  sorry  to  say  this ; 
for  the  vulgarity,  in  my  judgment,  is  in  those  who  reject  them,  and 
not  in  the  plays. 

The  officer  of  our  navy,  whose  visit  to  the  mansion  of  Lord  Hard- 
wick  1  have  spoken  of  on  page  90,  reports  that  on  the  evening  of  one 
of  his  visits,  the  play  of  blind-man's  buff  was  engaged  in  by  the 
whole  party;  and  that  his  Lordship  in  attempting  to  make  a  short 
turn  during  th"  play,  fell  upon  his  back,  when  one  of  his  daughters, 
who  was  blinded,  caught  him  by  the  heels,  and  being  assisted  by 
others,  drew  him  stern-foremost  half  the  length  of  the  hall,  amid  the 
shouts  of  the  whole  party.  This  would  have  been  deemed  very  vul- 
gar by  fashionable  people  in  this  country.  But  to  me,  who  am  no 
believer  in  any  nobility  which  Lord  Hard  wick  can  receive  from  kings 
or  queens,  this  simple  narrative  raised  him  at  once  to  a  peerage  in 
nature's  realm.  With*  \t  doubt,  he  is  one  of  nature's  noblemen.  A 
man  in  his  station,  am'  ^ith  his  wealth  and  temptations  to  snobbery, 
who  can  preserve  sucn  simplicity  of  character,  must  have  a  warm  as 
well  as  a  noble  heart  in  his  breast. 


mm^ 


116 


HYGIENE. 


Value  of  Domestic  Amusements.  —  I  remark  here,  that  in  all  our 
amusements,  we  should  am  far  as  possible,  seek  those  of  a  domestic 
character.  They  are  more  simple  and  childlike  in  their  nature,  and 
preserve  in  us,  even  to  old  age,  the  ueshness  of  feeling,  and  truthful 
simplicity,  which  spread  so  beautiful  a  greenness  over  the  autumn  of 
life. 

Simple  domestic  amusements,  too,  are  always  gotten  up  on  a  cheap 
scale ;  they  do  not  encourage  costly  extravagance,  and  can  be  indulged 
in  by  the  poor  as  well  as  the  rich. 

But  more,  and  belter  than  all,  they  keep  young  men  and  old  men, 
and  young  women  and  old  women,  at  home,  by  making  the  domestic 
circle  the  centre  of  attraction.  They  draw  the  seekers  of  pleasure 
around  the  hearth-stone,  instead  of  outward  intd  the  world.  They 
incline  young  and  old  to  look  to  the  family  circle  as  the  centre  of  the 
most  pure,  because  the  most  simple  and  natural,  enjoyments.  They 
teach  us  to  look  to  home  as  the  centre  of  life,  and  to  all  outside  as 
only  its  appendages. 

It  has  been  said  that  homes  are  f^und  only  in  England;  that  in 
other  countries,  life  wanders,  houseless  and  shelterless,  abroad,  seek- 
ing happiness,  it  knowj  not  where,  while  in  England  it  nestles  warmly 
in  the  bosom  of  home.  To  whatever  extent  this  is  true,  —  and  I  be- 
lieve there  is  truth  in  it,  —  it  is  owing  to  the  simple  household  amuse- 
ments of  England. 

An  American  Want.  —  One  of  the  great  wants  of  this  country  is  a 
more  liberal  provision  for  amusements.  We  attach  here  too  much 
value  to  wealth  ;  and  we  purt^^^ue  it  with  an  intensity  altogether  in- 
compatible with  health.  We  cannot  take  time  for  recreation  because 
we  are  in  so  great  a  hurry  to  be  rich.  • 

If  we  would  save  ourselves  from  a  total  wreck  of  health,  we  must 
takp  broader  and  better  views  of  life.  We  must  value  it  for  its  solid 
comforts,  rather  than  for  its  glitter  and  show. 

We  need  quite  an  increase  in  the  numbe'*  o^  our  holidays,  —  days 
on  which  the  people  can  give  themselves  up  to  sportive  recreations. 
Some  progress  has  been  made  in  this  dirercion  of  late.  Washing- 
ton's birlli  day  has  very  nearly  fixed  itself  among  us  as  a  holiday ; 
the  claim  of  Lafayette's  to  a  similar  observance  is  beginning  to  be 
acknowledged.  Quite  a  number  more,  scattered  through  the  year, 
are  much  wanted.  They  would  save  hundreds  of  our  population 
annually  from  insanity. 

Contrary  to  the  general  belief,  insanity  is  very  j^revalent  among 
seamen  and  farmers.  The  former  lead  a  life  of  dreary  solitude  upon 
the  ocean  ;  the  latter,  one,  if  not  of  equal,  certainly  of  very  objectioa- 
able  solitude  upon  the  land.  The  sailor  who  does  business  upon  the 
great  st-a,  should  provide  himself  with  great  numbers  of  games  to 
amuse  him  in  his  wanderings.  The  farmers  of  our  land  shouiu  culti- 
vate more  of  the  sociabilities  of  life.  Let  them  meet  together  in  the 
fine  summer  evenings,  like  the  peasants  of  France,  and  dance  gayly 
upon  the  green  lawns  before  their  cottages.  They  will  till  their  lands 
more  cheerfully  for  it ;  enjoy  better  spirits  and  health ;  and  live  to 
greater  age. 


W'  ':7)'SS' 


HYGIENE. 


117 


Completeness  of  Life. — Amusements  are  necessary  in  order  to  give 
a  completeness  to  life.  The  faculties  of  the  human  mind  are  nuruor- 
ous.  It  is  only  when  they  are  all  exercised,  in  their  due  proportion, 
that  there  is  a  harmonious  beauty  in  our  lives.  The  customs  of  soci- 
cty  twist  us  all  out  of  shape,  —  perverting  up  mentally,  morally,  and 
physically,  and  robbing  us  of  every  manly  and  healthful  quality. 
Getting  out  of  the  ruts  of  fashionable  life,  we  must  come  back  to  tlif 
simple  paths  of  nature. 

I  would  strongly  impress  upon  parents,  teachers,  and  guardians 
the  importance  of  studying  well  the  yarious  temperaments,  physical 
and  mental  peculiarities  of  their  children,  in  order  to  judge  wisely  of 
the  kind  and  amount  of  recreation  required  by  them. 

Instance :  a  pale,  delicate  child  of  ten  to  twelve  or  fourteen  year.s, 
with  clear  complexion,  flaxen  hair,  blue  eyes,  slender  frame,  and  a 
nervous,  sensitive  orginization,  with  strong  mental  cast,  requires  much 
more  recreation  and  oni-of-door  exercise  than  a  full-blooded,  robust 
chilu  of  that  age ;  a  fact  not  at  present  duly  considered,  as  a  general 
thi'jff, 


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TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS. 


Man  has  thinking;  warming;  nourishing;  and  moving-  powers.  For 
the  performance  of  each  of  these  great  functions,  he  has  organs  of 
the  best  possible  construction. 

For  Tliinkiiiji^,  he  has  a  drain.  If  this  be  large  in  proportion  to  his 
other  organs,  it  gives  a  character,  a  cast,  a  peculiarity  to  his  whole 
organization.  Everything  about  him  is  subordinate  to  his  brain. 
We  recognize  him,  at  once,  as  a  thinking  and  a  feeling  being.  He 
has  an  intellectual  look.  There  is  a  delicacy,  a  refinement,  a  sensi' 
tiveness,  a  studious  habit,  an  air  of  tho  aghtfulness  about  him,  which 
determine  his  traits,  his  tone,  his  temper,  his  whole  character.  Hence 
it  is  prop'ir  to  say  he  has  a  cephalic  or  thinking  temperament. 

The  Luiig'S  and  Heart,  devoted  to  renewing  and  circulating  the 
blood,  are  placed  in  the  chest  or  thorax.  If  these  be  large  in  man  in 
proportion  to  other  organs,  he  is  charar  prized  by  great  activity  of  cir- 
culation, by  a  large  supply  of  red  blood,  and  by  the  general  indica- 
tions of  a  full,  warm,  and  bounding  life.  This  activity  gives  him  his 
tone  and  temper,  and  shows  that  his  is  the  thoracic  or  calorific  temper- 
ament. 

In  tlie  Great  Cavity  of  the  Abdomen  is  done  the  work  of  receiving, 
digesting,  and  disposing  of  the  materials  which  nourish  the  body. 
If  tlie  organs  which  do  this  work  be  large  in  proportion  to  others,  the 
body  is  fed  to  repletion,  and  the  whole  organization  speaks  of  the 
table.  The  habit,  the  look,  the  temper,  are  all  sluggish.  This  is  the 
abdominal  or  alimentary  temperament. 

The  Bones  and  jWuscles  are  instruments  by  which  the  movements 
of  the  body  are  performed.  If  these  be  the  largest,  in  proportion,  of 
iuy  In  the  body,  then  the  locomotive  powers  are  in  higher  perfection 
tlian  any  others.  There  is  largeness  of  person,  energy  of  movement,  • 
and  greatness  of  endurance.  The  whole  cast  of  the  person  partakes 
of  the  strength  and  coarseness  of  bone  and  muscle.  This  is  the  mus- 
cular or  locomotive  temperament. 

This  gives  us  four  temperaments,  as  follows : 

I.  Tlie  Cephalic  Temperament,  denoted  by  large  brain,  activity  of 
mind,  and  general  delicacy  o.'^  organization. 


mm 


TEMPERAMENTS,  CONSTITUTION,  AND .  SYMPTOMS. 


119 


IT.  The  Tlioiacic  Temperament,  indicated  by  a  large  chest,  force 
of  circulation,  redness  of  skin,  great  activity,  vrarinth  of  temper,  and 
fulness  of  life. 

III.  The  Abdominal  Temperament,  denoted  by  a  large  develop- 
ment  of  the  stomach,  liver,  bowels,  and  lymphatics ;  by  a  fulness  of 
belly,  fondness  of  high  living,  and  a  disposition  to  float  sluggishly 
upon  the  current  of  the  world,  rather  than  to  struggle  against  it. 

IV.  Tlie  Muscular  Temperament,  indicated  by  largeness  of  frame 
and  limbs,  coarseness  of  ^structure,  and  ^eat  power  of  locomotion 
and  endurance,  • 

There  are  some  reasons  for  reckoning  but  three  temperaments  in- 
stead of  four,  by  reducing  the  thora  ic  and  abdominal  to  one,  after 
the  manner  of  the  jjhrenological  Fowlers,  —  especially  as  the  organs 
ill  the  chest,  and  their  appendages,  take  an  important  part  in  the  pro' 
cess  of  nutrition.  But  as  the  heart  and  lungs  are  placed  in  one  cavit'', 
and  the  stomach,  liver,  etc.,  in  another;  and  as  one  set  ot  these  organs 
may  be  largely  developed,  and  the  other  defectively,  I  ha  ve  thought  it 
most  convenient,  on  the  whole,  and  quite  as  philosophical,  to  retain 
the  four  temperaments. 

These  temperaments  seldom  or  never  appear  single  and  pure.  They 
mix  and  cross  with  each  other  in  all  possible  v/ays. 

Medication  and  Temperaments. 

The  object  of  speaking  of  temperaments  in  this  work,  is  to  make 
the  reader  acquainted  with  the  principles  upon  which  remedies  are  to 
be  adapted  to  their  development.  The  philo8ophical-mi!yled  physi- 
cian will,  in  prescribing,  always  keep  the  temperament  in  view. 

Persons  of  a  Cephalic  Temperament  cannc*,  bear  powerful  medi- 
cines, — particularly  drastic  purges.  Their  fine,  delicate  and  sensitive 
organizations  would  be  torn  all  to  pieces  by  doses  which  would  hardly 
be  sufficient  in  a  fully-developed  muscular  temperament.  This  should 
always  be  borne  in  mind  in  prescribing  for  persons  of  a  large  brain 
and  delicate  organization. 

In  this  temperament,  too,  fevers,  instead  of  running  a  high  and 
fiery  course,  take  the  low  typhoid  type,  the  patient  becoming  pale, 
and  showing  a  constant  tendency  to  sink.  Such  patients  would  be 
killed  by  purging,  leeching, "cupping,  sweating,  and  starving.  They 
want  tonics,  stimulants,  and  every  kind  of  support,  which  the  case 
will  possibly  permit. 

Persons  of  a  Thoracic  Temperament,  having  a  rapid  circulation,  and 
a  fulness  of  blood,  are  most  liable  io  inflammatory  diseases.  When 
fever  attacks  them,  they  have  what  is  called  a  "  high  fever."  If  rheu- 
matism comes,  it  is  acvte  rheumatism.  Disease  takes  hold  of  them 
smartly.  As  they  do  everything  with  emphasis  and  energy  when  well, 
so,  when  ill,  they  make  a  business  of  it,  and  are  sick  with  all  their 
might 


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TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS. 


Stimulants  and  tonics  generally  make  such  persons  worse.  They 
want  isedatives,  and  diaphoretics,  and  sweats,  and  purgatives,  and 
leeches,  and  cups,  and  low  diet,  and  cold  bathing,  and  whatever  else 
will  slacken  the  ferocious  swiftness  of  their  circulation. 

Those  of  the  Abcloininal  Teinperaiiient  are  not  particularly  subject 
either  to  very  high  fevers,  or  to  those  typhoid  forms  which  produce 
sinking.  As  in  the  two  temperaments  noticed  above,  their  com- 
plaints chiefly  attack  the  organs  most  largely  developed.  Their  dis- 
eases affect  the  stomach,  the  liver,  the  spleen,  and  the  bowels.  These 
are  the  largest  organs  in  their  bodies,  and  are  most  used ;  and,  being 
overworked,  they  fall  into  disease. 

As  these  persons  are  slothful  in  all  their  habits,  so  their  diseases 
run  a  sluggish  course.  They  are  not  so  liable  to  sudden  death  as 
persons  of  either  of  the  preceding  temperaments.  They  have  all 
sorts  of  chronic  diseases  which  linger  a  great  while,  and  are  cured 
with  much  difliculty. 

These  persons  will  bear  larger  doses  of  medicine  than  either  of 
the  preceding.  Neither  do  their  constitutions  respond  as  readily  to 
medicine.  A  physician  will  be  disappointed  if  he  expects  to  see 
them  recovering  as  fast  under  its  use. 

Those  of  a  Muscular  Temperament,  having  little  fonJness  for  any- 
thing but  a  hardy,  active  life,  are  much  exposed  to  the  elements. 
Though  strong  and  long-enduring,  the  hardship  of  their  lives  often 
breaks  them  down,  and  when  felled  by  disease,  they  are  oftentimes 
shockingly  racked  and  torn  by  it. 

These  persons  bear  large  doses  of  medicine,  and  when  sick,  need 
to  be  treated  with  an  energy  proportioned  to  the  strength  of  their 
constitution.  Rheumatism,  which  aflects  the  joints,  the  ligaments, 
and  the  tendons,  is  an  affection  from  which  they  suffer  severely. 

V  The  Constitution. 

In  prescribing  for  disease,  it  is  of  very  great  importance  to  take 
notice  of  the  constitution.  This  Is  a  different  matter  from  the  tem- 
peraments. Persons  of  the  same  temperament  are  often  quite  unlike 
in  the  strength  of  their  constitution.  And  those  having  good  natural 
constitutions,  frequently  abuse  them  by  improper  habits  and  Indul- 
gences, and  at  length  come  to  have  broken  and  very  feeble  constitu- 
tions. 

Some  persons'  muscles  and  other  tissues  are  put  together  as  If  they 
were  intended  never  to  come  apart.  Like  some  of  the  woods  of  the 
forest,  —  the  lignum  vitae  for  example,  —  they  are  fine-grained  and 
tough.  A  real  smart  boy  will  wear  out  an  iron  rocking-horse  sooner 
than  one  of  these  persons  can  exhaust  their  constitution  by  hard  work. 
Others,  to  outward  appearance  equally  well  made,  have  very  little 
endurance,  break  down  easily  under  hard  work,  and  lose  their  flesli 
from  trifling  causes. 

The  state  of  the  constitution,  therefore,  should  always  be  learned 
before  much  medicine  is  given  ;  for  what  a  person  of  a  strong  consti- 


',*!■ 


TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS. 


121 


tntion  will  need,  may  greatly  injure  a  feeble  person,  even  of  the  same 
temperament 

Habits.  —  These  must  likewise  be  attended  to.  Persons  using 
stimulants  require  larger  doses  of  medicine  to  affect  them  than  other 
persons. 

Climate. —  Medicines  act  differently  on  the  same  persons  in  sum- 
mer and  winter.  Narcotics  act  more  powerfully  in  hot  weather  and 
climates  than  in  cold,  and  must  be  given  in  smaller  doses. 

Idiosyncrasy. —  Medicines  of  only  ordinary  activity,  act  very  power- 
fully, and  even  violently  on  some  persons.  This  is  owing  to  a  pecu- 
liarity of  stomach,  or  constitution,  called  idiosyncrasy.  It  makes  the 
person,  in  this  particular,  an  exception  to  the  general  rule.  And  no 
physician  can  know  beforehand  in  what  particulars  this  exceptional 
disposition  will  show  itself.  Persons,  however,  learn  their  own  idio- 
syncrasies, and  should  make  them  known  to  those  who  prescribe  for 
them  for  the  first  time. 

The  Sex.  —  The  peculiarities  of  each  sex  should  never  be  forgotten 
in  prescribing  for  the  sick. 

Males  are  not  so  sensitive  as  females.  They  will  bear  more  medi- 
cine, and  their  nervous  system  is  not  so  readily  excited  by  it. 

Influence  of  Age, —  Human  life  is  divided  into  infancy,  childJiood, 
yowth,  manfiood,  and  old  age.  Each  of  these  periods  has  peculiarities 
which  modify  disease. 

Tlie  First  Periotl,  extending  from  birth  to  the  age  of  seven  years, 
is  marked  by  tenderness  and  excitability,  and  is  alive  ir  every  irrita- 
tion. Teething  and  other  disturbances  occur  at  this  period,  and  need 
careful  management. 

Tlie  Second  Period  extends  from  seven  to  fourteen,  and  is  quite 
subject  to  disease,  including  the  second  dentition.  During  these  two 
periods,  there  is  no  great  difference  between  the  sexes ;  both  are  ten- 
der, and  need  careful  watching. 

During;  tlie  Tliinl  Period,  the  changes  occur  which  mark  and  sepa- 
rate the  sexes.  This  is  a  developing  period,  when  the  functions 
become  established,  and  the  frame  acquires  form,  proportion,  and 
strength. 

At  this  time,  hereditary  tendencies  to  disease,  latent  till  now,  begin 
to  show  themselves,  and  call  for  every  possible  endeavor  to  break  thoin 
up,  and  fortify  the  constitutioii. 

Tlie  Fourth  Period  embraces  the  vigorous  maturity  of  life,  when 
the  powers  of  body  and  mind,  in  both  sexes,  are  at  the  summit  of 
their  excellence;  The  functions  are  now  well  established.  It  is  dur- 
ing this  period  that  the  female  is  subject  to  most  of  the  harassing 
ailments  peculiar  to  her  sex.  So  numerous  are  these  complaints,  and 
80  large  and  valued  the  class  of  persons  affected  by  them,  that  he  who 
treats  them  with  the  greatest  skill,  and  with  the  delicacy  which  their 
nature  demands,  maj«  be  said  to  be  at  the  head  of  his  profession. 


1 1 


15 


!  % 


M:- 


The  Fifth  Period  is  that  of  old  age,  when  the  functions  are  declln-r 
ing,  and  the  frame  is  bending  under  the  weight  of  years.  Old  age 
begins  earlier  with  females  than  with  males.  Many  ailments  are 
common  to  this  period,  which  require  peculiar  management,  both 
medicinal  and  hygienic. 

Proper  Frequency  of  Dose. — Each  succeeding  dose  should  be  given 
before  the  effect  of  the  preceding  is  gone.  If  this  rule  is  not  attended 
to,  the  cure  does  not  advance.  What  is  gained  by  each  dose  is  lost 
by  the  rallying  of  the  disease  in  the  interval.  Care  must  be  taken, 
however,  not  to  apply  this  rule  too  strictly  with  very  active  medicines. 

How  to  Examine  a  Patient. 

When  p*  patient  is  presented  for  examination,  having  observed  the 
temperanfient,  constitution,  sex,  and  age, 

1.  Learn  the  causes  of  tlie  disease,  whether  local,  specific,  or  gen- 
eral, and  ai^o  its  history. 

2.  Search  out  its  nature  and  character,  whether  febrile  or  other- 
wise. 

3.  Take  notice  of  the  whole  train  of  symptoms,  —  embracing  the 
pulse,  the  condition  of  the  mouth,  tongue,  and  digestive  organs,  the 
breathing,  the  urine,  the  fecal  discharges,  the  condition  of  the  brain 
and  nervous  system,  the  state  of  the  skin,  etc. 

Brief  Table  Explanatory  of  Symptoms. 

GENERAL    APPEARANCE    OF    PATIENT. 


1.  Tonic  spasm  of  the  trunk. 

2.  Distorted  features,  altered   position, 
and  impaired  motion  of  limbs. 

3.  Irregular  and  perpetual  motion. 

4.  Entire  and  absolute  immobility. 

5.  Great  and  unnatural  boldness. 

6.  Great  and  unusual  languor. 

7.  Ability  to  lie  only  upon  the  back. 


8.  Lying  upon  the  face. 

9.  Lying  upon  one  side. 


10.  Maintaining  the  sitting  posture  only. 

11.  The  head  thrown  back. 

12.  Restlessness  and  tossings. 

18.  G«oeraI  enlaigemen*;  of  body. 


1.  Lot'ked  jaws. 

2.  Paralysis  of  one  side. 

3.  St.  Viius's  dance. 

4.  Catalepsy. 

f>.  Insanity  or  delirium. 

6.  The  beginning  of  an  acute  diseasft, 
or  the  progress  of  a  chronic  one. 

7.  Apoplexy.  Oriianie  disease  of  tlie 
brain  or  spinal  marrow.  Acute  inHcUnma- 
tion  of  the  lining  of  the  abdomen.  Kiieu- 
matism  of  the  jomts. 

8.  Several  kinds  of  cholics. 

9.  Pleurisv,  or  inflammation  of  the  lungs. 
When  one  lung  only  is  aflfected  in  con- 
sumption, the  patient  generally  lies  on  tlie 
diseased  side. 

10.  Disease  of  the*  heart  or  lungs,  whicL 
interferes  with  breathing. 

11.  Severe  diseases  of  the  larynx  and 
windpipe. 

12.  The  beginning  of  acute  inflamma- 
tion.  Fevers.   Delirium,  and  acute  mania. 

IS.  Cell-dropsy.  EmplijrMina  from  • 
wound  of  the  chut 


TEMPERAMENTS,  PA^JSTITUTION,  AND  SYMPTOMS. 


123 


Head,  Face,  and  Neck. 


1.  Head  bent  to  one  side. 


2.  Head  increased  in  size. 

3.  Swollen  scalp. 

4.  Dull  expression  of  face. 

5.  Full,  red  face,  with  blood  vessels  of 
eyes  inje(!ti^d. 

6^  Pinched,  contracted  countenance. 

7.  Pinched  nose,  sunken  eyes,  hollow 
temples,  skin  of  forehead  tense  and  dry, 
complexion  livid. 

8.  Wrinkles  across  the  forehead. 

9.  Wrinkles  from  forehead,  vertically, 
to  root  of  nose. 

10.  A  white  line  from  inner  angle  of 
the  eye  to  just  below  the  cheek  bone. 

11.  White  line  from  the  upper  border 
of  the  wing  of  the  nose  (ala  nasi),  c"''ved 
to  the  outer  margin  o|"  the  orb  of  tl      .ye. 


12.  The  wjiite  line  in  children  from  an- 
gle of  mouth  to  lowor  part  of  face. 

13.  A  white  line  external  to  the  last 
two,  in  a  semicircular  direction  towards  the 
chin. 

14.  Swelling  of  face  and  eyelids. 

15.  Transient  redness  or  flushing  of  face. 

16.  Hectic  flush. 

1 7.  Paleness  of  face. 


18.  Dingy,  white,  or  gree;iish  face. 

19.  Yellow  tint. 

20.  A  citron  tint. 

21.  A  bluish  tint. 

22.  Perpetual  motion  of  eyelids. 

23.  Forcible  closure  of  eyelids. 

24.  Eyelids  remaining  open. 

25.  Balsy  of  the  upper  lid. 

26.  Flowing  of  tears  over  the  cheek. 

27.  Nostrils  dilating  forcibly  and  rapidly, 

28.  Itching  of  nostrils  in  children 


1.  Convulsions.  Paralysis  of  one-half 
the  body.  Dislocation  of  bones  of  neck. 
Swelling  of  glands  of  neck. 

?.  Chronic  hydropholiu.  Enlarged 
brain. 

3.  Erysipelas.    Small  pox. 

4.  Typhoid  fever. 

5.  Swelling  of  heart  Congestion  vf 
brain. 

6.  Acute  inflammation  of  peritoneum. 
Exposure  to  severe  cold. 

7.  Chronic  disease  just  before  death. 


8.  Excessive  pain  arising  externally. 

9.  Distress,  anxiety,  and  severe  inter- 
nal pain. 

10.  In  children,  a  brain  or  nervous  af- 
fection ;  in  adults,  abuse  of  the  generative 
organs. 

11.  In  consumption  and  wasting  of  flesh. 
The  lower  part  of  the  line  indicates  dis- 
ease of  stomach;  the  upper  part,  some  affec- 
tion of  upper  part  of  bowel.  When  united 
with  the  white  line  named  above,  and  with 
a  drawing  in  of  the  cheek,  fixed  eyes,  and 
a  wan  complexion,  it  implies  worms. 

1 2.  An  affection  of  the  chest,  with  diffi- 
culty of  breathing. 

13.  Chronic  and  obstinate  disease  in  the 
chest  or  belly.  ^ 

14.  Albumen  in  the  urine. 

15.  Suffering  from  the  monthly  irregu- 
larity. 

16.  Consumption.     Chronic  aflfections. 

1 7.  Cold  stage  of  fever.  Acute  inflam- 
mation. Chronic  diseases,  especially 
Bright's  disease,  during  recovery. 

18.  A  low  and  deficient  state  of  blood. 

19.  Jaundice. 

20.  Cancerous  disease. 

21.  Poor  circulation  in  the  veins.  Chol- 
era.    Typhus  fever.     Blue  disease. 

22.  Mania  and  idiocy. 

23.  Intolerance  or  dread  of  light. 

24.  Orbicularis  palpebrarum.  Paralysis 
of  the  muscle  which  closes  the  eye. 

25.  Injury  of  the  third  pair  of  nerves. 
2(5.  Obstruction  of  the  lachrymal  duet 

27.  Difliculty  of  breathing. 

28.  Worms  in  the  bowels. 


The  Tongue. 


1.  Surface  of  tongue  covere<l  with  a 
layer  of  whitish,  soft,  mucous  substance, 
which  may  partially  be  taken  off  with  a 
Kraper, — also,  clammy  mouth. 


1.  Derangement  of  stomach,  or  boweU, 
or  both. 


:l\      ■' 


I    '■ 


124 


TEMPERAMENTS,  CONSIITUTION,  AND   SYMPTOMS. 


2.  State  of  tonpiuu  as  above,  with  clammy 
mouth,  bitter  taste,  and  fetid  breath. 

3.  Great  load  on  tongue  as  above,  which 
peels  off,  leaving  the  tx>ngue  smooth,  red, 
and  tender. 

4.  Tongue  slightly  white  from  small  white 
points,  and  sometimes  covered  with  fur, 
like  the  fibres  of  coarse  velvet. 

5.  Tongue  pale,  tumid,  clean,  and  very 
mooth. 

6.  Tongue /urrcrf  and  rfry. 

7.  Tongue  white  and  loaded,  with  much 
tliirst. 

8.  As  above  at  first,  —  afterwards  clean, 
red,  and  dry. 

9.  Tongue  white  and  loaded,  with  dry- 
ness. 

10.  Tongue  drv,  parched,  tender,  and 
dark  brown  or  mack.  Pushed  out  with 
great  difficulty  and  trembling. 

11.  Tongue  loaded  with  white,  through 
which  numerous  elongated,  very  red  pap- 
illas  protrude  their  pomts. 


3.  Acute  dyspepsia.    Asthma. 

S.  Severe  cases  of  acute  dyspepsia. 

4.  Chronic  dyspepsia.     Some  afiection 
of  the  liver,  if  the  fur  be  yellow. 

5.  Chlorosis  or  green  sickness. 

6.  Violent  local  inflammation.     Irrita- 
tion in  bowels. 

7.  Inflanmiatory  fever. 

8.  Protracted  inflammatory  fever. 

9.  Mild  typhus  fever. 

10.  Severer  forms  of  typhus  fever. 

11.  Scarlet  fever. 


The  Throat. 


1.  Throat  enlarged. 

2.  Violent  pulsadon  of  carotid  arteries. 


3.  Pulsation  of  the  nameless  artery 
(arteria  innominata)  above  the  breast 
bone,  and  to  the  right  of  the  windpipe. 

4.  Circumscribed  swelling  about  throat. 


1.  The  approach  of  puberty  in  females. 

2.  Acute  mania.  Inflammation  of  brain. 
Enlargement  of  heart,  and  dilation  of  right 
ventricle.     Anemia. 

3.  Regurgitation  from  aorta. 


4.  Enlargement  of  glands. 


1.  General  enlargement  of  one  side  of 
chest. 

2.  Bulging  at  the  base  of  a  lung. 

3.  Bulging  at  front  upper  part  of  chest. 

4.  Bulging  right  hypochondrium  (See 
7ig.  96). 

5.  Bulging  in  region  of  heart. 

6.  Tumor  where  the  third  rib  joins  the 
breast  bone. 

7.  Tumor  between  the  base  of  the  shoul- 
der blade  and  the  spine. 

8.  Depression  or  retraction  of  one  side 
of  chest. 

9.  Breathinw  increased  in  rapidity.  Gen- 
erally, in  healtn,  about  twenty  breaths  are 
taken  in  a  minute. 

10-  Breathing  diminished  in  rapidity. 


The  Chest. 

1.  Large  effiision  of  water  from  pleurisy. 


2.  Water  from  pleurisy  settling  to  the 
bottom. 

3.  Emphysema. 

4.  Enlargement  of  liver. 

5.  Water  in  heart-case.     Enlargement 
of  heart. 

6.  Aneurism  of  the  ascending  aorta. 

7.  Aneurism  of  the  descending  aorta. 

8.  Consumption.      Absorption  of  fluid, 
effused  by  pleurisy. 

9.  Spasmodic  asthma.  ' 


10.  Pleurisy.  Paralysis  of  respiratorj 
muscles.  Inflammation  of  lungs.  Emphy- 
sema.   Pneumothorax.    Consumption. 


11.  Jerking  respiration. 

1 2.  Breathing  with  muscles  of  ribs  only. 


11.  Spasmodic  asthma.    Obstruction  in 
larynx  and  windpijie. 

12.  Abdominal  inflammation.     Inflam- 
mation of  diaphragm. 


The  Belly. 


1.  Increased  size  of  belly. 


2.  Enlargement  in  epigastrium.    Fig.  93. 
S.  Enlargement  in  hypogastrium.  Fig.  95. 


Enlargeme 
4.  Belly  diminished  in  size. 


m 


bowels.    Inflam* 
Obstruction    ia 


1.  Drorsy.    Wind 
mation  Oi    peritoneum, 
bowels.     Hysteria. 

2.  Hysteria.     Cancer  of  stomach. 

S.  Distension  of  bladder.  Ovarian  tu- 
mors.    Accumulation  of  feces  in  bowels. 

4.  Chronic  dysentery.  Lead  colic.  Aim 
in  most  chronic  diseases. 


Private  Organs. 


1.  Enlai^ed  penis  in  children. 

2.  Drawing  up  of  testicles. 

3.  Enlargement  of  scrotum. 


1.  The  limbs  immovable. 

2.  Limbs  contracted  and  rigid. 
't.  General  swelling  of  limbs. 

4.  Swelling  of  joints. 

5.  Limbs  diminished  in  size. 


1.  Stone  in  bladder.    Masturbation. 

2.  Stone  in  iiidneys. 

3.  Hydrocele.    I^matocele.    Sarcocele. 


The  Litnbs. 


1.  Paralysis. 

2.  Softening  of  the  brain. 

3.  Defective  circulation  of  blood. 

4.  Rheumatism.     Water  in  the  Joints. 
White  swelling. 

6.  Paralysis. 


The  Nervous  System. 


1.  Morbidly  increased  sensation. 

2.  Tensive  pain. 

3.  Dull,  heavy  pain.  - 


4.  Smarting  pun. 

fi.  Shooting,  tearing  puna. 

6.  Boring  pains. 

7.  Contusive  pains. 

8.  Itching.    Sensation  as  of  ants  creep- 
ing over  the  skin. 

9.  Exaltation  of  vision. 

10.  Black  flecks  floating  before  llie  eyes. 

11.  Painfully  acute  hearing. 

12.  Dull  hearing. 

13.  Increase  of  ttrengtL 

14.  DebiUty. 


and 


1.  Acute    inflammation  6(  brain 
spinal  marrow.     Fevers.     Hysteria. 

2.  Phlegmonous  inflammation. 

3.  Enlaraed  internal  organs.  Internal 
tumor.  Enusion  of  water  into  cavities 
lined  with  serous  membranes.  Felt  in  the 
loins  previous  to  discharge  fttun  menstruac 
tion,  and  from  piles. 

4.  Scarf  skin  removed- 
Neuralgia.  Cancer. 
Constitutional  syphilis.  Bheumatim 

Inflammation  of  periosteum. 
Bruises.     Acute  diseases. 
Several  diseases  of  the  skin. 


S. 
6. 
Gout 
7. 
8 


9.  Ophthalmia.    Inflammation  of  bnup- 
Some  nervous  diseases. 

10.  Aflections  of  the  brain  and  optic 
nerve.    Dyspepsia. 

11.  Inflammation  of  brain.    Hysteria. 

12.  Typhus  fever. 

13.  Delirium.     Inflammation  of  brain. 
Mania. 

14.  Most  diseases. 


''II  k 


1^ 


s 


ii.'.L 


I  i  '■ 


iiiMiii 


15.  Trembling, 


16.  Ri^dity  of  upper  extremities. 

17.  Cramp. 

18.  Temporary  spa^m. 

19.  Pain  at  extremity  of  penis. 

20.  Pain  in  rifrlit  shoulder. 

21.  Pain  in  left  shoulder. 

22.  Exaltation  of  aiTectiona. 

23.  Loss  of  moral  sensibility. 

24.  Exaltation  of  intellect 


1 5.  Cold  stage  of  fever.  Nervous  affec- 
tions. Old  age.  Action  on  the  system  of 
lead,  mercury,  strong  coffee,  alcoholic 
drink,  tobacco,  opium. 

16.  Soflening  of  the  brain.  InfiltratioQ 
of  blood  into  the  brain.     Hysteria. 

17.  Pregnancy.  Hysteria.  Painters' 
colic. 

18.  In  convulsions  of  children.  Somt 
affections  of  the  brain. 

19.  Stone  in  bladder. 

20.  Congestion  of  liver. 

21.  Diiwrdercd  stomach. 

22.  Hy])ochondria8is. 

23.  Mania.  Typhus  fever.  Masturba- 
tion. 

24.  Melancholy.  Sometimes  indicates 
close  of  life. 


The  Breathing. 


1.  Stiffness  of  chest. 

2.  Pressure  upon  parts. 

3.  Obstruction  of  air-tubes. 


4.  Compression  of  lungs. 


5.  Pain  in  parts  moved  in  breathing. 

6.  Paralysis  of  muscles  of  chest 

7.  Spasm  of  muscles  of  chest 

8.  Deficiency  of  red  blood. 


1.  Cartilages  turned  to  bone.  Pleura 
hardened.    Distortion  from  rickets. 

2.  Tumors.     Dropsy  of  belly. 

3.  Spasm  of  glottis.  Spasm  near  the 
small  ends  of  bronchial  tubes.  Mucus, 
etc.,  thrown  out  upon  the  inner  surface. 

4.  Effusions  in  pleurisy.  Water  in 
chest  Air  in  substance  of  lungs.  Aneu- 
rism and  other  tumors. 

5.  Pleurisy.  Inflammation  of  perito- 
neum. 

6.  Injury  of  spinal  marrow. 

7.  Locked  jaw.     Spasmodic  asthma. 

8:  Aneemia.  Chlorosis  or  green  sickness. 


The  Cough. 


1.  Hollow  and  barking  cough. 


2.  Sharp,  ringing  cough. 

3.  Hoarse  cough.  > 

4.  Wheezing  cough. 

5.  Belching  cough. 

6.  Cough  in  paroxysms. 

7.  Cough  sounding  harsh  and  concen- 
orated  when  listening  with  the  stethoscope. 

8.  Cough  sounding  hollow,  -when  listen- 
ing with  me  stethoscope,  as  though  it  came 
from  a  cavern. 

9.  Cough  having  a  metalic  or  ringing 
sound  when  listening  with  the  stethoscope. 


1.  Last  stage  of  consumption.  Chronic 
bronchitis.    Some  nervous  affections. 

2.  Croup. 

8.  Beginning  of  oold.  Chroniclaryngitil. 

4.  Asthma. 

5.  Some  diseases  of  larynx, 
fi.  Hooping  cough.    Hysteria. 

7.  Consumption.  Inflanunation  of  the 
lungs.  Pleurisy.  Enlargement  of  bron- 
chia tubes. 

8.  Tuberculous  cavity.    Enlarged  broo- 
hial  tubes. 

9.  Large  tabercnloas  caTiij. 


The  Expectoration. 


1*  Scanty  expectoration, 
t.  Copious  expectoration. 


1.  First  stage  of  acute  diseases  of  the 
lungs. 

2.  Decline  of  acute  diseases  of  air  pas' 
sages  and  lungs. 


8.  Watery  expectoration 


4.  Mucous  expectoration. 

5.  Expectoration  of  pus. 

C.  Expectorated    matter    shaped    like 
coin  (nummular). 

7.  Muco-purulent,  floculent  expectora- 
tion. 

8.  Tubular  expectoration, 

9   Whitish  or  greenish   expectoration, 
that  t'linijs  to  the  vessel. 

10.  Yellow  expectoration. 

11.  Rustjf  expectoration. 

1 2.  Putnd  smell  of  expectoration. 

13.  Faint  and  sweetisu  smell  of  expec- 
toration. 

14.  Expectoration  smelling  like  garlics. 


3.  Beginning   of  bronchiti*.     Conge». 
tion  of  lungs.    Vesiciilar  emphysema. 

4.  Bronchitis.     Inflammation  of  lungs. 

5.  Consumption.     Third   stage  of  in- 
flammation of  lungs. 

6.  Tubcntular  consumption.    Bronchi- 
tis of  measles. 

7.  Consumption  far  advanced. 

8.  Plastic  bronchitis.     Pneumonia. 

9.  Acute  affections  of  lungs,  particu* 
larly  bronchitis. 

10.  Chronic  bronchitis.     Other  chronic 
afiections  of  the  lungs  and  throat 

11.  Inflammation  of  the  lungs. 

1 2.  Gangrene  of  the  lungs. 

13.  Bronchitis.     First  stage  of  consump* 
tion. 

14.  Broncbo-pleural  fistula. 


1.  Dull,  heavy,  aching  pain  at  the  base 
of  the  chest. 

2.  Soreness  about  the  breast  bone,  and 
between  the  shoulders. 

3.  Sharp,  sudden,  tearing  pain  below 
the  nipple. 

4.  Pain  darting  from  front  part  of  chest 
to  between  shoulder  blades. 

5.  Constant  pain  between  the  shoulders. 


Pain. 

1.  Acute  bronchitis. 

2.  Acute  bronchitis. 

3.  Pleurisy. 

4.  Consumption. 


5.  Consumption.  Green  sickness.  Otbei 
chronic  diseases. 


The  Pulse. 


1.  Strong  pulse,  resisting   compression 
by  the  finger. 

3.  Weak  pulse,  easily  pressed  down. 


3.  Full  pulse,  as  if  the  artery  were  in- 
creased in  size. 
4   Small  pulse,  opposite  of  full. 


1.  Hard,  sharp,  contracted  pulse, — vi- 
brating like  a  cord  under  the  finger. 

6.  Soil  pulse,  yielding  readily  to  pres- 
sure. 

7.  Frequent  pulse. 

8.  Slow  pulse. 


1.  Inflammatory  affections,  especially 
of  the  substance  of  large  organs,  as  the 
liver,  tie. 

2.  Prostration  from  disease.  Nervous 
and  chronic   affections.     Fear.     Diseases 


of  women  and  children,  and  old  persons. 

3.  Congestion 
Disease  of  heart 


3.  Congestion    of    brain. 


t 


poplexy. 


4.  Inflanmiations  of  stomach,  bowels, 
bladder,  etc.  Hysteria,  and  other  nervous 
affections. 

5.  Inflammation  of  membranes.  Active 
bleedings.     Lead  colic,  etc. 

6.  Afiections  vharacterized  by  debility. 

7.  Inflammatory  diseases.  Hemorrhages. 

8.  Apoplexy.  Sometimes  in  disease  of 
heart 


i-ii 


l._  Tongue  trembling  and  dry,  and  di 
minished  m  size. 
2.  Voracious  appetite. 


Belating  to  Digestion. 

1.  Typhoid  and  other  low  fevers. 


2.  Pregnancy.       Hysteria.       Insanity. 
Sometimes  in  dyspepsuu 


/   '; 


;  !■  f 


.i:,,a 


3.  Diminished  appetite. 

4.  Inereaoed  thirst 

5.  Thinit  gone. 

6.  Vomiting. 

7.  Pain  increased  by  pressure. 

8.  Pain  relieved  by  pressure. 

9.  Urgent  desire  to  go  to  stool. 
iO.  Watery  stools. 

11.  Mucous  stools,  like  white  of  egg. 

1 2.  Hard  and  lumpy  stools. 

1 3.  Clay-colored  stools. 

14.  Yellow  or  dark-brown  stools. 

15.  Dark-green  stools. 

16.  Stools  red,  and  streaked  with  blood. 

1 7.  Pitchy  black  stools. 

1 8.  Stools  pure  blood,  with  no  colic. 

1 9.  Stools  like  rice-water. 

20.  Black  stools. 

21.  Shreds  of  false  membrane  in  stools. 

22.  Fat  with  stools. 

23.  Fetid  stools. 


3.  In  most  acute  diseases. 

4.  Acute    affections  of   stomach    and 
bowels. 

6.  Cerebral  disease,  with  coma. 

6.  Early  pregnancy.   Colic.  Disease  of 
brain.    Jnffamniation  of  stomach.    Hernia. 

7.  Inflammation  of  internal  organs. 

8.  Over-distention  of  bowels.    Neural- 
gia.    Colic. 

9.  Dvscntery.    Sometimes  in  diarrhcsa. 

10.  Diarrhcsa.     Cholera. 

11.  Chronic  inflammation  of  colon. 

12.  Constipation.      Colic.      Cancer    of 
stomach. 

13.  Deficiency  of  bile. 
Too  m?icn  bile. 
Bile  from  children  after  taking  cal- 


1. 

(Jim 

•i. 

Kxt 

;i. 

ll(it 

4. 

Hot 

6. 

Skii 

«. 

liar 

7. 

Acr 

ippl 

i(i<i. 

H. 

Cliil 

'J. 

Low 

0. 

Col. 

Dysentery. 
Melsena. 


14. 
15. 
omel. 
16. 
17. 

18.  Bleeding  piles. 

19.  Asiatic  cholera. 
Iron  taken  in  medicine. 
Dysentery.     Diarrhoea. 
Diabetes.     Consumption. 
Diseases  attended  by  debili^. 


20. 
21. 
22. 
23. 


Worma. 


The  Urine. 


1  Diminished  secretion  of  urine. 

2.  Retention  of  urine  in  the  bladder. 

3.  Urine  increased  in  amount. 

4.  Red  or  yellow  sand  deposits  in  urine 
(uric  acid). 

5.  White    sediment   in    urine    (earthy 
phosphates). 

6.  Oxalate  of  lime  deposits  in  urine. 

7.  Blood  in  urine. 

8.  Albumen  in  urine. 

9.  Mucus  in  urine. 


10.  Sugar  in  urine. 


1.  Profuse  perspiration. 


1.  Dropsy.  Inflammatory  and  fbbrils 
diseases. 

2.  Paralysis.    Typhoid  fever.    Hysteria. 

3.  Diabetes.  Cold  stage  of  fevers. 
Hysteria.     Various  passions  of  the  mind. 

4.  Fevers.  Acute  rheumatism.  Con- 
sumption. Dyspepsia.  Great  indulgence 
in  animal  food. 

5.  Depressed  state  of  the  nervous  sys- 
tem, of  serious  import. 

6.  Derangement  of  digestion. 

7.  Bleeding  of  kidneys,  etc. 

8.  BrighCs  disease. 

9.  Inflamed  mucotis  membrane  of  ure- 
thra, bladder,  etc. 

10.  Diabetes. 


Tke  Perepiration. 


2.  Diminished  perspiration. 

3.  Night  sweats. 

4.  Sour  smelling  sweats. 

5.  Fetid  smelling  sweat. 

6.  Sweat  with  mouldy  odor. 

7.  Smelling  like  ammonia. 

8.  Sweat  having  the  odor  of  mice. 

9.  Sweat  smelling  like  rotten-stone. 


Dropsy. 


1.  Acute  rheumatism.  Decline  of  acute 
inflammations  and  fevers,  being  sometimet 
critical. 

2.  Early  stage  of  acute  disease. 
Diabetes. 

S.  ConsumpUon. 

4.  Rheumatism.     GrOUt 

5.  Some  debilitating  fevers. 

6.  Measles.     Scarlet  fever. 

7.  Typhoid  fever  sometimes* 

8.  Insanity. 

9.  Miliary. 


Ti:.Mri:UA.Mi:N'TS,  CflXSTirUTlON,  and    SVMI'TUMS. 


'.' 


'I'he  Temperature. 


1.  fttMioral  Iioiit  of  HiirCace. 

2.  Kxtcrtiul  IcmhI  Iteat. 

3.  Hot  tbrolunnl. 

4.  Hut  seal]). 

6.  Skin  of  tlieat  hot. 
().  Hands  and  f«t>t  hot. 

7.  Acrid  heat,  burnin;j  thu  hand  whun 
iud. 

Chills. 

Low  t^'nipcratiire. 

Cold  handit  and  fueL 


uy 


17 


I.  Fovdps. 

'2.  Inllaniniation. 

».  Hfaitachc. 

4.  Disease  of  brain. 

5.  lofianiuiatioii  in  chMt. 

6.  Consiniiption. 

7.  Typhus  fever. 

8.  Beginning  of  fever. 

9.  Poor  circulation. 

10.  Nervous  diseaaeu.     Dyspepsia, 
state  of  the  bloud. 


Low 


i| 


SKIN    DISEASES 


The  skin  is  the  soft  and  pliant  membrane  which  covers  the  entire 
surface  of  the  body.  The  interior,  like  the  exterior,  is  likewise  covered 
by  a  skin,  which,  from  its  always  being  moist,  is  called  a  mucous 
membrane.  At  the  various  openings  of  the  body,  the  outer  and  the 
inner  skins  are  united,  —  forming  one  continuous  skin,  —  like  the 
same  piece  of  silk  turned  over  the  border,  and  covering  both  the  out- 
side and  inside  of  a  bonnet. 

From  this  continuity  or  oneness  of  the  skin  and  mucous  membrane, 
springs  an  important  medical  law,  namely,  that  a  disease  of  the  skin 
may  spread  to  the  mucous  membrane,  and  a  disease  of  the  mucous 
membrane  may  spvead  to  the  skin.  We  see  this  illustrated  by  the 
breaking  out  arouiid  the  lips  which  follows  colds,  and  the  itching  of 
the  nose  of  ch-'-xrcn  when  the  mucous  membrane  of  the  bowel  is  irri- 
tated by  worms.  , 

The  Skin  i;*  Composed  of  T^vo  Layers.  —  These  are  separated  from 
each  other  by  the  action  of. a  blister.  The  thin  portion  which  is 
raised  up  by  the  fluid  of  a  blister  is  called  the  sca/fs/iin,  the  cuticle, 
or  the  epidermis ;  that  vvhich  remains  in  connection  with  riie  body  i^ 
the  senailive  skin,  the  cutis,  the  derma,  or  the  true  skin.  The  two 
skins  have  very  difierent  .offices  to  perform.  The  scarf-skin  is  horny 
and  insensible,  and  serves;  as  a  sheath  to-  protect  the  more  sensitivr 
skin  under  it.  Were  the  scarf-skin  taken  ofl",  we  could  not  bear  to 
have  anything  touch  us. 

The  derma,  or  true  skin,  and  its  glands,  etc.,  are  the  seat  of  all  tlic 
cutaneous  diseases.  These  may  be  separated  into  four  great  divis- 
ions,—  namely,  diseases  of  the  true  skin,  diseases  of  the  sweat  g'lawls 
and  tubes,  diseases  of  the  oil  glands  and  tubes,  and  diseases  of  th« 
hairs  and  hair  glands. 

The:a  the  diseases  of  the  true  skin  are  divided  into 

Injiamfnatio'n  of  the  true  skin ; 

Enlurgenient  of  the  papillte  of  the  true  skin  ; 

Dist  )rders  of  the  vessels  of  the  true  skin ; 

Dis'irders  of  the  sensibility  of  the  true  skin; 

Disorders  of  the  color-producing'  function  of  the  true  skin. 

The  inflammation  of  the  true  skin  is  conveniently  di  dded  into  two 
groupt,  —  namely, 


lis  <" 


\M 


ir  1    1 


in^: 


I 


i 


hTHS 


# 


fi 


skj'w  diska*?^:}?. 


i'M 


•  a  -w,  an'  nuirked  by  intlfimniati^'U  <■>(  the  dp^ma.  and  raucoiis 
iranes,  wfV/i  >;u/  s.'Uut.ional  i://>rfi/oms  fff  »  !>/>eci/it-  Vt»*<i,  wnd 
■  h  art  ar«  di'?r.ini2;uJ6tn  d  by  infhuaiuauti!  of  ibc  Ufrma,  laihout 
'itional  si/niptoms  of  a  specijh  hind.      "       , 

Congestive  Indavjiniition  ot  tlu-  "i    ab  Skin. 

•''iiv.  f'iv'^t.  of  ijifse  <»r«»(i3ts. —  thoHf  'iKvm'.'tcriyCi"*  :«»   ;utiainus;»t.ian 
•;"  ■••utis,  f/,'i//i  fiinsHtiifutiuiJ  sifttsj^omit  iH' :i  spiicifti;  i'mui  ■     .uibruces 
•    scarld  fcver^  varioi'oid,  s//niu-fntti\  and  covtr-fiox. 

>  . 

Measles.  —  P.nhcAa. 

HEAsr.Es  is  :i!i  acutt'  iidiarnuiatiou  of  the  entirp  skin,  botli  external 
j  intprual,  associated  v/ith  an  iiiiection.«  and  cofttugJouK  fover. 

Mmi^tonis.. —  Tlie  dihoiisf  soiH>  in  with  eiiills,  su(C<;.-.dt'«i  by  bun-.l-M-T 

.;%  lisii( -.s.-iiK'ss,  !,uiguor,  drow^intifti.s ;  puiiis  in  tlie  head,  back,  and 

•jurt ,  frei|Uont   pnlsc  ;  horenoss  of  thi;  throuf  ;  tliirsr,  nuiis'ca,  youiit- 

!<,  fifqucut  dry  (.ougli  and   hi^h-colored  urine.      Thiise  »yinptoiiid 

easi'  in  viou'rii.e  fof  lour  day-^.     On  thu  thiiJ  dav  the  ev'^s  bi.eorue 

;l:ui;id,  cannot  bear  the  Hglil.  and  })our  fourtii  h  prolusion  of  \v:\v^. 

is  last,  .syrnpton;  is  railed  coryzn.     The  nu.HO  likewi-ie  di.«liafge8  a 

^■ff".  iju;;:itify  of  watery  secr'Mirn,  ami  Hn^czin^  is  freqncn!.      '.rhf 

.^nXj  windpip",  and  brujichi-.d  tuLxs  beeonia  iidiatuwi,  os)'i  ho.ir.-r- 

>*!»,  «rrreuc..s  of  the  breast,  etc.,  aw  1i»(!  nv^ult. 

TtU'  rednesb  of  the  skin  iuid  brt-»>:"!i;2  »iui  a;  j.>t.-  'C  iiimu!:  sim*  fourth 

Icy,  and  prodn<  e  lieal   and  it'-iilug.     This  breukihif  i>«t  i«  eharaeier- 

..*d  by  a  pntchy  ic.dne.*«s,  which,  on  t'lose  5nf*pt'er.iofi,  i<*  foun«t  to  eonsist 

ninni;Rrle.-i!s  nunute  n*tl  pi^intj*.  )»nd  ptutpiej*,  coIW'UhI  inJo  patehes 

K  d'gi  fhnpo  of  a  half  or  q(iHr»er  tiuv,)fi.     I'iity  app<ar  fir^t  on   ihe 

.f.hrti-d  and  fvoni  of  the  nock,  iheu  ujiou  xhe  liheek'^  v;nd  around  tl'e 

;i"<e  rt»td  month.     i)n  the  fifth  day  they  reach  tlu'ir  height  in  thin 

..-v-j^i^-ri.  and  tlit:;;    ;j>pe;^r  i;«|toii  the  bo<ly  and  arm.s  and  <»u  \\\n  Ax\h 

f..  ■.,  \iy<yi\  H>';  lcgi«.     The.  color  uf  thf  siiUt  \vhei»  the  inll.tmtuatiou  i-« 

fc  (;a;itt,  is*  of  a  bi'i^'kl  rashb^rn)  red.     The  flecJine  of  tlie  ra^h 

ee  in  the  .same  order  in  v.-hicU  ii  ti -!»'>$  onl.     The  n-dness 

hv  bi.xth  day  upon  the  face:  oh  tlie  tevtroth.  upon  Mm  li  -^  ' 

h;  Op  Uie  eighth,  upon  the  bf  cik*  <'*f  |;V»  ?;;»»4»«,     Tit*^  ei>f .  •  , 

••—Re.      <?.  d  the  cough,  d. dim:  tf^  vvlni'.- a 

:  eome.       I  abuut  ♦be  eighlti  i;  .t     rh.'   :l» 

'  ■      ;    uie  in» 
sKUi  peels  off  in  the  form  of  a 


an  ot  ti'i    'T>Meo(ij<  ri,"Mii>'" 


•tnmation  di.^;:,  i<ear.>>, 

scurf,     The  ani.sr.  hat  gi.cn  a  ,?ood  picture  of  the  disease  in  the 
.fn;  \   cohi-isl  lid-«"ra;)ii.  l^i  \   ^  I,  Fig.  1.     This  ])Iate  is  adtni« 


iou' 


•^nu'iit. —  When  the.  di' .  ise  is  mild  and  regular  in  its  eou..se, 

^.tiyihing  will   be   rei.iired,  except  mild  diet,  slightly  acid 

'■^h  ilnx-fieed  tt  h,  islippery  elm,  or  some  equivalent,  to  quiet 

;>ponging  with  tepid  water,  if  done  with  frequency,  mod* 


'.t,i^i 


l\\ 


i'l 


'\    I 


;f;r: 


■  /   -| 


to 


#* 


1- 


,.fe.- 


\\ 


-if^Jt    .  .,.j«itf:-  ■■• 


i'^iH" 


'.li.Vl!: 


.■.:i 


■■*^iii%^' 


'.^•'■ 


.>fv*«*;>it,. 


■■1^. 


*&' 


# 


■■'*,i«i^'^''' 


;r 


SKIN  DISEASKS. 


131 


Such  as  are  marked  by  inflammation  of  the  derma  and  mucous 
membranes,  with  constitutional  symptoms  of  a  specific  kind,  and 

Such  as  are  distinguished  by  inflammation  of  the  derma,  wUhoiU 
constitutional  symptoms  of  a  specific  kind. 

Congestive  Inflammation  of  the  True  Skin. 

Tlie  First  of  these  Groups,  —  those  characterized  by  inflammation 
of  the  cutis,  with  constitutional  symptoms  of  a  specific  kind, — embraces 
measles,  scarlet  fever,  varioloid,  small-pox,  and  cow-pox. 

Measles. — Rubeola. 

Measles  is  ap  ^  cute  inflammation  of  the  entire  skin,  both  external 
and  internal,  associated  with  an  infectious  and  contagious  fever. 

Syiliptoilis.  —  The  disease  sets  in  with  chills,  succcedt^d  by  burning 
heat,  listlessness,  languor,  drowsiness;  pains  in  the  head,  back,  and 
limbs ;  frequent  pulse ;  soreness  of  the  throat ;  thirst,  nausea,  vomit- 
ing, frequent  dry  cough  and  high-colored  urine.  These  symptoms 
increase  in  violence  for  four  days.  On  the  third  day  the  eyes  become 
inflamed,  cannot  bear  the  liglit,  and  pour  fourth  a  profusion  of  tears. 
This  last  symptom  is  called  coryza.  The  nose  likewise  discharges  a 
large  quantity  of  watery  secretion,  and  sneezing  is  frequent.  Tho 
larynx,  windpipe,  and  bronchial  tubes  become  inflamed,  and  hoarse- 
ness, soreness  of  the  breast,  etc.,  are  the  result. 

The  redness  tf  the  skin  and  breaking  out  appear  about  the  fourth 
day,  and  produce  heat  and  itching.  This  breaking  out  is  character- 
ized by  a  patchy  redness,  which,  on  close  inspection,  is  found  to  consist 
of  numberless  minute  red  points  and  rimples,  collected  into  patches 
in  thf  shape  of  a  half  or  quarter  moon.  They  appear  iirst  on  the 
forehead  and  front  of  the  neck,  then  upon  the  cheeks  and  around  the 
nose  and  mouth.  On  the  fifth  day  they  reach  their  height  in  „'.ns 
region,  and  then  appear  upon  the  body  and  arms,  and  on  the  sixth 
day,  upon  the  legs.  The  color  of  the  skin  wheji  the  inflammation  is 
at  its  height,  is  of  a  brig'hl  raspberry  red.  The  decline  of  tiie  rash 
takes  place  in  the  same  order  in  which  it  comes  out.  The  redness 
fades  on  the  sixth  day  upon  the  face  ;  on  the  seventh,  upon  the  body 
and  limbs ;  on  the  eighth,  upon  the  back&  of  the  hands.  The  coryza, 
the  hoarseness,  and  the  cough,  decline  about  the  seventh  day,  while  a 
diarrhoea  comes  on  about  the  eighth  or  tenth,  —  showing  that  the  in- 
flammation of  the  mucous  membrane  is  subsiding.  When  the  in- 
flammation disappears,  the  whole  scarf-skin  peels  off  in  the  form  of  a 
scaly  scurf.  The  artist  has  given  a  good  picture  of  the  disease  in  the 
beautifully  colored  lithograph,  Plate  I,  Fig.  1.  This  j)late  is  admi< 
rably  done. 

Trentiiieut.  —  When  the  disease  is  mild  and  regular  in  its  course, 
scarcely  anything  will  be  recjuired,  except  mild  diet,  slightly  acid 
drinks,  with  flax-seed  tea,  slippery  elm,  or  some  equivalent,  to  quiet 
the  cough.     Sponging  with  tepid  water,  if  done  with  frequency,  mod* 


:iy; 


i::!  1' 


erates  ihv  fever,  uiul  adds  to  tlie  eorufort.  of  the  patient.  If  the  fever 
ruiii~  high,  take  half  an  ounce  of  roehelle  salt,  and  use  recipe  51. 
Should  the  eruption  "strike  in,"  apply  leeches  or  cups,  over  the  inter- 
nal organ  allected,  if  any,  and  recall  the  rash  by  a  mustard  bath. 

Those  who  have  been  exposed  to  th(!  contagion,  and  are  liable  to 
have  the  disease,  should  avoid  all  unnecessary  exposure  to  wet  or 
cold, —  keeping  the  feet  warm  and  dry,  and  the  whole  body  well  clad. 
With  these  precautions,  and  a  mild,  unstimulating  diet,  much  of  the 
force  of  the  disease  may  be  broken. 

During  the  first  stages  of  the  disease,  bathing  the  feet  once  or  twice 
a  day  witli  hot  water,  and  freely  using  warm,  sweating  drinks,  as 
saftVon,  summer-savory,  pennyroyal,  balm,  and  mullein  tea,  and  put- 
ting mustard  drafts  to  the  feet,  will  hasten  the  coming  out  of  the 
eruption. 

Should  the  breaking  out  be  delayed  by  excessive  fever,  give  full 
doses  of  tincture  of  veratrum  viride,  or  nauseating  doses  of  ipecac, 
antimony,  lobelia,  or  hive-syrup,  and  teaspoonful  doses  of  comj^ound 
tincture  of  Virginia  snake-root. 

Beside  the  milder  forms  of  the  disease,  cases  occur,  chiefly  in  broken- 
down  constitutions,  in  which  the  rash  delays  its  coming  out  till  the 
seventh  day,  and  is  then  mingled  with  dark  and  livid  spots,  which 
remain,  often,  for  ten  or  twelve  days.  The  fever  is  of  a  low,  typhoid 
kind,  and  the  patient  is  extremely  weak  and  languid. 

In  this  condition  of  things,  the  patient  must  be  supported  by  tonics 
(49),  and  stimulants  (134),  and  expectoration  promoted  by  some  ap- 
propriate remedy  (106),  (124). 

If  at  any  stage  of  the  disease,  there  should  be  fixed  pain  in  any 
part  of  the  chest,  which  is  made  worse  by  coughing,  or  by  taking  a  full 
breath,  we  'lay  conclude  there  is  some  inflammation  of  the  chest; 
and  it  must  be  treated  as  directed  for  pneumonia. 

Scarlet  Feyer.  — Scarlatina. 

This  is  likewise  an  acute  inflammation  of  the  entire  covering  of 
the  body,  bofh  external  and  internal,  connected  with  fever  which  is 
infectious  and  contagious. 

Syiiijitoiiis.  —  The  fever  comes  on  somewhere  between  the  second 
and  tenth  day  after  exposure.  On  the  second  day  of  the  fever,  the 
eruption  comes  out  in  the  form  of  very  small  points  and  pimples, 
which  appear  either  in  patches,  or  constitute  a  general  redness,  of  a 
brig-ht  scarlet  color.  In  Plate  I,  Fig.  2,  the  artist  has  given  a  fine 
picture  of  the  disease. 

The  disease  begins  with  languor,  pains  in  the  head,  back,  and  limbs, 
with  drowsiness,  nausea,  and  chills ;  and  these  are  followed  by  heat, 
thirst,  etc.  When  the  redness  appears,  the  pulse  is  quick,  and  the 
pa.'cnt  is  anxious,  restless,  and  sometimes  delirious.  The  eyes  are 
red,  the  face  swollen,  the  tongue  covered  in  the  middle  with  white 
mucus,  and  is  studded  with  elevated  points  of  extreme  redness. 
The  tonsils  are  swelled,  and  the  throat  red.     The  greatest  degree  of 


yui. 


redness  is  reaehetl  on  the  evening  of  the  third  or  fourth  day  fronfi  its 
beginning,  when  a  gentle  moisture  a[)|)ears,  the  disease  begins  to 
deehne,  with  itehing,  and  the  scarf-skin  fails  ott'  in  branny  scales, 

A  swelling  or  putHness  of  the  flesh,  which  spreads  out  the  fingers 
in  a  singular  manner,  seems  to  he  peculiar  to  scarlet  fever. 

Jn  tiie  lirst  stage  of  the  complaint,  the  tongue,  as  stated  above,  is 
covered  with  a  fur;  but  as  it  advances,  the  tongue  often  becomes 
wuldenly  clean,  and  presents  a  glossy,  fu^ry-red  surface,  which  is 
nometimes,  with  llu;  whole  lining  of  the  mouth,  raw  and  tender. 

It  is  peculiar  in  This  complaint,  that  the  inflammation. of  the  throat, 
almost  always  runs  into  a  state  of  ulceration.  As  far  as  can  be  seen, 
on  pressing  down  the  tongue,  the  throat  is  swollen  and  of  a  deep, 
florid  red  ;  anti  on  the  tonsils  may  be  seen  while  or  gray  ulcers.  This 
makes  swallowing  very  dilficult,  and  aggravates  the  surterings  of  the 
patient.  Tlu;  great  amount  of  mucus  in  these  parts  causes  also  a 
continual  rattling  in  the  throat. 

The  eustachian  tube,  which  extends  up  to  the  ear,  is  apt  to  get 
involved    in  the  inflammation,  and  cause  swelling  and  pain  in  thar 

region.     The  glands  under  the  ear  and  jaw 
sometimes  inflame,  and  after  a  time,  they  oe 
casionally   break.      Abscesses   formed   in  the 
ear,  frt^quently  produce  some  deafness  which 
is  not  easily  cured. 

In  the  cell-dropsy,  which  sometimes  appears 
after  scarlet  fever,  the  crystals  of  nrate  of 
ammo'iia  may  often  be  found  in  the  urine 
with  the  microscope  (Fig.  72). 

This  disease  resembles  measles  ;  but  may 
be  distinguished  from  it  by  the  absence  of 
cough  ;  by  the  eruption  being  Jiner,  and  of  a 
more  scarlet  color  (see  jilate) ;  by  the  rash  coming  out  on  the  second 
day  instead  of  \\w.  fourth  ;  and  by  the  ulceration  in  the  throat. 

Treatllieut.  —  In  ordinary  cases,  the  treatment  should  be  very  simple. 
The  apartment  should  be  kept  cool,  and  the  bed-covering  light.  Tlie 
whole  body  should  be  sponged  with  cool  water  as  often  us  it  is  hot  and 
rfry,  and  the  patient  be  permitted  to  take  cooling  drinks.  Beside  tlii.--, 
in  many  cases,  very  little  is  needed,  except  to  give  a  few  dro])s  of  the 
tincture  of  belladonna,  night  and  morning. 

In  some  cases  where  there  is  a  good  deal  of  fever  and  soreness  of 
throat,  give  tincture  of  veratrum  (1^4)  often  enough  to  keep  down  the 
j)ulse.  It  would  be  well  also  to  begin  the  treatment  of  such  cases 
with  an  emetic,  (1)  (4)  (2).  In  addition  to  this,  the  feet  and  hands 
should  be  soaked  in  hot  water,  with  a  little  ground  mustard,  or  pul- 
verized cayenne,  stirred  in.  This  bath  should  be  continued  twenty 
minutes,  twice  a  day,  for  two  or  three  days. 

The  cold  stage  iiaving  passed,  and  the  fever  set  in,  warm  water  may 
be  used  without  the  mustard,  etc.  If  the  head  be  aflec^ted,  put  mus- 
tard drafts  upon  the  feet.  Should  the  bowels  be  costive,  they  may  be 
gently  opened  by  some  very  mild  physic. 


'  'i'l 

■    ri 

■l 

■1 

[ 

'>: 


:f 


!:i'i;l' 


ISi 


SKIN  DISEASES. 


No  solid  food  should  be  allowed ;  but  after  the  first  shock  of  the 
disease  is  passed,  drinks,  in  reasonable  quantities,  will  be  advisable, — 
such  as  cold  water,  lemonade,  barberry  and  tamarind  water,  rice 
water,  balm  or  flax-seed  tea,  and  some  thin  water  gruel. 

To  i)romote  the  action  of  the  skin,  the  spirits  of  nitre,  with  other 
articles  (125),  adapting  the  dose  to  a  child,  will  be  found  usi^ful.  The 
nitrate  of  potash  is  useful,  given  in  one  to  three-grain  doses,  dissolved 
in  water,  every  three  or  four  hours.  j 

The  muriatic  acid,  forty-five  drops  in  a  tumbler  filled  with  water, 
and  sweetened,  and  given  to  a  child  in  teaspoonful  doses,  is  a  good 
remedy. 

In  very  violent  attacks,  the  system  sometimes  inclines  to  sink  im- 
mediately ;  typhoid  symptoms  show  themselves  ;  there  is  great  pros- 
tration ;  the  eruption  strikes  in  ;  the  skin  changes  to  a  purple  or 
mahogany  color;  the  tongue  is  of  a  deep  red,  or  has  a  dark-brown 
fur  upon  it,  and  the  ulcers  in  the  throat  become  putrid.  This  is  called 
scarlatina  jnaligna;  but  it  is  only  a  severer  form  of  the  same  disease. 

The  treatment  of  this  form  must  be  ditferent  from  that  recom- 
mended above.  It  must  be  tonic.  Quinia  (65)  must  be  freely  given. 
Wine  whey,  mixed  with  toast  water,  will  be  useful.  Tincture  of 
cayenne,  in  sweetened  water,  may  be  given  often  in  small  doses. 
Ammonia  (135)  may  likewise  be  given  as  a  stimulus.  Gargles  (245) 
(244)  (243)  are  also  required. 

A  dropsical  allection  is  one  of  the  most  frequent  results  of  scarlet 
fever.  It  is  believed  that  this  seldom  occurs,  if  the  warm  bath  is 
daily  used,  as  soon  as  the  skin  begins  to  peel  off.  After  the  dropsy 
has  set  in,  give  the  warm  bath  twice  a  week,  and  encourage  perspira- 
tion by  the  compound  tincture  of  Virginia  snake-root,  and  similar 
articles.  The  child  should  have  a  gene'roua  diet,  at  the  same  time,  to 
bring  up  its  strength.  -         ,     ' 


Small-Pox.— F«no/lfl5. 

This  is  another  disease  characterized  by  acute  inflammation  of  the 
entire  skin,  both  external  and  internal,  connected  with  infectious  and 
contagions  fever.  The  eruption  has  the  form  of  red  ))oints,  which 
!-()oi)  become  pimples,  then  vesicles,  then  flattened  and  scooped-out 
vesicles,  then  pustviles,  and  finally  hard  brown  scabs.  These  last  fall 
otl  from  tho-  eleventh  to  the  twenty-fifth  day,  and  leave  behitid  them 
small  pits  and  scars.  The  fever  is  remittent,  and  precedes  the  eru|)- 
tion  some  three  or  four  days,  —  ceasing  when  the  eruption  is  devel- 
oped, and  returning  when  it  has  reached  its  height.  The  period 
between  exposure  and  the  attack  of  the  disease,  called  incubation,  is 
from  five  or  six  to  twenty  days, — being  short  in  the  severe  cases,  and 
longer  in  the  milder  ones. 

Syni))toiii$.  —  The  disease  begins  with  languor  ana  lassitude,  with 
shivering,  and  pains  in  the  head  and  loins ;  with  hot  skin,  and  quick- 
ened pulse  and  breathing ;  with  thirst,  loss  of  appetite,  and  furred 
tongue ;   with  nausea,  vomiting,  constipation,  restlessness,  and  uai- 


,liM 


SMATI  ^OT 


PI  0 


'm 


i^* 


■■-*; 


^r^% 


;^ 


V 


•k'ld 


/V^m;     ^"Mii/  .>'.''t/m/     J^tJm       <ifrimi        (i'^fkui       il^Nm 


4-^' 


I'Mtij     2':^'dan   muy        VhtiUf  I'Miff 


;=4f 


^Ji 


HUf 


(i'l^daif 


'^.       \: 


3?>ehy 


//^hffVf 


\\ 


RKTIS  3»TF!EAS1''H 


liiil 


I 


'10  s.jiid  ui(.,«  .•'Uuuli.i  i.'V  ;i:iovv<-d  ;  tuji  hUih  tht,' I'irsi  yhock  of  r.lip 
ii^")!  i-,  T.  ;■•*.•  I.  drinks,  in  reasunutiU'  quanutio.s,  will  be  ativiaable,  — 
1  Iter,  IttmonfHJ* ,  bitrb^rry  and  tarnarirui  water   run 

WiiJiM,  K^,%,iH  i>r  ilttx-sot'd  U;i,  and  souu;  Ihia  wati-r  grn«;l. 

'fVi  iinnnnte  Ihi-  action  of  the  "kin,  tfu?  ^pirii:?  uf  nitre,  with  other 

r\-!      ■  .  ii'io),  adapting  the  dt>«w^  Ui  a  child,  will  he  lound  viwfnl.     Th<> 

"TftU"  of  potabli  ih  useful,  givfo  in  one  to  three-grairj  doses,  dissolved 

♦!.  water,  evtny  three  or  I^Mirfumrs,  "  •  ^ 

The  i-nnriatic  acid,  forry-five  tnopM  in  a  turnbler  filled  with  waiter, 

and  .'iwect^Jied,  and  given  t«"u  chikl  m  tRaspoonful  do!M:»,  is  a  good 

in  vf>ry  viol'?nt  «ito«'.k»,  the  8y»ti*tti  ioinetinns  incliu"**  to  sink  im- 
]'  "diateiy;  iyphwtd  3ymptom»  show  theniaelv  !i  .  •  >-.■  i.,;r  pros- 
1  ration  :  th*-  e-ntption  »trikt»j  m ;   i«h    skin   {i.'mii'^es  to  a  purple  or 


iuahogany  iX)U»  \  the  loiigii' 
fur  upon  It,  and  the  (dt'e*'^  \r 
seariatinM  nud^r'ia ;  ' 

'Vh(i.ir<  ■•'••■'■'■ 
inemli"'!  .V 
\V 


».  deep  H:d.  or  hat  a  dmk-brown 
-tat  it/!H-oine  p«(rid.    Tiii-  \a  called 
!'  form  of  the  same  dineafte. 
'   fvTfut   from   ihat  reeon?- 
>)  um  it  be.  frei'Iy  givcji. 
"•   MJriefni.      Tincture  of 
cfivvuiuv  '.vaui.  ;au,    v«'  ii.A\eit  ot'ieij  in   ^•-alajl  do'<e^. 

AmiiKHixs  ,  _         i*4?«' ti««  given  «t  a  :?thpuluH,     fhufrler*  (5i->/ 

opsual    I'liriion  is  ftnc  of  the  mo^t  frequent  rci^ukss  of  Ntrirlet 

li  )■■  iM'iie'  eti  that  this  seklora  oecur»,  it  tt'e  V:  ni,    '1  ;.th  ir, 

..  HB  JMJon  as  iiie  skin   begin*  to  ]>eel  off,     Aftt ;    ,;      droj>rty 

give  tho  warm  bwth  twice  a  wr- !.  :  vjiuage  pt-tHpira- 

he  cottipfmnd  tincture  of  Vir;j:in.;i    :-■;.»;•' -root,  and   sinul-j-r 

't'he  ehilfl  .■■Ijoidd  have  a  generous  tlict,  at  the  t<auie  time,  to 

■      'fCKgrh.  ^  ■-  -  :■      ■  .,  ,■ 


\ 

If.  '■■ 
da. 
ha 

tioti  Ir. 
aritelos 
brin. 


Sm&lt*f^«kiir.  ■"•  f^^riok. 


■f;  -A  wr.  ii  ijjii  (rllOUtj  HfKl 

•  •■'■  r"d  points,  whrf'fe 

!.'■';  Hid    .('"X.pcd'Oaf 


'j'lil  -  :.    ..•    -!«:J  t.ih-^1   •.-'■      '.■■-.' 
'  T!t!i-e  -ivui,  Uofii  fc^•^:W;r!,irU   auU 
eontagioui?  fevtr.     'I'he  erupti^u.   ;  • 
r^ooij  iieeonie  pirripk's,  then  vef-fcrlto*.  t- 

'     Jcles,  then  pustLUes,  ami  iina%'  '.."  •  'i'hcjse  i-.ust  f#l 

'.'li-iVoui  the  eleventh  fo  thf-  lsver\iy-i'.i,,  ..  ,  .  ^t  i  it^iivc  behind  thmit 
jfuiaii  pitrf  and  scars.  The  fever  v  remilterM!.  iuH  preeeden  lhtrpni|>» 
tion  some  three  or  iVuir  day!*,  —  (■«':.>!»;?«;  wH«<fi  i%v  erujjti<:)n  is  Jr^pl^ 
op('({.  and  f='fur'iin2  wh*\'i  it  hua  (*-«rhed  ih  height.  The  p«ri»'' 
bt'tvvri-'n  exposure  und  ihe  attack  of  thf  liU^hiitm., -mIM  incuhaiio/i.  ■ 
IV.  Mu  iivtJ  fti^  tws  to  twenty  daya,-— l>e»4^3?  sfeort  la  the  Wivere  cases,  imd 
'•-.::         '  U-i:  ones. 


. !  «54Mtt».  <•  —  The  di><ease .  begin 


Hi.-. 


'itngnor  ana  lassitnde, 
•   ■■'■';  hot  rkiji.  and  (jtt.- 
.    ;•>■::  ,;^r"^;tp,   add    h>" 

'pat;i'iu  r-i'    ,-:.     .-    •     .,,    ;'. 


SMALLPOX 


P1.2. 


«?; 


it 


t 


«>*^:?*-  ■**• 


I 


..<!;.  ^    fc 


« 


4    €- 


■C 


:-^  -^^  -'^:'^:^ 


?.  r 


I 


!,  M'!' 


!:  'il  t 


1^(1(1  irxi  of        dk 
Small  Wx 


VmlviU 


\f1v9mof 
mnalm 


^^. 


^day  6^day 


Stday 


n'daij     2¥da!/ .ii'dinj     if»/%       ,i'!f(taij        /4'Mnj       HHrnj 


fi'daij     2':'*day  J^day       4*tlay  S^day 


fO'J'dny 


tN*iiay 


\  :}J 


I 


i 

1 

'            1 

■    '■'                                                            '4 

.         :„.jl 

■ 

"m 

il 


f 


SKIN  DliEASKS. 


13.") 


veraal  prostration.  To  these  symptomsi  sometimes  succeed,  diiKcult 
breathing,  cough,  drowsiiu'.ts,  and  even  insensibility.  The  tongue, 
white  at  first,  soon  becomes  red  at  the  point,  and  over  the  whole 
surface.  The  fever  is  highest  during  the  night.  The  constitutional 
symptoms  are  more  violent  just  before  the  eruption,  but  inunediately 
subside,  and  soon  disappear,  when  the  breaUing  out  is  established. 
The  eruption  is  at  first  in  the  shape  of  small  red  points,  wliich  are 
bard  to  the  touch,  and  shaped  like  a  cone,  and  are  proportionate  in 
riumher  to  the  subsequent  pustules.  In  Pi.ati:  II,  the  artist  has  well 
exhibited  the  developed  disease,  as  well  as  the  progress  of  the  erup- 
tion from  day  to  day. 

Trentllieilt.  —  Like  the  two  preceding  diseases,  the  ordinary,  un- 
complicated form  of  this  requires  only  the  most  simple  treatment. 
Not  much  is  wanted,  except  confinement  in  bed,  cooling  drinks,  cool 
and  even  t<'mperature,  frecpient  changes  of  linen,  and  sponging  the 
Ix.dy  with  cool  water.  But  when  what  is  called  the  fever  of  invasion 
is  past,  and  the  eruption  \h  ful/i/  deretopcd,  and  has  brought  along  with 
it  the  secondtiri/  fever,  ihvn  some  recipe,  as  131,  (124)  (12''3)  will  be 
in  place,  and  some  gentle  laxative  to  keep  the  bowels  open  (S),  —  also 
gentle  injections,  (249)  and  opiates  to  relieve  sleeplessness  and  ner- 
vous symptoms. 

Should  the  system,  at  this  period,  appear  to  be  sinking,  a  more 
generous  diet,  and  a  little  wine  may  be  allowed.  If  the  brain  sutlers, 
apply  leeches  to  the  mucous  membrane  of  the  nose,  or  behind  the  ears, 
and  put  the  feet  in  a  mustard  bath  (242).  If  the  breaking  out  appear 
with  difficulty,  put  the  ))atient  into  a  warm  bath,  and  tartrate  of  anti- 
mony, (104)  or  Dover's  powders  may  be  empU)yed.  Gargles  will 
frecjuently  be  needed  for  the  intlammation,  and  dryn(>ss  of  the  mouth 
and  throat  (243).  Cold  sponging  may  be  considered  as  highly  bene- 
ficial, in  both  the  i)rimary  and  secondary  fever.  The  belladonna  like- 
wise is  a  useful  remedy,  used  in  the  same  way  as  in  scarlet  fever. 
The  plaster  288,  applied  to  the  face,  will,  it  is  said,  arrest  the  formation 
of  matter,  and  prevent  the  unsightly  scars  which  so  often  cover  the  face 
of  persons  who  have  suffered  from  small-pox.  Paint  the  face  once  or 
twice  a  day  with  glycerine,  which  will  eflfectually  prevent  pitting. 

Varioloid. — Varicella. 

Varioloid,  or  modified  small-pox,  begins  with  symptoms  similar 
to  those  of  small-pox,  but  nmch  milder  in  degr(?e.  These  symjitoms 
are  feverishness,  nausea,  vomiting,  pains  in  the  loins  and  head,  and  a 
quickened  pulse.  The  eruption  comes  oat  on  the  third  or  fourth  day, 
and  looks  like  that  of  small-pox.  It  reaches  its  height  the  fourth  or 
fifth  day,  and  then  declines  without  any  secondary  fever.  The  pus- 
tules dry  up  and  form  brown  scabs  which  fall  oft"  in  a  few  days,  and 
leave  slight  pits,  and  a  few  red  or  purple  spots. 

Varicella  appears  under  a  variety  of  forms,  called  "hives,"  "swine- 
pox," "  chicken-pox,"  "  horn-pox,"  etc.  Bu^^^  they  all  have  a  family 
likeness,  and  need  not  be  described.  The  treatment  of  all  these  forms 
must  be  conducted  on  the  same  principles  with  small-pox.    Sponging 


i 


<1 


H 


136 


SKIN  DISEASES. 


the  skiii  in  all  these  inflammatory  conditions  has  the  happiest  effect, 
and  should  seldom  be  omitted. 

Cow-Pox. — Vaccina. 

Tht3  disease  exists  to  some  extent  among  lower  aninials,  and  is 
identical  wi*h  small-pox  in  man.  The  immortal  Jenner  tanght  tlio 
world  that  the  pus,  taken  from  the  cow  having  this  disease,  and  inti\^ 
duced  under  the  skin  of  man,  wonkl  produce  an  eruption  similar  to 
that  of  small-pox,  ar.d  that  this  would  protect  the  system  from  the 
I  it'T  disease.  This  was  an  immensely  important  discovery,  and  will 
render  the  name  of  Jenner  famous  through  all  time. 

It  is  a  question  of  great  importance  how  far  vaccination,  or  inocu- 
lation with  the  matter  of  cow-pox,  does,  in  fact,  protect  the  system, 
from  small-pox.  That  it  is  a  protection,  to  a  certain  ex.ent,  is  doubted 
by  none.  That  in  some  instances  it  protects  through  life,  is  likewise 
generally  admitted.  Is  it  a  protection  in  all  cases,  and  through  the 
whole  life  ?  Perhaps  not,  though  this  is  a  disputed  point.  Proba- 
bly the  mild  form  of  th(;  vaccine  disease  does  not  impress  the  system 
powerfully  enough  to  last  more  than  a  certain  number  of  years.  Most 
thinking  physicians  now  believe  it  is  wise  to  revaccinaic  occasionally, 
to  make  sure  of  the  protection.  It  i .  done  with  little  trouble,  and 
may  save  a  terrible  inlliction.  Platk  II,  Fig.  4,  gives  a  good  idea 
of  tiie  appearance  and  progress  of  the  eruption. 

The  8cconil  Group  of  diseases,  characterized  by  inflammation  of 
the  true  skin,  without  constitutional  symptoms  of  a  specific  kind,  are 
Erysipelas,  Nettle-Rash,  False- Measles,  and  Inflammatory  Blush. 

Erysipelas. — St.  Anthonys  Fire. 

Erysipelas  is  a  diffused  inflammation  of  the  skin,  afTecting  only  a 
part  of  the  surface  of  the  body,  and  i^  accompanied  by  a  fever,  which 
is  generally  thought  to  be  infectious  and  contagious.  The  local  in- 
flammation is  disposed  to  spread ;  it  extends  deep,  and  is  attended 
by  swelling,  a  tingling,  burning,  and  pungent  heat,  and  by  a  redness, 
which  disappears  when  the  skin  is  pressed  by  the  finger,  and  returns 
tfn  remitting  the  pressure. 

Syniptoiiis.  —  The  constitutional  symptoms  are  chillinee.j  and  shak- 
ing, succeeded  by  heat;  lownese  of  spirits,  lassitude,  pains  in  the 
back  and  limbs,  pains  in  the  bead,  quick  and  hard  pulse,  thirst,  losa 
of  appetite,  white  and  coatt  d  tongue,  bitterness  of  mouth,  nausea, 
vomiting,  pain  in  stomach,  t  nd  costiveness. 

These  symptoms  go  before  the  local  inflammation  several  days; 
they  increase  with  the  redness  of  the  skin,  and  disappear  upon  its 
decline.  The  nervous  system  is  sometimes  severely  aftected,  and 
indicated  by  low,  muttering  delirium.  At  the  close  of  the  inflam- 
mation there  is  generally  a  relaxation  of  the  bowels,  and  the  seait- 
skin  peels  off.  Sometimes  matter  forms  under  the  skin,  and  occa- 
sionally mortification  occurs.     The  face  is  the  most  frequent  seat  of 


EBr^IPELAS 


ns. 


.jllfj-te^ig 


JO!^,...  ,  , 


'•*'WVi 


1r^ 


S?^' 


■   ./-•-»*«/'■.  ••■■•'v., 


^; 


1 


J^^^A. 


ii.I 


v.^  ■.::"^' 


ft 


%l 


r,j 


SKIN  i>Ii>i;A.31iS. 


I  tlie  skin  in  ;jll  thene  inrtammatory  lomJiuonft  U*»  .'M  liuppiest  etfect, 
and  fthoiili!  seldosa  be  omittoti 


U^^ 


Tina  f.li-sr'ipo  oxis's  to  sonw  exft'nt  furnj<i(;?  Iw'pr  afiirnalr",  an<i  is 
identiru!  with  staall-pox  in  \n<\n.  The  iitHrti'.Jvi  Jeuiier  tuiighr  the 
worid  iliJit  l.he  p;ts,  takoji  mmi  the  cow  ha^itsiitt^t*.  disease,  atul  iufro- 
(inccni  imder  the  :i<iiiof  miui, -.vonkl  pHwltM;-;  a«  fruprion  .^imibr  to 
th:it  of  small-pox,  and  that  tiji.H  would  frf^ftc*  'he  Mv^tt'in  iroru  d)e 
I  uler  flisfasf.  Tbi;-.  was  an  iauTsensfly  'siii-p»,.tt'»i]!t  di.>oinery,  and  will 
render  the  iiiune  nl'  Jeniior  tamoui*  thnmgtkiiily  mm. 

If.  U  ii.  que- 'ion  of  pT<"«t  imjiortatjce  how  »*'.f  ^U!"^'»nation.  or  inocn- 
Irtiio)^  v.iih  thf"  ntarter  of  cow-pov,  dvW^t^  Mi  -i!i|p<,n  proi*  ct  Ihe  syri»et>i, 
tro'vi  small- pox.  That  it  if  a  prbfectton.  iott  <»rtairt  exteni;  is  dciuhn-d 
by  worn;.  'Fhnt  in  sorn^j  instanoeB  it  pTtiifvfs  iliroxgh  iito,  i^  HKowis**' 
gVneraUy  adinttted.  lb  ii  a  Tjrotfctioii  m  nil  case-^  and  iLraugh  the 
whole  lite.'  Perhaps*  not,  thougli  this  is  n  dispir«:'»:l  poim.  Proba. 
biy  the  nslkl  rorri*;  t-f  the  vij^^diic  Uise;ii-ie  dov'ii  iioi;  imprrss  the  systi-m 
po\vfi*?3i|iv  ettout'h  ^*i  hi-ii  mavtx  thnn  a  certain  ntnnbt'r  oi  yearf,  Mtwl 
ihitikiHg  pi>y«i<.-i*»i'.H  wow  h«»}ie'.'r-;  it.  is  wi.sc  lo  rovacH;inau?.  occasionally, 
!«?^»»  *^?f'  fjrf  ;»>>«'  p;  ■  i;u  It  (,-5  do ae  with  ii'tk;  troiibU-,  ant'. 
coay  ttrVT  ,,  ■;i'?;/t»»4'  loMui  loij.  VhvvK  i  I,  Fig.  4,  givi':}  a  good  id»-a 
of  5ti*i  npftj' .311.1.  ;  H'id  progress  (>f  the.  f-ruptiou. 

fiiif  .H4'«;*m«^  iKffU})  .of  disca&ea,  oharaoterizcd  by  iunanuuaTiou  t#!" 
Crysipoias.  >«euie-Hnah,  Fabe-Measles,  and  hifiamniato'y  Blvfeh. 

IljrjBipelAa. — St.  Antktfny.'i  Fire. 

EKvstJ'via.^s  y  a  ditfus*  d  p»fli!ii;nnt«tioM.  of  the  J^kin,  af^ctintr  oft'y  a 
part  of  th«i  i^ori'ueo  of  thr^  bcM.v.  !:«.;j<j  i*  iKvonipairicd  by  i  fevi-r,  %\'};,,ch 
is  gcn'^rally  thought  to.  be  iiilWti* jh*  >  :^ml  couta^ions.  The  Un'mt  tn- 
llafoniation  is  di.<ppf<ed  to  sprf  v  .  ..  »••  >»«inst  dor-p,  and  i^  attr-m^vd 
hy  swelling,  a  iio^liiiig,  bwriiing,  HttjJ  4,»sw.'!ifB»f  hi-at.  h'hI  by  a  rc<iiiess, 
v;hi''h  ••ii«iiy)|)(Mir-  whfii  l.b«  skin  id  pn  '?->a!td  s>y  tlie  linger,  and  roturiv* 
o\<     ■'   :■■■,■      .  !!•  presaiiTB,  ^   ■  ■•<>  ^  '■'-■■, 

Synmtmns.  -  -  Ihn  const  itutiojial  8yrfti»:itvi*  «re  chillinf*BH  and  #hn,k« 


tag,  f^dciatcded  by  htial; ;  Iowih's^  f)f  S|'! 
bvu.k  and  linibs,  j)aiMs  in  the  hvad.  quiei 
of  .ipfK'tiU',  white  and  coated  touijiic,  tl 
•  i.i    -  ng;,  pain  i\\  sinnafh.  anvi  coH/is- 

lii    ••:   ^  o.ipioius  go  hck»rc   fh*'     «•( 
they  with  the  redness  oi    iii     k 

dci  '''*■■  a«pvou»  f^vstem  is  shows' 

)«ij    .^^        .  _f   h?""     '''Mitenitg  deliriuni 
m%ti*'a  there  i»  '!y  a  rolaxatiti.     ' 

,     .•."els  otf.     t'      .    (lies  mutter  foroi;'. 
i..it;»i.lv    nortjficis.jon   .tfX'Urs.     Tl,e  fi 


«^itnde.  pain*?   in    ihe 

'  ir<.i  jjnJM',  thir.'it.  \om 

■  ■■•  9I  month,  luujsea, 

ninwtion  wverai  days: 

.  ]  disappear  up-jo  A-* 

!   Iv   alTeeie'l,  and 

.       — "  of  the  ndlatn- 

V    1^^  and  the  N-arf- 

in«  nUin,  and  oeca- 


i 


EBYSIPELAS 


~"*«-^, 


;l; 


SKIN  DISEASES. 


137 


the  disease.  It  commonly  begins  0!i  one  side  of  the  nose,  and  soon 
spreads  over  one  side  of  the  face,  closing  up  the  eye,  and  changing 
the  features  in  a  shocking  manner.     See  Platk  III,  Fig.  1. 

Somewhere  about  the  third,  fourth,  or  fifth  day,  very  minute  blisters 
appear  on  the  inflamed  parts,  filled  with  water,  which  increases  until 
the  bliscers  break  and  let  it  out.  The  disease  comes  to  a  head  on  the 
eighth  or  ninth  day,  when  the  blistered  parts  drv;  and  the  skin  begins 
to  peel  off". 

Treatment.  —  In  the  treatment  two  things  are  to  be  done,  —  to  sub- 
due the  fever,  and  the  local  inflammation,  ^'he  fever  is  nssuaged  by 
rest,  mild  diet,  gentle  laxatives,  (26)  (21),  etc.;  and  by  the  use  of 
tincture  of  veratrum.  For  the  local  inflammation,  various  things  have 
been  advised,  but  nitrate  of  silver,  on  the  whole,  has  the  prefeience. 
First  wash  the  inflamed  part  with  soap  and  water  to  remove  any 
oily  substance,  and  wipe  the  skin  dry.  Then  moisten  the  inflamed 
and  surrounding  skin,  and  pass  over  it  a  stick  i)t"  nitrate  of  silver, 
touching  not  only  the  inflamed-  part,  but  going  even  an  inch  beyond 
it  on  all  sides.  Or,  a  solution  of  nitrate  of  silver  and  nitric  acid,  (214) 
will  in  many  cases,  according  to  Dr.  Iligginbottoni.  do  ev(Mi  Ix'tter. 
A  solution  of  coj  ^'ras  (215)  is  a  good  ap|)lication.     So  is  30o. 

In  mild  cases,  flour  may  be  dusted  on  the  inflamed  part  from  the 
dredging-box.  Warm  fomentations  arc  al.-o  useful,  and  elotlis  wet 
with  water,  and  laid  on.  A  solution  of  per.  cliloride  ot"  iron,  applied 
to  the  inflamed  skin,  is  much  used  now. 

In  erysipelas  tlie  powers  of  the  system  are  generally  reduced,  and 
tonics,  such  as  quinine,  wine,  ctv.,  are  generally  required.  Dr.  Robert 
Williams,  —  high  authority  in  these  matters,  —  says  he  puts  his  pa- 
tients upon  milk  diet,  gently  opens  the  bowels,  and  gives  them,  daily, 
from  four  to  six  ounces  of  port  wine,  together  with  sago,  and  tliat  he 
seldom  has  to  change  this  course,  whatever  the  symptoms. 

For  the  inflamed  skin,  a  tea  made  of  buckwheat  meal,  is  a  good 
wash.  Alcohol  and  water,  or  new  rum,  may  be  used  for  the  same 
purpose. 


$ 


ii  ^i' 


i\>' 


\*¥ 


Nettie-Rash. — Urticaria, 


Nettle-rash  begins  with  fever,  v^hich  lasts  two  or  three  days, 
when  wheals  of  various  shapes,  rouiid,  oval,  and  oblong,  appear  in 
the  midst  of  red,  slightly  elevated  patches,  attended  by  great  itching 
and  tingling,  as  if  the  common  nettle  had  been  applied  to  the  skiiL 
The  wheals  go  ofl*  during  the  day,  and  come  again  at  night.  The 
•^ruption  is  often  a  symptom  of  other  diseases,  or  of  mental  anxiety. 
Sometimes  it  is  the  effect  of  articles  of  diet.  Children  have  it  tM-ca- 
sionally  while  cutting  teeth.  A  lighter  form  qf  the  disease  (.'xists,  in 
which  the  wheals  appear  and  disappear  at  short  intervals,  according 
to  the  heat  of  the  weather,  the  exercise,  diet,  etc. 

Treatment.  —  The  treatment  varies  according  to  the  cause  of  the 
disease.  If  this  be  anytl  ig  offending  the  stomach,  es|H'cially  if  it  be 
putrid  fish,  an  emetic  (2)   (4)  will   be  required,  followed  by  brisk 


138 


SKIN  DISEASES. 


physic  (29).  After  which  take  a  few  doses  of  quinine  (67).  For  exter- 
nal application,  the  lotion  (216)  or  common  vinegar  and  water  ^215) 
will  be  useful.  Dr.  Wilson  recommends  corrosive  sublimate,  etc.  (217) 
as  the  very  best  lotion  to  apply  outwardly. 

The  diet  should  be  simple  and  cooling,  all  stimulating  food  and 
condiments  being  avoided. 

Rose  Rash. — Roseola. — False  Measles. 

Synip^ii  \s.  —  The  summer  rose  rash  appears  first  on  the  arms,  face, 
knd  neck,  thence  it  spreads  over  the  whole  body,  producing  tingling 
and  itching.  It  is  usually  )ireceded  by  the  symptoms  of  fever-chills, 
succeeded  by  flushes  of  heat,  languor,  pains  in  the  head,  back,  and 
limbs,  restlessness,  quick  pulse,  and  thirst.  The  rash  appears  in  small 
irregular  patches,  paler  than  those  of  rheasles,  and  of  a  more  roseate 
hue.  There  is  some  hoarseness  from  inflammation  of  the  throat.  The 
rash  never  continues  more  than  five  days,  unless  it  be  merely  partial, 
in  which  case  it  sometimes  comes  and  goes  at  intervals  for  weeks. 
If  it  "strike  in,'  it  generally  produces  disturbance  of  the  stomacli, 
headache,  and  faintness,  wliich  are  relieved  by  its  reappearance. 

The  autumnal  rose  rash  is  in  more  distinct  patches  than  the  for- 
mer, of  a  circular^figure,  slightly  elevated,  and  of  a  dark  damask-rose 
hue.     Seldom  any  fever,  or  itching  and  tingling. 

Treutliieilf. —  For  the  first-described  form  of  the  disease,  light  diet, 
acid  drinks,  and  gentle  laxatives  ;  for  the  second,  recipe  59,  or  51,  ac- 
cording to  convenience. 

Inflammatory  Blush. — Erythema. 

What  is  called  marginated  inflammatory  blush,  is  a  mottled,  red, 
smooth  fulness  of  the  skin,  occurring  on  the  extremities  and  loins,  in 
irregular  patches,  bounded  on  one  side  by  a  hard,  elevated,  red  border. 
This  species  of  the  disease  attacks  old  people,  and  indicates  some 
internal  disorder,  which  is  dangerous. 

Another  form  of  the  complaint  appears  on  the  arms,  neck,  and 
breast,  in  extensive,  bright-red,  irregular  patches,  slightly  elevated. 
The  redness,  at  its  height,  is  very  vivid,  and  continues  about  a  fort- 
night, when  it  assumes  a  purplish  hue  in  the  centre. 

Treiltiiieut.  —  Light  diet,  gentle  purgatives  (21),  opiates  (218)  lo 
allay  the  tingling  and  secure  sleep,  and  the  mineral  acids  (63),  with 
bitter  tonics,  comprise  all  that  is  required,  except  sponging  with  water, 
and  friction. 

Watery  Pimples. 

We  now  come  to  a  class  of  diseases  characterized  by  watery  pim- 
ples. Wilson  says  they  are  distinguished  by  "  effusive  inflammation 
of  the  derma,"  which  means  that  there  is  inflammation  of  the  trui- 
vkin,  which  causes  water  to  be  poured  out  on  top  of  the  derma,  and 


undernea 
of  smf,ll 
pies  'A  ti 
this  fluid 
scales  off 


An  en 

head,  fille 
erally  a  i 
faiiitne.ss, 

Anothe 
tion  of  v( 
These  vei 
curs  only 

In  .still 
itching,  ill 
the  blister 
skin,  whic 
with  a  thi 

Tretitnu 

baths.  In 
corrosive  s 
of  the  afit 


After 
of  small, 
times  wit 
on  the  ex 
little  largt 
days,  the 
crusts,  w 
irritable, 
and  restle 
lierpes,  in 

Treatm 

vanced  in 
applicatio 
(174),  or 


Toth 
j  rnon  tha 
i    whose  CO 


IS 

n 


SKIN  DISEASES. 


139 


underneath  the  scarf-skin,  causing  the  latter  to  be  lifted  up  in  the  form 
of  smf.ll  or  large  blisters,  or  vesicles.  At  first  the  fluid  in  these  pim- 
ples 'A  transparent,  but  in  a  short  time  becomes  milky.  Sometimes 
this  fluid  absorbs ;  at  other  times,  it  dries  up,  and  with  the  cuticle, 
scales  off  as  scurf. 

Salt  Rheum. — Eczema. 

An  eruption  of  minute,  round  pimples,  about  the  size  of  a  pin'« 
head,  filled  with  a  colorless  fluid,  and  terminating  in  scurf.  It  is  gen- 
erally a  symptom  of  a  feverish  state,  and  is  preceded  by  languor, 
faiiitnes.s,  perspiration,  and  a  pricking  and  tingling  of  the  skin. 

Another  species  of  this  disease  is  called' sun  heat,  which  is  an  erup- 
tion of  vesicles  without  any  redness,  of  a  white  or  brownish  color. 
These  vesicles  generally  terminate  in  Lrownish-yellow  scp.bs.  It  oc- 
curs only  in  summer,  and  atTects  those  parts  which  are  uncovered. 

In  .still  another  species,  the  eruption  is  attended  with  pain,  heat, 
itching,  intense  smarting,  and  a  swelling  of  the  affected  part.  When 
the  blisters  break,  the  water  which  runs  Oiit  irritates  and  inflames  the 
skin,  which  be(;omes  red,  rough,  and  thickened,  —  covered  sometimes 
with  a  thick  crust. 

Trentnieilt  —  Low  diet,  cooling  drinks,  gentle  purgatives,  warm 
baths.  In  old  chronic  cases,  apply  externally  either  lime  water,  or 
corrosive  sublimate  (212)  in  solution.  In  ihe  second  and  third  forms 
of  the  affection,  apply  externally,  a  solution  of  nitrate  of  silver  (219). 

Tetter— Shingles. — Herpes. 

After  a  slight  feverish  attack,  lasting  two  or  three  days,  clusters 
of  small,  transparent  pimples,  tilled  sometimes  with  a  colorless,  some- 
times with  a  brownish  lymph,  appear  on  the  cheeks  or  forehead,  or 
on  the  extremities,  —  and  at  times  on  the  body.  The  pimples  are  a 
Jittle  larger  than  in  eczema,  —  about  thv  size  of  a  pea.  After  a  few 
days,  the  vesicles  break,  pour  out  their  fluid,  and  form  brown  or  yellow 
crusts,  which  fall  oif  about  the  tenth  day,  leaving  the  surface  red  and 
irritable.  The  eruption  i-:  attended  with  heat,  itching,  tingling,  fever, 
and  restlessness,  especially  at  night.  Ringworm  is  a  curious  form  of 
ht-'rpes,  in  which  the  inflamed  patches  assume  the  form  of  a  ring. 

Treatment.  —  Light  diet,  gentle  laxatives.  If  t'  ■  patient  be  ad- 
vanced in  life,  and  feeble,  a  tonic  (64)  will  be  desirable.  For  external 
application,  white  vitriol  (220),  or  an  ointment  of  sulphuret  of  litn** 
(174),  or  elder-flower  ointment,  etc.  (175). 

Itch. — Scabies. 

To  this  disease  all  classes  are  liable,  though  it  is  much  less  com- 
mon than  in  former  years.  It  is  found  frecjuently  among  the  poor, 
whose  condition  in  life  does  uot  give  them  the  means  to  guurd  at  all 


I  /"  , 


140 


SKIN  DISEASES. 


points  against  it;  but  it  is  most  common  among  such  as  neglect  per- 
»onul  cleanliness. 

Syiiiptonis.  —  An  eruption  of  distinct,  cone-like,  wat«ry  pimples, 
which  are  transparent  at  the  summits,  and  are  accompanied  by  an 
excessive  itx;hing,  which  is  made  worse  by  high-seasoned  food,  bv 
drinking  liquor,  and  by  the  heat  of  the  bed.  When  these  pimples  an* 
scratched  and  torn,  a  sticky,  watery  fluid  is  poured  out,  which  forms 
small  scabs;  and,  in  time,  if  the  disease  is  not  cured,  these  scabs  being 
often  torn  off,  extensive  sores  are  made. 

Cnu.se.  —  It  will  excite  the  wonder  of  many  readers  to  state  that 
animals  of  so  small  a  size  as  scarcely  to  be  seen  with  tiic  naked  cyt- 
exist  in  the  skin  of  man.  Yet  such  is  the  fact;  and  it  is  the  presents 
of  these  minute  creatures,  or  the  effect  of  their  presenct^,  which  con- 
stitutes the  disease  called  itch.  The  little  creature  (acariis  saihici, 
by  name),  a  species  of  mite,  is  one  seventy-seventh  part  of  an  inch  in 
length;  and  when  closely  inspected  under  the  microscope,  is  really  a 
beautiful,  1  may  say  an  elegant,  animal.  Here  are  a  front,  a  side, and 
a  back  view  of  him,  well  done  by  the  artist. 


Fig.  73. 


Fig.  74. 


Fio.  :.■). 


His  Method  of  Attack.  —  When  placed  upon  the  skin,  the  little 
fellow,  like  the  squirrel  and  other  ground  animals,  sets  himself  to  make 
a  hole  through  the  scarf-skin  with  his  head  and  fore  feet.  Into  this 
he  pushes  his  whole  body.  He  then  begins  to  burrow  himself  in  the 
derma  or  true  skin  —  making  a  channel  many  times  his  own  length. 
at  the  end  excavating  a  chamber  where  he  sleeps,  and  whence  he  goes 
out  to  do  his  day's  work  at  mining,  or  boring  for  food.  When  tired 
of  this  sleeping  apartment,  he  digs  onward  and  scoops  out  another. 

This  travelling,  and  boring,  and  turning  about  in  an  organ  as  sen.si- 
tive  as  the  true  skin,  must,  of  course,  occasion  a  tickling  and  itching: 
and  from  this  circumstance  the  disease  took  its  name  of  itch.  Bur 
this  itching  is  not  painful.  James  the  First  is  said  to  have  remarked 
that  the  itch  was  fitted  only  for  kings  —  so  exquisite  is  the  enjoyiiieiit 
of  scratching.  Probably  it  is  a  royal  luxury.  Be  that  as  it  may,  most 
persons  would  cojisent  to  have  it  all  done  by  royal  fingers.  They 
have  been  used  for  meaner  purposes. 


Treiitiiiciit.  —  Whatever  will  kill  the  little  animal  described  above, 
will  cure  the  itch.  Various  agents  have  been  employed  for  this  purpose, 
hut  none  have  been  found  equal  to  sulphur.  The  compound  sulphur 
ointment  is  a  sovereign  remedy  for  the  disease.  Four  ounces  of  this 
should  be  well  rubbed  into  the  skin,  before  the  fire,  morning  and  even- 
ing, for  three  or  four  days.  This  will  put  an  end  to  the  whole  colony 
of  these  sovereign  squatters  upon  forbidden  soil. 

Two  ounces  of  sulphuret  of  potash,  and  the  same  amount  of  soft 
soap,  dissolved  in  a  pint  of  water,  and  applied  well  to  the  skin,  is 
used  ill  many  cases  with  good  effect. 

I    Caustic  potash,  one  part  to  twelve  parts  of  water,  applied  in  a  sim- 
ilar way,  is  said  to  be  a  pretty  sure  remedy. 

A  solution  of  the  chloride  of  lime,  used  as  a  wash,  will  often  eftect 
a  cure. 

The  ointment  of  the  American  hellebore  sometimes  does  well. 

Before  applying  any  of  these  preparations,  let  the  skin  be  washed 
with  warm  water  and  soap,  and  well  dried. 


Rnpia. 

This  is  from  a  Greek  word  which  means  dirt,  from  the  dirt-colored 
cnists  which  are  formed  after  the  breaking  of  the  large  watery  pim- 
|)l('s.  'J'he  vesicfes  are  like  those  of  eczema  and  herpes,  except  that 
ilu-y  are  /ar^er.  This  is  distinguished  from  all  other  skin  diseases  by 
ilic  formation  of  unln-althy,  foul,  and  burrowing  sores,  which  pour  out 
a  reddish  matter  in  such  quantities  that  it  collects  and  dries  upon  the 
soiv,  and  forms  a  crust  of  great  thickness,  —  sometimes  of  the  size 
of  an  oyster-shell.  Rupia  has  its  origin  in  a  weakly  and  debilitated 
constitution,  and  cannot  be  cured  without  renovating  the  whole  sys- 
tem. 

Treatment.  —  Warm  baths  once  or  twice  a  week,  with  generous 
and  nutritious  diet.  Tonic  medicines  (63)  (51)  (67)  (61)  (65)  will  be 
required.  For  external  treatment,  dust  the  surface  of  the  ulcers  with 
cream  of  tartar,  or  apply  nitrate  of  silver  (214)  (219)  (220),  white 
vitriol,  etc. 


Pemphigus. — PomphoUa;. 

The  first  of  these  terms  is  from  the  Greek,  and  means  a  bubble ;  the 
second, -pompholix,  is  from  the  same  language,  and  means  a  vmler- 
bubble.  This  is  still  more  applicable  to  the  disease  in  hand,  which 
consists,  in  fact,  in  the  raising  up  of  the  scarf-skir*  in  the  shape  of 
bubbles,  containing  a  watery  fluid.  These  bubbles  are  just  like  com- 
mon blisters.  They  vary  from  the  size  of  a  split  pea,  to  that  of  a 
hen's  egg.  They  rise  up  very  rapidly,  and  break  in  two  or  three  days, 
leaving  a  raw  surface  which  soon  becomes  covered  by  a  thin  crust. 

Treatment. —  Similar  to  that  for  Rupia,  with  the  addition  of  iodide 
of  potassium  (140),  and  applying  the  stick  nitrate  of  silver  to  the 


I'.t 


■'I 
I 


142 


SKIN  DISEASES. 


whole  surface  of  the  ulcer,  and  a  short  distance  beyond  it  on  all  sides, 
or  the  ointment  (176). 

Mattery  Pimples. 

Another  natural  group  of  skin  diseases  are  distinguished  by  an 
eruption  of  pimples,  Hlled,  not  with  water,  like  those  just  describee), 
but  with  matter.  The  pimples  of  this  class  are  not  transparent,  or 
whitish,  but  opaque  and  yellov)  from  the  first.  The  matter  is  pouii'd 
out  upon  the  true  skin,  and  raises  up  the  searf-skin,  in  the  same  way 
as  the  watery  pimples.  As  in  the  preceding  diseases,  too,  the  dryiiii,' 
up  of  the  matter  forms  crusts.  But  these  pimples  are  never  so  suiull 
as  those  of  eczema,  nor  so  large  as  those  of  pemphigus.  : 

Crusted  Tetter. — Impetigo. 

This  eruption  consists  at  first  of  slightly-elevated  pustules  or  pim- 
ples, closely  congregated,  with  an  inflamed  border.  These  break,  aiul 
the  surface  becomes  red,  excoriated,  shining,  and  full  of  pores,  through 
which  a  thin,  Xiuheaithy  fluid  is  poured  out,  which  gradually  hardens 
into  dark,  yellowish-green  scabs.  These  scabs  sometimes  look  like  a 
dab  of  honey  dried  upon  the  skin.  This  has  given  impetigo  the 
name  of  "  honey  disease,"  or  honey  scab.  This  honeyed  look  is  well 
represented  in  the  crusts  which  form  on  the  lips  and  ears  of  children. 
Sometimes  these  scabs  cover  nearly  the  whole  face,  and  are  called  tlic 
milk  crust.  This  is  putting  the  agreeable  words  milk  and  lumen  to 
rather  questionable  uses !  When  this  crusted  tetter  invades  the  licad 
or  scalp,  it  causes  the  hair  to  fall,  and  becomes  what  is  called  a  scall. 

Treatment. —  The  vapor  bath,  and  water  dressing.  The  following 
ointments  are  useful :  oxide  of  zinc,  white  precipitate,  or  diluted 
nitrate  of  mercury  (178).  Hydrocyanic  acid  (221),  applied  externally 
has  a  fine  effect.  The  crusts  should  first  be  removed  by  a  weak  lye 
made  from  hard-wood  ashes,  or  potash ;  then,  after  applying  one  of 
the  ointments  above,  or  the  lotion,  cover  the  part  with  oil-skin.  If 
the  crusts  are  on  the  head,  the  hair  should  be  cropped  off  before  the 
remedies  are  applied. 

Papulous  Scall. — Ecthyma. 

The  mattery  pimple  called  ecthyma  is  developed  on  a  highly  in- 
flamed skin.  The  bladders  are  about  the  size  of  a  split  pea,  and  are 
surrounded  by  a  broad  ring  of  redness.  They  are  generally  separate, 
not  clustered  like  impetigo.  They  are  scattered  over  various  parts  of 
the  body,  and  are  followed  either  by  a  hard  black  crust,  or  by  a  sore. 
The  disease  is  either  acute  or  chronic.  The  latter  attacks  weakly 
children,  and  persons  reduced  by  sickness  or  low  living. 

Treatment.  —  For  the  acute  form,  low  diet,  gentle  laxatives,  with 
ointment  (176),  and  the  cold  sponge  bath  on  the  sound  parts.   For  the 


chronic  form,  (140)  (()0)   (63)  (61)  (48)  to  be  taken  internally,  and 
(176)  (175)  (214)  (211)  for  external  applioation. 

Scaly  Eruptions. 

The  scaly  eruption  is  called  dry  tetter.  It  is  an  inllainmation  of 
the  true  skin,  and  in  distinguished  from  the  rashes  and  pimples  by  the 
alteration  of  the  searf-skin.  The  diseases  forming  this  group  art* 
three  in  immber,  —  lepra,  psoriasis,  and  pityriasis. 

Leprosy.  —  Lepra. 

In  this  disease,  the  eruption  makes  its  appearancic  as  a  small, 
salmon-red  spot,  raised  a  little  above  the  surrounding  skin,  and  con- 
stituting, in  fact,  a  flat  pimple,  almost  as  large  at  the  top  as  at  the 
bottom.  On  top  of  this  pimple,  the  scarf-skin  becomes  rough,  and 
after  a  little  while,  a  thin  scale  is  produced.  New  layers  are  added 
to  its  under  surface,  and  it  accordingly  grows  thicker.  It  has  a  bright, 
silvery  lustre.  These  scaly  spots  multiply,  and  become  tiit;  form  of 
leprosy  called  lepra  guttata,  from  the  Latin  viutta,  a  drop,  the  scales 
looking  like  drops  of  water  on  the  skin. 

But  the  eruption  more  frequently  spreads  out  into  circular  patches, 
of  the  size  of  a  fifty  cent  piece.  These  generally  appear  below  the 
elbows  and  knees,  and  on  the  breast  and  shoulders,  and  buck  of  the 
hands.  Sometimes  the  entire  band  is  covered  with  scales  of  a  |)ecu- 
liar  silvery  whiteness.     These  patches  heal  from  the  centre. 

Psoriasis. 

This  differs  from  lepra  in  the  eruption  being  more  irregular.  The 
spots  sometimes  come  out  in  thick  clusters,  and  blend  in  various  ways. 
Instead  of  appearing  in  distinct  circular  forms,  as  in  leprosy,  the 
patches  are  irregular,  and  of  every  size.  Instead  of  one  well-formed 
and  thick  scale,  there  are  many  small  and  thin  ones.  And  instead  of 
a  depressed  centre  with  rising  edges,  the  surface  is  level.  While  lep- 
rosy is  a  circular  dry  tetter,  this  is  an  irregular  dry  tetter. 

Pityriasis. 

This  is  much  like  the  two  preceding,  except  that  it  gives  rise  to  a 
copious  production  of  very  small  bran-like  scales.  Indeed,  its  name 
is  from  the  Greek,  and  means  chafi'  or  bran.  It  is  a  bramiy  tetter. 
It  may  occur  on  any  part  of  the  body. 

Treatiiieut.  —  When  the  skin  is  highly  inflamed,  and  stiff  with  heat, 
pain,  and  itching,  the  diet  should  be  light,  and  the  drinks  of  a  cooling 
and  unexciting  kind.  The  warm  bath,  and  gentle  friction  of  the  skin 
are  useful.  Laxatives  or  tonics  may  be  employed,  according  to  the 
indications,  —  frequently  laxatives  first,  and  tonics  afterwards.  The 
specific  remedies  for  curing  the  disease  are,  corrosive  sublimate  (139), 


I'!    ', 


1  ;i^.: 


odidc  of  potassium  (140),  arscniato  of  iron  (08),  Fowl(!r'»  solution, 
ill  t\v(»  (Iroj)  (loses,  ihrvv,  times  a  day;  or  ])t)iiovair.s  solution,  in  live 
drop  doses,  tlirv.'c  tim«\s  u  day.  For  external  u|)plication,  use  a  nap- 
th.iline  ointintMit  (177),  zinc  ointment,  white  precipitate  ointment, 
diluted  nitrate  of  mercury  ointment,  or  solution  of  corrosive  subli* 
mute  {2L'2). 

Dry  Pimples. 

Tmk.sk  are  distinguished  by  the  high  degree  of  irritation  of  the  skin 
which  they  create.  They  are  exceedingly  troublesome,  not  only  from 
the  distress  and  itching  they  occasion,  but  because  they  are  likely,  in 
con><e(|uence  of  this  to  be  torn  into  painful  and  obstinate  sores. 

W!  -n  appearing  in  children,  they  are  called  red  g-um,  and  tooth- 
rnsh.  In  growii  persons,  one  form  is  named  lichen,  and  another,  dis- 
tinguished by  excessive  itching,  prurigo. 

In  this  form  of  pimples,  the  fluid  is  not  poured  out  upon  the  swr- 
face  of  the  true  skin,  —  as  in  several  of  the  preceding  diseases,  —  but 
is  collected  within  the  tissue  of  this  organ,  and  the  pimples  feel  hard 
under  the  finger. 

The  tooth  rash  of  infants  is  always  accompanied  with  some  fever- 
islmess,  caused  generally  by  irritation  of  gums  from  growing  teeth, — 
occasionally  by  flannel  worn  next  the  skin. 

Lichen  has  a  variety  of  forms.     In  one  case  the  pimples  are  of 
bright  red,  in  another,  bluish  or  livid.     In  one  case  they  appear  in 
circular  groups,  in  another,  they  produce  great  disorganization  of  tii.^ 
skin,  and  occasion  terrible  suH'ering. 

l*riii'i(po  is  a  still  more  cruel  disease  than  lichen.  The  pimples  are 
not  very  manifest,  but  the  skin  is  thickened  or  swollen,  and  condensed. 
The  su tiering  from  it  is  terrible.  It  gives  one  no  sleep,  night  or  day. 
That  form  of  it  called  ant-bite  prurigo,  gives  the  sensation  of  millions 
of  ants  eating  the  flesh,  or  as  many  red-hot  needles  piercing  it.  This 
renders  the  existence  of  many  elderly  persons  a  terrible  burden. 

Treatment. —  Careful  diet,  and  gentle  cathartics  or  tonics,  accord- 
ing to  the  condition  of  the  system.  Externally,  the  cold  salt-water 
eponge  bath,  and  glycerine,  applied  with  a  soft  sponge,  vinegar  and 
water,  corrosive  sublimate  (222),  creosote  ointment,  the  diluted  nitrate 
of  mercury  ointment,  laudanum  ^nd  sulphur  (179),  prussic  acid,  etc 
(171).  For  relieving  the  terrible  itching  of  the  private  parts,  whicli 
females  sometimes  sufl'er,  I  have  found  morphine  (223),  for  external 
use,  very  effectuaL 

Lupus. 

This  makes  its  appearance  in  the  form  of  one  or  more  circular 
elevations,  of  a  dull  red  or  salmon-color,  and  partially  transparent. 
When  [.ressed  under  the  finger,  these  elevations  are  found  to  be  soft, 
and  when  the  finger  is  removed,  they  are  flat  and  whifened.  They 
generally  appear  on  the  face,  and  particularly  the  nose. 


TrejH 

iiole  in 
jceting 
•silver  so 
ell"  very 
t  orns 
water  a 
luickskii 
•••ather 
<'asiJy  sc 
^•roys  w 
irreat  to( 
(•-'•-'4),  w 
zontal 
^way  ti< 


mf:-    —TT" 


SKIN  DISEASES. 


145 


Kio.  70. 


In  another  and  >sorH<!  form  of  the  disease,  the  tubercles  arc  harder ; 
and  after  a  linn',  th.'y  become  covered  with  thin  brown  scabs,  which 

an;  scratched  off,  and  followed  by  others, 
and  these  by  others,  until  ulcers  upjiear, 
which  are  Monietimes  slow  and  some- 
times rapid  in  their  progress.  The  whole 
nose  has  been  destroyed  by  them  in  a 
month.  (See  Fig.  70.)  This  is  t)ne  of 
tlir  diseases  which  Erasmus  Wilson 
■  thinks,  and,  in  my  judgment,  correctly, 
l(o  be,  like  scrofulti,  the  nviilt  of  tlie 
syphilitic  poison,  tiltered  thro\igli  th< 
blood  of  several  generations.  (See  col- 
ored Plate  IV.)  Tlie  artist  has  here 
given  a  beautiful  likene^js  of  the  disease. 

TiTrttiiM'iit.  —  The  internal  remedies 
are  iodide  of  arsenic  (141),  and  iodide  of 
potassium  (140);  the  external,  vinegar  of 
Spanish  flies;  and  to  promote  the  he-' 
ilutiou  of  nitrate  of  silver  (211)  (214) 


heal- 
ia 


ing  of  tlie  ulcers,  a  weak  solut 
iidapted. 

Warts  and  Corns. — Verruca  —  Tylosis  —  Clovtfs. 

In  the  derma  or  true-skin,  there  are  a  great  many  small  arteries, 
veins,  and  nerves,  united  together,  and  formed  into  loops  (see  cut  43), 
resembling,  in  shape,  the  peaks  of  miniature  mountains.  These  are 
(•idled  papilhe.  These  loops,  fre(|uently,  without  any  apparent  cause, 
take  on  a  disposition  to  grow,  and  by  extending  themselves  ui>ward, 
iliey  carry  the  scarf-skin  along  with  them,  which  is  thickened;  and 
tDgether  they  form  what  is  called  ivarls.  Corns  are  formed  by  a 
somewhat  similar  growth  of  the  papilUe,  brought  about  by  the  pre«- 
MU'C  and  friction  of  tight  boots  and  shoes. 

TreittiiK'iit.  —  For  warts,  take  a  piece  of  diachylon  plaster,  cut  a 
iiole  in  the  centre  the  size  of  the  wart,  and  stick  it  on,  the  wart  pro- 
jecting through.  Then  touch  it  daily  with  aqua  fortis.  Nitrate  of 
f-ilver  sometimes  answers  well  for  touching  it.  They  may  be  taken 
ctf  very  neatly,  sometimes,  by  tying  a  string  tight  around  them, 
t'orns  should  be  shaved  down  close,  after  being  soaked  in  warm 
water  and  soap,  and  then  covered  with  a  piece  of  wash-leather,  ot 
luickskin,  on  which  lead  plaster  is  spread,  a  hole  being  cut  in  the 
Iffither  the  size  of  the  corn.  They  may  be  softened,  so  as  to  b** 
ciisily  scooped  out,  by  rubbing  glycerine  on  them.  Manganic  acid  de- 
stroys warts  and  corns  rapidly.  Bunions,  which  affect  the  joint  of  the 
iricat  toe,  must  be  treated  with  fomentations,  and  sugar  of  lead  water 
(■2','4),  when  there  is  consideral^le  inlhunmation,  with  rest  and  a  hori- 
zontal position.  But  the  best  cure  for  corns  and  bunions,  is  to  put 
liwav  tight  shoes. 

19 


II 


i!tJ 


.* 


'  Ih 


1,;  . 


I '*™  ^ 


ammww 


1:1 


146 


SKIN  DISEASES. 


Mother's  Marks.  —  Nevus. 

The  small  vessels  of  the  skin,  called  capillaries,  suffer  certain  alter- 
«-ions  of  structure  which  pass  under  the  name  of  mother's  marks. 
These  marks  are  simply  a  great  dilatation  of  these  minute  blood 
vessels.  These  marks  vary  in  size  from  a  uu're  point  to  a  patch  of 
several  inches  square. 

The  smallest  of  all  is  the  spider  mark.  It  is  a  small  red  point, 
from  which  several  little  straggling  vessels  s[)read  lut  on  all  sides. 
Sometimes  this  is  of  the  size  and  appearance  of  ii  j-ed  currant;  at 
other  times,  of  a  strawberry  or  raspberry ;  and  occasir  nally  it  is  even 
much  larger,  ai'  1  is  compared  to  a  lobster. 

When  ihe  circuhiTion  is  active  through  them,  or  Ihc  individual  is 
excited  by  exercise,  or  by  moral  causes,  these  marks  an;  of  a  bright 
red  color.  Some  are  naturally  livid  and  dark-coloretl,  and  look  like 
blackberries,  and  black  currant'*.  The  blueness  of  these  is  owing  to 
the  vessels  being  still  more  stretched  and  dilated,  anil  to  the  conse- 
quent slower  passage  of  the  blood  through  them,  wincli  gives  more 
time  for  its  change  from  the  arterial  red  to  the  venous  blue. 

Trcsetmeiit.  —  Jf  the  mark  is  not  making  progress,  it  had  better  be 
let  alone,  or  only  subjected  to  gentle  pressure  by  putting  a  piece  of 
soap  plaster  over  it.  When  its  course  is  threatening  mischief,  it  is 
.•sometimes  cured  by  pencilling  a  small  portion  of  its  siwface,  from 
time  to  time,  with  nitric  acid. 

Disordered  State  of  the  Nerves  of  the  Skin. 

Itchin)(. —  Pruritus.  This  is  supposed  to  be  dependent  on  an 
altered  condition  of  the  nerves  of  the  skin,  and  consists  in  a  painful 
sensation  of  itching.  There  is  no  perceptible  alteraiioii  i:;  the  ap- 
pearance or  structure  of  the  skin.  This  itching  is  thought,  I'eneraliy, 
to  be  a  result  of  sympathy,  through  the  nerves,  with  souir  cli.  I'ascd 
and  excited  condition  of  a  distant  part.  The  itching  is  broiighi  mh 
by  the  most  trifling  causes,  and  for  hours  may  deprive  the  sulli'rrr  tW 
every  particle  of  repose.  It  more  frequently  allecta  the  fundain«'iii. 
or  the  |>rivatt;  parts,  particularly  the  scrotum. 

Treiltiiieilt.  —  As  this  disease  is  only  a  symptom  of  several  other-;, 
the  constitutional  treaiment  belongs  under  tin;  heads  of  these  other 
diseases.  The  local  applications  for  relieving  the  itching  are,  a  solu- 
tion of  svigar  of  lead  (224),  of  white  vitriol  (220),  of  corros^ive  subli- 
mate (212),  diluted  nitrate  of  mercury  ointment,  and  poppy  fomenta- 
tiona.     Also  (223). 

Disorders  Affecting  the  Color  of  the  Skin. 

Colored  Putclies.  —  Macuke.  The  depth  of  color  in  the  skin  <lependp 
on  the  amount  of  a  certain  coloring  matter,  called  pigment,  incorpo- 
rated with  the  deeper  and  softer  portion  of  the  scarf-skin.     In  the 


LUPIJS  NQN  EXED^'NS 


life;;^;' 


^^■v  ■' 


:'■■  ^  '■ 


•■•«(<«,• 


\ 


1 1 


I  f 


'm 


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■Sr  .'lii 


.^•:^"^^' 


J- 


f  ■ 


.11' 


:.,:.,l::l-' ^  .«*W.-^1 


SV..S  |n6KA.v-K> 


W     ' 


Moth  or '3  M<rk&.-"-  S'mm,      ■  , 

.;t,;^B  vp«»<'.i9  of  the  skia,  called  capiilv»«*«,  s-J.tTcc  certain  altw 

of   .trwoiurc  which  })^m  undtJf  the  naowr    >    nioth<^r'H  marks' 

'kin'*.'.  HJarks  arc  sijnply  u  f:,r('at  (lilui:sjf5<»n  of'  Uif.fe   rniimte  hloot 

ve»3i(>l!',     T'lCtaC  rnark.s  vury  in  si/.o  from  4  :t;veic  Vfoiiit  I0  u  patch  0/ 

8t^vt.'rul  iiKihtM  sqnnre.  : 

The  .sniaHejit  of  all  i,<  tlif-  spkkr  mark     h  >''■    i  miuW  red  poin* 
from  whif'h  ^*:-\'-  ml  iii'ie  8iragf?lin.2;  vi!»f«ir*  »p,r»  aJ  out  on  nil  n-'iiit^. 
S<.>itiK  jiui'.-'.  ihi«(  irf  of  th(!  ^i7X'.  aiK?  ajjipeasaiict'  1-  u  r<-<l  currani:;  w: 
other  i.lm«s.  01  ;i  isinnu;.'rr>  or  ra^tpl-^rVy ;  W**!- ^v  ra^jorially  it  is  evoj. 
Miij"!i  iari^ir,  uiwi  i--^  coiiipajred  to  ;..  l-<.b;'ir=-ii; 

\V|jf?u  ihc  cii-cuiafit-n  i»  ;»vtivv  rhix-u^ii  TlrRinr,  or  thf*  iiidivitloaj  » 
■  ciifti  by  excTcisfi^cf  by  mc^ml  ftatt''e«,  tin'w  iX'^rks  un  »)f  h  briii^ 
.r^:<i  color.'  i-^mm:  iu«>  luiiiiraUy  livii^  and  d«rk-<'')lof"(!, -irid  look  lis. 
blaciib^Tvics  a!id  bliu%  <".irraiiVs.  Tlie  bluvMi'^vij  of  tlu'rf*-  is  owin-;- 
rhc  vf's^cls  being  m\i  inon?  sfr»,'TohP«i  Uml  iliinieii,  and  to  Ihe  con** 
qticm  -'.uwer  pasfaieo  of  the  blcH>ti  thjrowKh  *^h<^"!i,  wliich  givna  nuv 
ti'iK*  lor  m  c-rauge  from  tfe*'  wre^fM?.!  i^-d  to  ih«  vt-uojis  bliio.     • 

Tr»^.Mrtif«t — If  thp  i-K.<ri<.  i*  wo*;  making  "fo^rp.-*^.,  it  had  beitrr  '■ 
'>':  uk-o«r,  vf  «>nly  H.il-.if;. '.  u  to  gontk-.  pre^.-ur^;  by  putting  ;.i  pi«-'f;< 
;. Kip  pUt!*tk";r  over  b      When  i'-i?'  coors*^  ia  thrcatouini;  init^chief,  i: 
sosuctisn*'-  i;arc<!  !>v   p»in  illing  a  s'tnatl  jwrtloii  of  itis  hiirfa<-c,  ffn.  s 
iituH  'c  tUDe,  wtth  nitric  ucid. 

Djaordernd  State  of  the  Serves  of  the  Skin. 

it'tiiimg.  —  PrnrUux.      Tlu.^   is   f>!ipjx)si>d   to   in?  <lfp''ndciit  o' 
nit«rrd  wndition  of  the  nerves  of  the  skin,  and  coiiHint;*  in  a  ptiX'' 
ft.  nMdti4)iJ  of  iu'liiMg.     'Iliere  i#.  110  p'l-ot'ptible.  aiNirutioi.  in  I'v 
p.'taraaoc  or  «*troc(urc  of  tU^  ^kin.     Thi  •  uchuig  ifc  tlioi.gli',  g-'iiv: 
to  Ihs  n  rr-pnit  of  svnuvaib*   through  ?h»i  nerves,  with  m>um*  dii^n  • 
and  excited  fot-.dirion  o(  k  distant  pnrt.     The  jtrhioij  i;*  l'M>n^^»t 
bv  the  mo!<t  trill. o^;  crin.^v^,  i»4.'<l  f>r  Konrs  may  deprive  tiie  >nlHf 
every  parti*!.**  of  te(K»i^e      h  »jv>r6  i'rt'vjriently  att'MU  the  funda   •• 
or  the  private  partii,  partjeaiariy  th<«  f'.otcui'.  '    ;, 

Tk  utuii'ut — As  this  disease  in  only  «  -unpfcsn  of  severt' 
thi-  coustitutional  trentment  belongs  io. -> -r  ihe  head?  of  the  . 
<U»e!iseR.      J'lie  U»ck1  iippliral.toiib  io'  r-i'*-   •' ).r  the  itching  !\re,  :«  • 
,.»n  of  fiugar  of  lead  {2-lX),  of  whiU'       ^       fiJ^H)),  of  cxirrosiv 

luuu-  (-^i-*),  diluted  nitrate  of  rnyr.jurv  c  •.■a.v.nt,  and  poppy  l<>e 


Disofders  Affectirjg  f  U»f  C«>m 

he  Skin. 

r:oU»r.'<M*i)!tehev       MotruU.     The  defrt^.  <-«f  ■ 
<v                          of  a  iTitain  colorie.)B    : 

siior  iti  the  skin  ttep-'no 
i((i  pij^inent,  ine- 

•■"•    ien'i'--l\il).      'Ci 

_JI 

m 


LUPlfS  NQN  EXEDENS 


PU 


\ 


*, 


ml 


it!® 


srkM 


■i'l 


l!;'!^ 


c*- 


■!r 


;   !  i^ 


M 


^_)i 


»K!,*- 


»<carf-g 
of  thii 
deal ; 
iiilernr 
The 
III  the 
lilted  t 
and  ii 
siiiiurK 
Ibrinin 
ihi'  \yi 

lllCIlt, 

Wh 

action 
color  ii 
the  for 
parts  c 
skin,  a 
and  sp 

Occi 
diininii 
tniies,  i 
albinos. 

In  n 
when  |: 
with  yi 
of  frea 

Treal 
be  very 
eJliptict 
In  the 
stimula 
called  s 
paratioi 
(222). 


The 
sign.  ' 
(ittle  sw 
is  so  alt 
This  is 
she  swe 
and  the 
memora 
the  gan 
recordeti 

The  j 
these  oh 


m 


SKIN  DISEASES. 


147 


Mcarf-skin  of  the  inhabitants  of  northorn  latitudes,  there  is  but  little 
of  this  pigment;  in  that  of  the  dwellers  in  Africa,  there  is  a  great 
deal ;  among  the  inhabitants  of  Southern  Europe,  the  quantity  is 
intermediate  between  the  two. 

The  depth  of  color  in  the  skin,  depends  on  the  energy  of  its  action. 
In  the  tropics,  where  light  and  heat  are  in  excess,  the  skin  is  stiinu- 
liited  to  great  action,  jur?t  as  vegetation  is,  and  the  color  is  increased 
and  intensified.  This  is  ilhistrsitcd  every  year  before  our  eyes.  In 
Slimmer  under  the  heat  of  the  sun  and  the  flood  of  light,  the  pigrnc  .- 
Ibrining  power  is  increased,  and  t'.ie  fairest  skin  is  brown«'d  ;  wiiile 
till'  \yithdrawal  of  these  forces,  leaves  the  winter's  scarf  without  pig- 
ment, and  blanched. 

What  the  sun  and  light  do,  under  natural  circumstances,  diseased 
action  may  eft'ect.  Hence  we  occasionally  meet  with  alterations  of 
color  in  the  skin,  from  a  disordered  state  of  the  system.  We  witness 
the  formation  of  patches  of  dark  color  and  irregular  shape  on  various 
parts  of  the  body.  Sometimes  they  are  raised  above  the  level  of  the 
skin,  and  are  called  moles.  At  other  times,  they  have  no  elevation, 
and  spread  over  the  whole  body. 

Occasionally,  from  some  peculiarity  of  constitution,  the  pigment  is 
diminished,  and  white  patches  appear  all  over  the  body.  At  other 
tunes,  a  black  person  will  become  completely  white.  Such  are  called 
albinos. 

In  many  cases  the  coloring  of  the  skin  has  varklies  of  tint,  as 
when  persons  of  light  complexion,  are,  in  the  summer  season,  covered 
with  yellow  spots,  like  stains.  These  spots  are  known  by  the  name 
of  freckles,  or,  in  learned  language,  lentigo. 

Treati>»eilt, —  It  is  generally  best  not  to  meddle  with  a  mole.  If  it 
be  very  unsightly,  let  it  be  removed  by  two  incisions,  taking  out  an 
elliptical  portion  of  skin,  and  closing  the  wound  with  sticking  plaster. 
In  the  case  of  bleached  places,  apply  the  shower  bath,  tonics,  and  a 
stimulating  liniment  (163)  to  the  faded  spots.  For  the  change  of  color 
called  sun-burn,  a  liniment  (191)  of  lime  water,  etc.,  is  the  best  pre- 
paration. For  freckles,  use  lime  water  (191),  or.  perhaps,  still  better 
(222). 

Disorders  o?  the  Sweat  Glands. 

Thk  perspiration  is  sometimes  greatly  increased  above  nature's  de- 
sign. This  is,  technically,  idrosis.  In  other  instances  there  is  too 
little  sweating.  This  is  called  nnidrosis.  Sometimes  the  perspiration 
is  so  altered  in  its  physical  qualities  as  to  have  some  peculiar  smell. 
This  is  osmidrosis.  In  some  rare  instances,  according  to  old  writers, 
she  sweat  was  changed  in  color.  This  was  chromidrosis.  And  now 
and  then  a  case  occurs  of  bloody  perspiration,  of  which,  the  luost 
memorable  case  on  record,  is  that  of  the  Redeemer  of  men,  who,  in 
the  garden,  sweat  great  drops  of  blood.  Several  cases  of  this  are 
recorded  in  medical  books.     It  is  called  hfcmidrosis. 

The  proper  action  of  the  skin  b(ung  so  vitally  important  to  health, 
these  changes  often  involve  very  serious  consequences. 


Vii  I 


r;j.!i 


!'    :i 


I    !- 


n-\ 


I        M 


i'        !' 


I 


if?:: 


148 


SKIN  DISEASES. 


Tretitiiieiit.  —  EifluT  too  much  or  too  little  sweating  can  generally 
be  corrccited  by  the  cold  or  warm  bath,  friction,  tonics,  and  proper 
clothing. 

Disorders  of  the  Oil-Glands  and  Tubes. 

That  the  skin  may  be  limber,  healthy,  and  fit  for  use,  it  is  neces- 
sary to  have  it  oiled  every  day.  For  this  object,  the  Creator  has 
wisely  provided,  by  placing  '"\  the  true  skin  a  large  number  of  very 
small  glands  and  tubes,  whose  ofUce  it  is  to  prepare  and  pour  out 
upon  the  siiiface  the  prop*  .  amount  of  oil.  The  gland,  regular 
little  oil-pot,  is  in  the  true  skin;  and  from  it  a  piece  of  hose  or  tube 
runs  up  thioiigh  the  scarf-skin,  through  which  the  oily  Huid  is  poured 
out.  Some  of  these  tubes  are  spiral,  others  are  straight.  On  some 
parts  these  vessels  do  not  exist;  on  others  they  are  quite  abundant, — 
as  on  the  face,  nose,  ears,  head,  eye-lids,  etc.  I^hey  produce  the  wax 
of  the  ears ;  and  on  the  head,  they  open  into  the  sheath  of  the  hair, 
and  furnish  it  with  a  hair-nil  or  pomatum  better  than  the  chemist  can 
make. 

These  little  vessels  are  always  at  work,  when  the  skin  is  healthy; 
and  no  persons  need  be  afraid  to  wash  all  over  every  day,  lest,  as  the 
Boston  Medical  JoK ma/  taught,  the  skin  will  be  injured  by  having  the 
oil  removed  from  it.  You  might  as  well  be  afraid  to  eat  a  meal  of 
victuals,  lest  the  saliva  should  all  be  swallowed  with  it,  and  none  be 
left  for  future  use.  There  is  oil  enough  where  that  upon  the  skin 
comes  from,  and  the  vessels  which  produce  it  are  in  <  injured  by  work, 
any  more  than  the  ivuiscles  of  the  legs  are  by  walking. 

Cil'llbs  or  Honns. —  But,  unfortunately,  the  skin  is  not  well  taken 
care  of  in  all  cases,  as  in  cities  and  towns  where  sj'dentary  habits  pre- 
vail. Here,  the  actions  of  the  skin,  instead  of  being  regular  and  com- 
plete, are  often  sluggish  and  imperfect;  and  the  contents  of  the  oil- 
cells  and  tubes,  instead  of  flowing  easily,  become  hard  and  impacted, 
and  the  vessels  are  not  emptied.  "When  this  matter  becomes  station- 
ary, dry,  and  hard,  it  distends  th(»  tube,  and  fills  it  to  the  surface;  and 
then  coming  in  contact  with  the  dust 
and  smoke  of  the  atmosphere,  the  ends  K». 77. 

become  black,  and  look  like  the  heads  of 
worms.  These  s|)ots  an;  conuuou  on 
the  nose  and  face  of  persons  who  have 
u  sluggish  skin.  They  may  be  squeezed 
out  by  pressing  the  nails  on  each  side  of 
them.  These  are  called  tr-rubs  .ind 
worms,  or,  technically,  comedones.  When 
this  matter  ))ro(luces  inflairunation  of  the 
tube,  there  is  then  a  l)lack  spot  in 


middle  of  a  red  pimpfc,  and  the  disease 
is  called  spotted  acne.     Now  and  t 
the  oily  matter  becomes  very  hard, 
ducing  spine-like  growths,  and  even 
lects  and  forms  soft  tumont,  as  we 


SKIN  DISEASES. 


1^9 


called  encysted  tumors.  Sometimes  the  action  of  the  glands  is  too 
great,  and  oil  is  poured  out  so  profusely  that  the  face  shines  with  it. 
At  other  times  there  is  so  little  that  the  skin  is  dry  and  harsh.  In 
the  hardened,  oily  matter,  which  constitutes  grubs,  are  foiuid  small 
animals,  which  Dr  Wilson  calls  the  "  animal  of  the  oily  product  of 
the  skin. '     Here  are  three  views  of  him. 


Fio.  79 


Fici.  80. 


Trciifiiieiit. —  For  roughness  and  harshness  of  skin,  wash  with  soap 
and  water  every  night,  and  rub  well  into  the  skin  after  the  bath,  and 
in  the  morning,  the  ointment  (ISO),  and  take  a  dose  of  sulphur,  v\v. 
(:23),  twice  a  week.  Or,  nih  the  skin  every  morning  with  a  damp 
sponge,  dipped  in  line  oat-meal,  anil  after  drying  the  surface,  the 
liniment  (104)  may  be  a|)plied.  The  spinous  varii'fy,  or  porcupine 
disease,  reipiires  washing  witli  a  quart  of  warm  water,  havhig  a  huge 
tcaspoonful  of  saleratus  dissolved  in  it,  and  the  use  of  the  ointmcMt 
(181)  twice  a  day.  For  grubs,  stimulate  the  skin,  by  wu:  hing  it  witli 
strong  soap  suds,  twice  a  day,  and  rubbing  briskly  with  a  ct)a"se  towel  ; 
and  by  using  tin;  corrosive  sublimate  {2'2't)  as  a  lotion. 

A  spare  diet  will  do  much  towards  improving  the  skin  in  many 
cases. 


Barbers'  Itch— Jackson's  Itch. — Sj/co. 


SIS. 


This  is  very  much  like  acne, —  only  dilFering  from  it  in  its  location. 
It  appears  chiefly  on  the  hairy  parts  of  the  face,  —  the  chin,  the  upper 
lip,  the  region ^of  the  whiskers,  the  eyebrows,  and  the  nape  of  the 
neck.  It  consists  in  little  conical  elevations,  which  maturate  at  the 
top,  and  have  the  shaft  of  a  aair  j.assing  through  them.  These  pim- 
ples are  of  a  pale  yellowir  h  color.  In  a  few  days  they  burst,  and  the 
matter  running  out,  form  >  into  hard,  brownish  crusts.  These  crusts 
fall  off  in  one  or  two  weeks,  leaving  purplish,  sluggish  pimples  behind, 
which  disappear  very  slowly. 


I  'H4 


150 


SKIN  DISEASES. 


The  eruption  is  preceded  by  a  painful  sensation  of  heat,  and  tight- 
ness of  the  skin. 

The  disrase  is  supposed  to  be  brought  on  frequently  by  using  a 
dull  razor  in  shaving.  It  is  very  obstinate,  —  often  lasting  for  many 
months,  and  even  for  years. 

Trentnieilf.  —  The  most  important  part  of  the  treatment  is  the  re- 
moval of  the  cause.  Tlie  beard  must  not  be  pulled  with  a  dull  razor; 
the  shaving  had  better  be  discontinued  altogether,  and  the  beard  be 
mertdy  cro|)ped  ott'  with  scissors  instead.  All  intemperance  in  eating 
and  drinking,  and  exposure  of  the  face  to  heat,  must  be  avoided.  A 
light,  cool  diet  will  do  much  towards  curing  the  disease. 

The  nitrate  of  mercury  ointment,  and  a  solution  of  oxalic  acid,  aro 
the  best  applications.     If  one  does  not  succeed,  try  the  other. 

Disorders  of  the  Hair  and  Hair  Tubes. 

The  hair  is  an  appendage  to  the  sc^arf-skin,  and  is  intended  to  bo 
both  useful  and  ornamental. 

It  is  sul)ject  to  several  disorders.  It  may  grow  too  long,  or  too 
thick,  or  it  may  appear  in  an  improper  place.  This  last  happens  ii! 
the  case  of  those  little  spots  and  patches,  which  disfigure  the  face, 
and  are  called  Jiio/es.  The  hair  may  be  defective  in  its  growth,  or 
may  fall  off  prematurely  from  various  causes,  or  in  the  natural  course 
of  things  from  old  age.  This  last  is  called  calvilies.  It  may  change 
its  color,  too,  under  a  great  variety  of  circumstances,  and  at  nearly 
every  age.  It  is  not  very  uncommon  to  find  a  single  lock  varying  in 
color  from  that  which  surrounds  it.  Old  age,  the  winter  of  life,  nat- 
urally brings  the  frosted  locks  ;  but  they  frequently  appear  also  upon 
the  heads  of  younger  persons.  Strong  mental  emotions,  such  as  fear, 
grief,  or  sorrow,may  bring  a  bleaching  o  the  hair  in  a  brief  period, 
or  even  suddenly.  Byron,  in  his  "  Pri  .ner  of  Chillon,"  beautifully 
refers  to  this  fact : 


"  My  hair  is  gray,  but  not  with  years, 
Nor  grow  it  wliito 
III  a  single  night, 
As  men's  have  grown  from  sudden  fears." 

I*orri}»'0.  —  There  is  a  troublesome  disease  of  the  hair  and  hair  tubes 
called  pon'i^o.  It  begins  with  the  formation  of  a  ihin  layer  of  scurf 
either  around  single  hairs,  or  in  ])atches  which  enclose  several.  These 
patches  fre<|ueiiily  have  a  circular  form,  which  give  to  the  allection 
the  character  of  a  rin>cw()nti.  The  hair  tubes  are  generally  a  little 
elevated,  in  the  shape  of  pa|)illffi,  which  gives  to  the  diseased  seal|)  the 
a])pearance  of  "  goose-dcsh."  These  hairs,  losing  their  proper  nour- 
ishment and  healthiness,  brejik  olf  at  unequal  distances  from  the  skin, 
leaving  thi-ir  rough  ends,  twisted,  and  bent,  and  matted  into  thick 
grayish  and  yellow  crusts.  Upon  the  surface  of  these  crusts  may 
generally  U;  seen  the  ends  of  a  few  hairs,  looking  like  the  fibres  of 
hemp  or  tow.  The  scratching  causes  iuHammation  of  the  skin  after 
u  time,  and  matter  is  poured  out,  which  still  further  mats  the  hair, 


SRIN  DISEASES. 


151 


and  thickens  the  crusts.  There  are  several  varieties  of  this  disease, 
differing  slightly  from  each  other ;  but  this  general  description  will 
answer  all  practical  purposes  for  this  work. 

The  reader  will  often  notice  a  disease  of  the  hair-glands,  character- 
ized by  a  yellowish  and  dirty-looking  powder,  covering  the  scalp  and 
hairs.  This  matter  is  collectt'd  at  the  mouths  of  the  follicles,  and 
considerable  of  it  is  strung  upon  the  hairs  like  beads.  Pull  out  a  hair, 
and  the  root  will  be  fonnd  thin,  dry,  and  starved  in  its  appearance^ 
In  this  disease,  it  is  difTicult  to  keep  the  hair  cleansed,  or  to  i)revent 
its  failing  olK 

Fiivii.s.  —  Still  another  disease,  called  favus,  is  known  by  the  collec- 
tion of  a  yellow  substance,  at  first,  around  the  cylinder  of  the  haiii 
This  substiince,  after  a  time,  spreads  out  upon  the  scarf  skin,  and 
dries  into  yellow  crusts,  in  the  forin  of  a  cup,  around  the  base  of  each 
hair,  A  intnilur  of  these  cups,  collected  together,  look  like  the  cells 
of  a  honey-comi).  'J'liis  disease  is  contagious,  and  is  conuimnicable 
by  contact  to  any  part  of  the  skin. 

Treatlllt'llt. —  For  removing  the  hair  from  particular  parts  of  the 
scalp,  it  is  common  to  resort  to  depi/d/orics.  Of  these,  the  recipi-s 
200,  261,  262,  are  frequently  used,  and  are  as  good  as  those  adver- 
tised ;  indi>ed,  they  are  the  same. 

To  prevent  loss  of  hair,  and  to  restore  it  when  lost,  the  circulation 
should  be  stimulated  in  the  small  vessels  of  the  scalp.  With  this 
view,  washing  tlu^  head  every  morning  with  cold  water,  drying  it  by 
friction  with  a  rough  towel,  and  brushing  it  to  reilness  with  a  stilf 
hair-brush,  are  excellent.  To  these  should  be  added  some  stimulating 
ointment  (183),  or  liniment  (2o7)  (258)  (2;')9).  These  last  are  about 
the  best  known  preparations  for  causing  the  growth  of  the  hair. 

Rin^ivoriii  of  the  scalp  requires  attention  to  the  diet,  and  such  rem- 
edies as  will  improve  the  general  health,  with  stimulating  applications 
externally  (257)  (258)  (259). 

To  color  the  hair,  several  preparations  are  used.  Of  these,  263  is 
about  the  best.  It  produces  a  beautiful  black.  A  preparation  of  sul- 
phur and  sugar  of  lead  (264)  is  the  famous  compound  reconnnended 
by  General  Twiggs,  and  extensively  used.  Preparatit)ns  of  nitrate 
of  silver  (265)  (266)  (311)  are  much  in  use  in  some  (piarters.  Tliey 
perhaps  give  a  liner  black  to  the  hair,  but  they  render  it  dry  and  crisp, 
and  they  will  stain  the  skin,  if  care  is  not  used  in  applying  them. 

Ill  Favus,  the  two  great  objects  to  be  gained  are,  to  remove  all  local 
causes  of  irritation,  and  to  excite  the  diseased  hair  glands  to  healthy 
action.  The  first  object  is  effected  by  cutting  olf  the  hair  with  the  scis- 
sors, and  removing  the  crusts  by  washing  the  scalj)  with  castile  soap 
and  water.  It  may  be  well  first  to  wet  the  crusts  through  with  corro- 
sive sublimate  (212),  in  weak  solution.  The  washing  with  soap  and 
water  should  be  repeated  every  day,  and  be  followed  by  rubbing  into 
the  scalp  a  stimulating  ointment  (183).  A  very  weak  solution  of  the 
acid  nitrate  of  mercury  (226),  applied  every  other  day,  with  a  camel's 
hair  brush,  sometimes  produces  excellent  effects. 


'"'i' 


.1,' 


I     ' 


VI 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


The  brain  and  spinal  cord  are  the  great  centres  of  the  nervous 
system. 

The  brain  produces  sensation,  thought,  and  voluntary)  motion.  When 
thift  organ  is  diseiV(<ed,  therefore,  we  may  expect  one  of  these  functions 
to  be  either  disturbed  or  destroyed. 

Of  Sensation  there  are  various  disturbances,  perversions,  and  sus- 
pensions, ciiused  by  disease  of  the  brain  and  nerves ;  such  as  nausea, 
giddiness,  specks  floating  before  the  eyes,  ringing  in  the  ears,  decep- 
tive tastes  and  siriells,  intolerable  itching,  neuralgic  ciins,  boisterously 
high  spirits,  depression  without  apparent  cause,  ar    <'iy,  and  dread. 

Thou»iit,  in  like  manner,  is  disturbed  and  pervened  in  many  ways. 
There  is  high  delirium,  dulness  and  confusion,  loss  of  memory,  weak- 
ened judgment,  and  every  degree  of  stupor,  down  to  entire  loss  of 
consciousness. 

Voluntury  Motion  is  perverted  and  destroyed  in  muscular  twitch- 
ings,  trembling  of  the  limbs,  spasmodic  stillness,  involuntary  jerkings, 
convulsions,  muscular  debility,  and  palsy. 

The  brain  is  composed  of  three  parts,  —  the  cerebnnnAhc  cerebel- 
lum, and  the  medulla  oblongata.  These  are  all  contained  within  the 
skull  bones,  and  are  immediately  covered  by  three  membranes,  called 
the  dura  mater,  the  arachnoid,  and  tlu;  pia  mater.  The  dura  mater  is 
a  fitroi\g,  fibrous  membrane  lying  next  to  the  skull-bones.  The  arach- 
noid is  a  serous  membrane,  lying  next  below,  and  the  pia  matter,  which 
means  pious  mother,  is  a  vascular  membrane,  lying  next  to  the  brain, 
dipping  into  it  in  places,  and  containing  the  vessels  which  bring  to  it 
all  its  nutrient  materials.     Hence  its  name. 

These  membranes  are  all  liable  to  be  inflamed,  —  and  so  is  the 
brain 

Inflammation  of  the  Dura  Mater. 

The  inflammation  of  this  membrane  does  not  often  occur  sponta- 
neously ;  but  it  happens  frequently  from  external  injuries,  as  blows 
upon  the  head. 

After  a  blow  upon  the  head  which  stuns  him,  a  man  may  recover 
himself,  and  for  some  days  remain  in  perfect  health.     Then  he  has 


t    ;m 


';w 


iM'. ' 


DISEASES  OF  THE  BRAIX  AND  NERVES. 


15a 


pain  in  the  head,  is  restless,  cannot  sleep,  has  a  flushed  face,  red  eyes, 
hot  skin,  hard  pulse,  rigor,  nausea,  vomiting,  —  ending  with  convul- 
sions and  delirium. 

This  disease  is  often  caused  by  what  is  called  ofifis,  or  iiiflamiim- 
tion  r'f  the  internal  ear.  In  such  cases,  inflammation  will  arise  within 
the  tympanum,  causing  intense  earache;  matter  comes  at  length  from 
the  external  ear.  but  the  pain  does  not  stop ;  the  patient  shivers,  be- 
comes drowsy,  perhaps  delirious,  and  finally  sinks  into  stupor.  The 
dura  mater  is  inflamed. 

Treatment. —  When  the  disease  arises  from  inflammation  in  the 
ear,  leeches  are  to  be  applied  behind  the  ear,  and  blisters  and  other 
irritants  afterwards.  Other  modes  of  treatment  will  be  mentioned 
after  the  next  two  forms  of  disease. 

Inflammation  of  the  Arachnoid  and  Pia  Mater. 

Arachnitis. 

Thesk  two  membranes  are  generally  infl  .J  together.  They 
are  so  intimately  connected  that  each  involves  the  other  in  its  own 
troubles. 

Generally  this  is  divided  into  three  stages : 

The  Irritative,  characterized  by  wakefulness,  irritable  temper,  re- 
pugnance to  strong  light,  and  contraction  of  the  pupils. 

Tlie  lufla minatory  stage,  known  by  transient  pains  in  the  head, 
alternating  with  similar  ones  in  the  bowels,  inemised  restlessness  dn<l 
irritability,  a  quick  and  tense  pulse,  an  expression  of  discontent  on 
tlie  face,  the  eye-brows  knit  and  frowning,  the  eye-lids  half  closed, 
retching  and  vomiting,  deep  sighing,  and  torpid  bowels. 

Tlie  Depressing^  Stag:e,  in  which  the  delirium  is  more  continuous, 
the  countenance  has  a  look  of  surprise  and  stupor,  the  pupils  are 
contracted  or  dilated,  the  white  of  the  eyes  injected  and  red,  the 
pupils  rolled  up  during  sleep,  constant  sleepiness,  inattention  to  sur- 
rounding objects,  torpidity  of  mind,  gradually  increasing  until  com- 
plete coma  closes  all  the  senses. 

The  disease  does  not  always  exhibit  all  these  symptoms,  or  eome 
I  in  the  regular  way  described.     Sometimes  the  first  thing  noticed  is 
long-continued  paroxysm  of  general  convulsions.     Again  these  con- 
vulsions will  come  on  after  violent  pains   in  the   head,  and  are  at- 
tended with  screaming. 

Inflammation  of  the  Brain.  — Brain  Fever. 

Encephalitis.  —  Phrenitis. 

Acute  and  general  inflammation  of  the  brain  and  its  membranes 
has  two  stages. 

The  Stajpe  of  Excitement,  in  which  there  is  intense  and  deep-seated 
pain  in  the  head,  extending  over  a  large  part  of  it,  a  feeling  of  tight- 
ness across  the  forehead,  throbbing  of  the  temporal  arteries,  a  flushed 


;j  \ 


|i' 


'; 


iiti'A 


K- 


154 


DISRASKS  OK  TlIK  BRAIN  AND  NERVK8. 


TIk 


face,  injected  eyes,  looking  wild  and  brilliant,  contraction  of  the  pupils, 
great  shrinking  from  light  and  sound,  violent  delirium,  want  of  sleep, 
general  convulsions,  a  parched  and  dry  skin,  a  quick  and  hard  pulse, 
a  white  tongue,  thirst,  nausea  and  vomiting,  and  constipation  of  the 
bowels. 

The  Strtjft'  of  Colliipse,  in  which  there  arc  indistinct  mutterings,  dull 
and  perverted  lu'aring  and  vision,  double  vision,  the  pupil  from  being 
contracted  expands  largely  and  In-eomes  motionless,  twitchings  of  tlw 
nmseles,  tremors  and  palsy  of  some  of  the  limbs,  a  ghastly  and  cii- 
daverons  countenance,  cold  sweats,  profound  coma,  and  death. 

TIk"  disease  will  not  sliow  all  these  symptoms  in  any  one  ease.  It 
runs  ii  nipid  course,  causing  death,  sometimes,  in  twelve  or  twenty- 
four  hours;  or  it  may  run  two  or  three  weeks. 

Trcilfmeilt.' — This    should    be    energetic    and    administered    rar/i/. 
meiisurcs  usually  employed  nre  hlood-lcttini^,  jNirjL^hiii;  and  the 
upplicatiuii  of  cold  lu  t/tc  /nun/. 

Cioiicnil  Itlood-h'ttins:. —  'I'liis  is  much  approved  by  numy;  for  my- 
self, 1  do  not  like  it.  Wet  cups  and  leeching  are  about  the;  extent  to 
which  1  would  ever  cany  the  abstraction  of  blood  in  these  diseases. 
These  may  sometiuu's  l)e  applied  with  advantage  to  the  neck,  and 
behind  IIh?  ears, 

Cohl  Ap|)linitioils.  —  These,  applied  to  the  head,  are  of  great  iui- 
portance.  First,  shave  the  head,  and  put  on  clot  lis 'w»^tted  in  water 
as  cold  as  it  can  be  made,  changing  them  often;  or,  put  powdered 
ice  in  a  llexibU;  bladder,  and  lay  it  upon  the  head,  —  taking  care  not 
to  make  it  too  heavy. 

Plir$t,'ill!;'.  —  This,  while  tla^  inllammation  is  in  the  active  stage, 
shotdd  be  lliorough  and  energetie.  To  cllect  it,  numy  use  calomel 
and  other  forms  of  mercury.  They  are  not  needed.  Croton  oil  is 
one  of  the  best  articles  (31),  or  calacynth,  gamboge,  etc.  (32),  without 
the  oil,  or  the  compound  powder  of  jalap. 

In  the  stage  of  collapse,  if  there  is  pallor  of  the  count«Mianee,  a 
feeble  and  Mying  pulse,  great  debility  and  tremors,  coldness  of  the 
extremities,  etc.,  give  wine  and  other  stinudants. 

tSee  that  the  bladder  is  emptied  every  day. 

The  feet,  in  the  early  stage  of  the  complaint,  should  be  l)i'he<l  ir 
warm  water,  or  mustard  and  water  (242). 


also  be  put  upon  the  feet. 

•  The  tincture  of  veratrum 
pulse,  and  produce  sweati 


Mustard  a.'auglits  i.iu; 


t5» 


given  in  full  doses,  to  bring  down  the 
imist  not  be  ouiitted. 


>  h 


Softening  of  the  Brain. — RamolUssement. 

Inflammatiox  of  the  brain,  when  it  has  run  its  course,  sometimes 
leaves  this  organ,  or  portions  of  it,  in  a  softened  condition.  The 
same  mischief  may  happen  to  the  brain  from  the  blood-vessels  which 
run  to  it  being  diseased,  so  as  not  to  be  able  to  carry  blood  for  its 
proper  nourishment. 


§( 


^f'^^nr 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


153 


SyRiptoills.  —  The  most  n'rnarkablp  symptom  of  th?'*  diHeusr  is  the 
rigid  coiitmction  of  the  iiiuselos  which  draw  up  the  limbs ;  the  huiid 
nii.y  Ix'  ficnelied  and  pressed  against  tlie  shouldtT,  or  the  heel  earried 
up  to  the  hip. 

Tlie  other  symptoms  are  various, —  fiiigling  and  luniibness  in  the 
ends  of  the  fingers;  perverted  vision,  and  sometimes  blindness;  paraU 
ysis  of  one  limb,  or  lialf  the  body;  diliiculty  of  answering  (piestions ; 
forget  fulness,  making  it  dillieult,  at  times,  for  the  patient  lo  nua-mber 
his  own  name. 

Suppuration  and  Abscess  of  the  Brain. 

Wmkn  a  diseased  l)rain  is  examined  after  deatli,  sometimes  matter 
is  found  mixed  in  with  the  softened  portion.  This  shows  that  suppu- 
ration took  plaee.  At  other  times,  the  matter  is  found  in  a  cavity, 
whieh  shows  that  an  abseess  had  formeil  during  life. 

The  symptoms  of  these;  mischiefs  arc  convulsions  in  the  earlier 
stages,  and  palsy  in  IIk;  latter. 

Induration  of  the  Brain. 

Instead  of  softening  the  brain,  inflammation  sometimes  (U)es  the 
very  opposite,  —  it  hardens  it,  —  producing  a  change  something  like 
that  which  happens  to  white  of  egg  when  dipped  in  hot  water. 

Convulsions  ap|)ear  as  the  result  of  tiiia  change,  as  in  suppuration 

and  abscess  ;  palsy  much  more  seldom. 

« 

Tumors  of  the  Brain. 

Tumors  infect  the  brain,  occasionally,  —  growing  around  it,  on  all 
sides,  pressing  themselves  into  its  substance,  and  causing  many  dis- 
turbances. Cancers  and  hydatids  are  found  there.  Tlu;  signs  which 
these  irritating  bmlies  produce,  are  like  those  of  other  diseases  of  the 
brain,  and  therefore  caimot  be  distinguished  during  life. 

Delirium  Tremens.— Drunkards'  Delirium. 

Mania  a  Putn. 

This  is  often  mistaken  for  brain  fever;  but  it  is  quite  a  difTerent 
disease.  It  is  not  the  result  of  injiammaliua  of  the  brain,  but  of 
irritation.  It  is  important  to  distinguish  it  from  inllaiimiation,  be- 
cause the  remedies  which  are  employed  for  that  would  be  injurious 
if  used  for  this. 

Tlie  Syiii|itoiils  are  incessant  talking,  fidgeting  with  the  hantls,  trem- 
bling of  the  limbs,  a  rapid  pulse,  profuse  sweating,  utter  sleeplessness, 
and  a  mingling  of  the  real  with  tlie  imaginary  in  the  busy  talk.  The 
patient  is  apt  to  think  somt;  one  is  about  to  do  him  a  great  injury, 
yet  is  unwilling  to  be  alone.  His  face  is  pale  and  sallow  (sometimes 
red  and  flushed),  his  eye  is  rolling,  quick  and  expressive,  his  speech 


<[!■'}■ 


n  1.'; 


;i- 


«[ 


156 


niSKASRS  OF  THK  HKAIN  AND  NEKVES. 


%    :..« 


situtterincr  uikI  inarfii'iilatc. —  bodily  and  imMiliilly,  ho  l*  hnsi/  day  ami 
night,  and  can  with  dilliciilty  bv.  conlined  to  hi.s  bed  or  room.  As  tin' 
discv'sc  advancer^,  and  lie  Una  born  long  without  nJccp,  ho  iniagints 
vonniti  to  b<  crawling  uj)on  his  scalp  and  body;  troops  of  rats  run 
across  !i\s  bed,  or  look  at  iiim  out  of  the  wall ;  giant  boxers  oonlVoni 
hiiri,  and  he  squares  olf  for  a  round  at  fisticuffs  ;  animals,  figures  of 
a'l  sl)a|)es,  and  horrible  monsters,  frighten  his  imagination  ;  tleviU 
langii  at  him,  and  dance  before  him.  In  long  and  sleepless  hours,  he 
talks  a)id  chaitiTs  with  tliese  sp(ctral  phantoms,  —  now  beekoniiii.' 
them,  now  ^llrinking  from  them,  till  Ik;  wears  out  and  sinks  from  ex- 
haustion. This  is  a  disease  of  drunkards  and  opium  eat<'rs,  'F'lic 
aitack  generally  occurs  in  "•onsequence  of  the  withdrawal  lor  three  or 
fouv  days  of  the  accustomed  stimulus. 

Tresitiiient. —  Opium  am!  its  preparations  are  the  sovereign  remedv. 
Giv<;  one-third  of  a  grain  of  morphia;  if  this  does  not  (piiet  tin- 
|)atient-.  give  thirty  drops  of  huiuamuri  every  two  hours,  till  slee|)  is 
produeevl.  Sleej)  will  cure  him,  and  nothing  els(>  will.  A  draught  or 
two  of  his  a(  customed  drink,  l)randy,  gin,  or  whatever  it  may  be,  will 
also  generally  dispose  him  to  slei-p. 

R(>cently,  a  very  efil-etual  n  rnedy  has  been  found  in  the  use  of 
tepid  baths,  j)r<)long<'tl  from  four  to  ten  hours,  in  toime  -tion  with 
cold  aitphcaiions  lo  the  In-ud.  In  connection  wi'.ii  this.  snn»ll  dwsc- 
of  opium  are  recpiinid  ;  but  tin"  treatment  ma\  yet  prove  to  bi-  vitv 
vaiuabie  by  tMiabling  ns  to  dispense-  with  excessive  doses  of  oj)ium. 


m 


Enlargement  of  the  Brain. —  Ifi/perfrop/n/. 

Tms  is  cnielly  a  disease.  t»f  ciiildliood.  it  <-onsisls  in  an  unnatural 
growth  o!"  the  brain.  Sometimes  the  sfuill  grows  with  it,  and  liierc 
may  not   !>e  any,  or  only  slight,  symptoms  of  disease. 

The  c()i(i|)iaint  is  sometimes  congenital,  —  the  child  being  boni 
with  a  head  !ar  above  the  natural  standard  of  size.  Sonnciimes  a 
child's  licail,  from  this  disease,  will  reach  the  size  of  an  adnlt'.^',  I)V  llw 
tim(!  it  is  live  or  six  years  old.  This  is  not  necessarily  a  disfasr, 
though  children  that  snll'er  from  it  are  very  apt  to  die  linallv  of  soin»' 
atieclion  of  the  brain. 

M)lHj>t«llls,  —  Dulness  of  iatelh'cr,  indillerein  e  to  (>xternal  object^, 
great  irriiability  of  temper.  ':Ordii',ate  a|)petit<',  gic'diness,  and  an  lia- 
biViial  headache,  which  ai  liinc''.  is  very  severe.  In  additi«)n  to  taese, 
there  are,  at  times,  convulsions,  epih-ptic  fits,  iiml  idiocy.  There  is  a 
peculiar  pfojection  of  the  parietal  bones,  which  serves  well  to  di.^lia- 
gui^h  tills  disease  from  acute  hydrocephaln^. 

TroitllM'llt. — Ah  far  as  possible,  suspend  and  rcjiress  all  exercise  of 
the  mind.  Take  the  child  fnnu  scht)ol  as  soon  as  the  di.seasc  is  dis- 
covered, and  |)UT  it,  to  the  most  acttive  imiscular  xerci.se  in  the  opt-n 
air.  The  moment  there  is  any  excitement  of  the  brain,  or  heat  on 
Ihe  top  of  tlic  head,  apply  cold  water,  ice,  or  cold  evaponuing  ](;tioiis. 
If.  HI-"  the  child  grows  up,  the  signs  of  mischief  increase,  the  diet  m'!<t 


V 

and 

V5> 

til.' 

'i.' 

IllfS 

DISKASKS  OF  THK  BKAIN  AND  NKRVKS. 


157 


1)»>  simple,  and  carefully  regulated.     Bread  and  milk  only  is  some- 
I lines  advisable. 


Shrinking  of  the  Brain.  —  Atrophy. 

I'ms  is  a  disease  in  w  liicli  the  volume  of  the  brain  is  diminished. 
There  are  two  forms  of  it  ;  one  is  congenital,  the  brain  not  being 
properly  developed  at  biriii  :  the  other  occurs  in  consecpicnee  of  dis- 
I  ;ise  cither  in  tin-  nicnibrancs  or  the  arteries.  The  symptoms  are  not 
(listingnishiil)lc  during  life  from  those;  of  other  brain  allcctions,  and 
therefore  it  can  only  be  treated  according  to  general  principles. 

Water  in  the   Ke&d.~-   icKte  IIj/drorepfKdus. 

'J'liis,  like  eidargement  of  the  brain,  is  likewise  a  disease  of  child- 
hood, and  often  attacks  srmfiihus  children. 

Being  an  inllunimaiory  disease,  it  is  im|)ortant  to  have  early  notic' 
c'f  its  existence,  !ind.  if  possible,  to  be  aware  of  its  approach;  which 
we  may  be,  fretiuenlly,  by  observing  the  following  pretnonitori/ 

Syiiiptoilis;  nnmely,  a  disturl)anee  of  the  disgestive  functions,  indi- 
(iitcd  by  a  capricious  appetite,  —  the  food  at  one  time  being  disliked. 
;it  another  devtMircd  urccdily;  afoul  tongue,  ollensive  breath,  enlarged 
::n(l  sometimes  tender , belly,  torpid  bowels,  stool^  light-colored  from 
liiivim;  no  bile,  or  daik  from  vitiated  bih*,  fetid,  sour-snu'lling,  slimy 
and  lumpy.  'I'lie  child  loses  its  healthy  look,  and  grows  paler  and 
ihiimer.  lis  customary  spirit  and  activity  are  gone;  it  is  heavy,  lan- 
guid, dejccicd  ;  it  is  fretful,  irritable,  uneasy;  and  sometimca  is  a 
little  tt)ttcriiig  in  its  gait. 

After  these  warning  sym))tonis,  the  disease  may  begin  in  one  of 
three  ways : 

'J'he  pains  in  the  head  become  more  severe  and  frequent,  and  are 
sharp  and  shooting,  causing  the  lifth*  patient  to  wake  and  shriek  out. 
As  the  drowsy  state  advances,  the  shrieking  gives  place  to  moaning. 
Heside  these  symptoms,  there  are  stillness  in  the  back  of  the  neck, 
pain  in  the  limbs,  great  tenderness  of  the  scalp,  vi^miting,  sighing, 
iiitoleraMcc  of  light,  knitting  of  the  brows,  increased  tlisturbaiice  of 
^toinacli  and  l)owels.  This  stage  may  last  ten  to  fourteen  days,  the 
child  growing  more  weak  and  p<'cvish. 

Another  form  of  atta('k  is  marked  by  acute  pain  in  tin;  head  and 
high  fever,  convulsions,  flushed  face,  brilliant  eyes,  intolerance  of  light 
and  5ound,  pain  and  tenderness  in  the  belly,  stupor,  great  irritability 
of  stomat;h,  causing  retching  and  vonuting  upon  every  attempt  to  sit 
up  in  bed. 

The  third  mode  of  attack  is  very  insidious,  —  the  early  symptoms 
being  mild  and  hardly  notic<>!d)le,  or  not  even  occurring  at  all.  In 
such  case,  the;  convulsions  or  palsy  come  suddenly,  without  notice, 
bringing  swift  and  unexpected  destruction.  This  lias  sometinies  been 
called  water-stroke. 


!  i 


fl'ii 


'  'I 


158 


DISEASES  OF  THE  BRAIN  AND  NEHVES. 


Tlie  First  Stiijife  is  the  period  of  increased  sensibility  and  excite- 
ment, caused  by  inHamrnation,  in  which  the  pulse  is  quick  antl  irreg- 
ular. 

TKe  S«*coild  Stslge  is  one  ot"  diminished  sensibility,  or  lethargy,  dur- 
ing which  water  is  elluscd  upon  the  brain,  and  the  pulse  is  slow. 

Tlu'  Third  IVriod  is  one  of  palsy  and  convulsions,  with  squinting 
of  the  eyes,  rolling  ot"  the  head,  stupor,  and  a  rapid,  thread-like  j)u1m'. 

Trciltllicilf. —  III  the  first  or  iullaiiiiiiatory  st;ige,  purging  is  very 
important,  and  it  must  l)e  coiitiiiiird  for  three  or  four  days.  Scaiii- 
iiioiiy  and  crotoii  oil  (:j:i)  may  l)e  chosen  for  this  piir|)osc.  Apply 
cold  water,  ice,  etc.,  to  the  head. 

In  the  second  stage,  ])ut  l)listcrs  upon  the  back  of  the  iieik,  and 
one  upon  the  bowels  if  tht-v  are  very  tender. 

•  In  the  third  stage,  ellusion  having  taken  place,  use  the  warm  bath, 
or  the  vapor  bnili,  —  also  di<,'italis,  scpiills,  and  iixlid*'  of  potassium, 
(Ml)  (l-J.s)  (:JO:i)  (i:JO). 

Coiilint?  the  child  to  a  darkened  room,  of  moderate  temperat\U'«.', — 
exchidiiig  all  noise  and  causes  of  excitemciit.  and  let  him  lie  upon  a 
hair  mattress,  with  his  head  somewhat  elevated. 

IMft, —  Gruel  only  (luring  the  stagi'  of  excitement,  —  during  that 
of  collapse,  it  should  be  nourishing,  but  mild  iind  easy  of  digestion, 
as  l)eef  tea,  j)lain  chicken  or  mutton  broth,  and  animal  jrllies.  At 
the  same  time,  support  the  patient  by  the  cautious  use  of  the  aro- 
ruatic  spirit  of  anmioiii  t,  ten  drops  every  four  hours,  valerian,  wine 
whey,  and  infusion  of  gentian,  columbo,  or  (piassia,  (04)  (t)()). 

Dropsy  of  the  Brain. — Chronic  Uj/drocep/ialus. 

Acute  hydrocephalus  is  an  inflammation ;  chronic  hydrocepiialn?. 
now  to  be  considered,  is  a  dropsi/.  It  often  begins  before  birth.  It  con- 
sists in  the  acciunulation  of  enormous  (piantities  of  water  within  the 
brain,  sometimes  within  its  ventricles,  at  other  times,  upon  its  surface. 
When  it  occurs  soon  aftt^r  birth,  it  advances  slowly,  and  impercepti- 
bly,—  the  enlargeuuMit  of  the  head  being  the  first  thing  noticed. 

The  skull  being  tender  in  infancy,  it  separates  at  the  fontanelles,  as 
the  fluid  accunuiiates,  and  the  head,  at  times,  attains  an  enormous 
si/e, — so  great  that  the  child  cannot  carry  it  upright,  but  lets  it  droop 
laterally  upon  the  shoulder,  or  forward  upon  the;  breast. 

As  the  disease  advances,  the  senses  become  blunted,  the  child  jp 
deaf  or  blind,  the  intt  licet  is  weakened,  perhaps  idiocy  appears,  the 
flesh  and  strength  pass  away,  convulsions  and  paralysis  coine  in  their 
turn,  and  a  stupor  is  apt  to  occur  which  euds  in  death. 

'rreiitiiimt.  —  The  remedies  may  be  external,  or  internal,  or  both. 

IiiteriDil  KeiiiedirN.  —  These  should  be  purgatives  (88)  (31),  ordi' 
uretics  and  aitcrativi-s  (30:2)  (145)  (144). 

EvtiTiml  Rfint^dicM.  Apply  nn  ointment  of  the  iodide  of  uota?- 
MUiu  lo  the  stiiip  I'very  night  ( ]«>">).     A  tight  bandage  appLiea  over 


tlie  whole  head  will  sometimps  have  a  favorable  eflect.  Another  ex- 
pc'lieiit  is  to  puiuture  the  skull  and  draw  oH'  the  water.  Tapping 
the  brain  has  elleeted  a  cup:  mi  many  carte.s,  and  perhaps  proinisies  the 
most  relief  of  any  remedy  we  have. 

Diseases  of  the  Spinal  Cord. 

Fm. 81.  Tnr.nr,  are  few  diseases  ujore  interestinjc^,  as  a  study, 

tiian  those  which  ail'cct  llic  nervous  cord  winch  rmis 
throu!^h  the  centre  of  tlic  Imck-honi-.  This  cord  is  ;i 
ii)iilinniition,  an  !i|)pcnda<fc  or  tail  ol'  tlic  brain.  (iSec 
Fiii['>i''  ^1-)  It  is  the  s<'at  and  centre  of  c<Tlain  ncr^ 
voiis  functions,  called  /r//r.r,  by  whicii  so  many  move. 
uicMts  tak(>  plu<  c  which  arc  not  under  the  control  of  the 
will. 

In  order  that  we  may  feci  wliat  takes  place  in  any 
part  of  tlic  body  or  limbs,  and  that  the  will  may  have 
powiT  to  move  sncii  part,  it  is  necessary  tiiat  nervous 
matter  should  be  continui)ns  and  mibrokcn  lj(>tweeu  the 
part  in  (pu'stion  and  the  l)rain. 

If  the  spinal  cord  be  cut,  broken,  or  crushed  at  anv 
point,  all  those  parts  which  n'ceive  nerves  from  he/oir 
the  injury,  lost;  their  power  of  motion  and  their  fecl- 
mg.  When  the  injury  is  in  the  upper  pint  of  the  cord, 
the  brcathin:;  and  the  circulatit)n  will  stop,  and  death 
is  the  innncdiate  eonseipicncc.  If  the  miildle  portit)n 
of  till-  cord  be  the  seat  of  the  injiu'y,  the  bowels  and 
other  organs  may  lose  their  motion  and  feeling;  if  the 
lower  |)ortion,  then  the  lower  limbs  only  will  be  the 
sutfcrers. 

Disease  or  injury  in  the  upper  j)art  of  the  cord  is 
therefore  much  more  dangerous  than  the  samo  thing 
owunring  in  the  lowe.- 

Inflamn  ation  of  the  Spinal  Cord. 

Tuf,  membranes  wl'ic  h  surround  the  cord  may  be  inflamed  jtist  as 
those  arc  which  'iieiose  the  brain;  but  as  the  cavity  running  through 
the  spine  is  (piite  Hmall,  there  cannot  very  well  be  inflammation  of 
the  membranes  without  its  involving  the  cord  at  the  same  time. 

Symptoms.  —  Pains,  often  int<'n.se,  running  along  the  spine,  cxten<l- 
iiig  out  in!"  the  (.mbs,  and  made  wor-^c  by  motion.  They  are  similar, 
iu  some  respects,  to  rheumatic-  pains.  There  is  rigid  contraction,  and 
sometimes  violent  «fiasms  of  the  muscles  of  the  back  and  neck,  —  so 
great,  at  times,  as  too  b<'nd  the  intiiy  back  into  the  sha|)e  of  a  hoop ; 
also  a  feeling  of  constri'-tion  in  various  parts,  as  if  they  were  girt  by 
a  tight  string;  a  sense  of  su  fl<  "cation  :  ntention  of  ini.ie;  a  most 
obstinate  constipation  ;  anfl  frecpit-nt  chills  or  rig<>i>.  The  pain  which 
is  felt  along  the  eord  is  aggravated  by  rapping  upon  the  spint;,  but 
not  by  pressur'" 


#  - 


m. 


;';l'  ' 


I'VQi 


The  above  symptoms  are  supposed  to  be  the  result  of  iiiflammation 
predoniiiiating  in  the  membranes.  When  its  seat  is  more  particularly 
ill  the  substance  of  the  cord,  the  symptoms  are,  —  convulsive  afiec- 
tions  of  the  head  and  face,  inarticulate  speech,  loss  of  voice,  squint- 
ing, and  (iilliculty  of  swallowing,  if  the  extreme  upper  part  of  the 
cord  is  iiiHained;  if  the  disease  be  slightly  lower,  ditliculty  of  breath- 
ing, irregular  action  of  the  heart,  and  tightness  of  the  chest ;  if  lower 
si  ill,  vomiting,  pain  in  the  belly,  sensation  of  a  cord  tied  round  the 
abilomen,  pain  and  heat  in  passing  water,  retention  of  the  urine,  ina- 
bility to  retain  the  urine,  desire  to  go  to  stool,  or  involuntary  stools. 

Spasm  and  stifiness,  then,  are  the  results  of  indammation  of  the 
membranes;  convulsions  and  palsy,  of  the  same  alfection  of  the 
cord.  .. 

Treii fluent.  —  When  the  inflammation  is  acute,  apply  a  few  leechi's 
/)r  wet  cups  along  the  sides  of  the  spine.  In  chronic  inllammation, 
powerful  friction,  or  mustard  draughts,  stimulating  liniments  (190), 
or  plasters,  will  generally  answer  the  purpose. 

Apoplexy. 

Ai'opi.F.xv  is  that  condition  in  which  all  the  functions  of  animal 
fife  are  suddenly  stopped,  except  the  pulse  and  the  breathing;  —  in 
which  there  is  .leither  thought,  nor  feeling,  nor  voluntary  motion;  in 
which  the  person  falls  down  suddenly,  and  lies  as  if  in  a  deep  sleep. 

diodes  «f  Attack.—  There  are  at  least  three  ways  in  which  this 
fcrriblc  disease  may  make  its  assault. 

The  First  Form  of  attack  is  a  sudden  falling  down  into  a  state  of 
insensibility  and  apparently  profound  sleep,  —  the  face  being  generally 
rlushed,  the  breathing  stertorous  or  snoring,  the  pulse  full  and  not 
frecjuenl,  with  occasional  convulsions. 

From  this  mode  of  attack  some  die  inunediately,  others  get  entirely 
well,  and  others  get  off  with  the  exception  of  paralysis  on  one  side, 
or  the  loss  of  speech,  or  some  one  of  tlu'  senses. 

The  Second  mode  of  attack  begins  with  sudden  pain  in  the  head. 
The  |)atient  becomes  pale,  faint,  sick,  and  vomits.  —  has  a  cold  skin 
and  feeble  pulse,  and  occasionally  some  convulsions.  He  may  full 
down,  or  be  only  a  little  confused,  but  will  soon  rwuver  from  all  ilie 
symptoms,  except  the  headache,  —  this  will  eontiimet  and  the  patient 
will  sooner  or  lat<>r  beeome  heavy,  forg«'tfnl,  unabli-  to  connect  ideas, 
and  finally  sink  into  insensibility,  from  which  he  never  rises. 

This  mode  of  invasion,  though  not  aj)[X!»ring  't.'  frightful  as  the 
first,  is  of  nmcli  more  serii-uis  impv)rt. 

In  the  Third  form  ot"  arrack  lliere  U  sudd»'«  Ian-s  of  power  on  one 
side  of  the  body,  aiul  also  of  speech,  hi>t  not  t>£"  «HmM'iousness.  The 
patient  retains  his  mi-id,  and  answers  c;««^f»o*»s  either  by  words  or 
signs.  This  may  l)e  ealled  ])ara!\tic  :»i>'*plr\y.  The  patient  miy 
either  die  so«)n,  or  get  well,  or  live  for  v«>ars  with  imperfect  speech, 
or  a  leg  dragging  after  him,  or  an  amilMngmg  useless  at  his  >ide. 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


161 


Tlie  Person!}  Attacked  are  apt  to  have  large  heads,  red  faces,  short 
and  thick  necks,  and  a  short,  stout,  square  build,  though  it  occurs 
often  aniong  th<»se  who  are  thin,  pale,  and  lall.  The  tendency  to  it 
increases  ifi  advanced  life. 

The  Forerunners  of  apoplexy  are  headache,  vertigo,  slight  attacks 
of  palsy,  double  vision  or  seeing  two  objects  when  there  is  but  one, 
faltering  speech,  inability  to  remember  certain  words,  sometimes  a 
sudden  forgetful ness  of  one's  own  name,  a  frequent  losing  of  the 
thread  of  ideas  attempted  to  be  pursued,  and  occasionally  yn  unac- 
countable dread,  for  which  no  reason  can  be  given- 
Exciting  Causes.  —  Whatever  hurries  the  circulation  of  the  blood, 
as  strong  bodily  exercise,  is  an  exciting  cause.  So  are  all  those  things 
which  cause  the  blood  to  flow  towards  tho  head,  as  couching,  sneez- 
ing, laughing  and  crying,  straining  at  stool  when  costive,  lifting  heavy 
weights,  singing,  and  playing  on  wind  instruments.  To  these  may 
be  added,  ex|X)sure  to  the  sun,  the  bad  air  of  crowded  rooms,  holding 
the  head  down,  or  turning  it  around  to  look  backward,  tight  cravats 
worn  about  the  neck,  and  exposure  to  severe  cold. 

Treatment.  —  If  the  patient  have  the  appearance  of  surtering  from 
fulness  of  blood  in  the  head,  as  «!vinc<*d  by  redness  and  turgescence 
of  the  face,  and  throbbing  of  the  temporal  arteries,  and  if  the  pulse 
be  full  and  hard,  feeling  like  a  tense  vibrating  rope  untler  the  fuiir«'r, 
phic»!  him  in  a  half-recumbent  posture,  with  his  head  raised  ;  UKustMi 
his  (;lothes,  particularly  his  ncek-cldtli  and  shirt  collar,  and  whatever 
may  press  upon  the  neck,  and  tluMi  as  quickly  as  possible  apply  cold 
wet  cloths  to  his  head,  changing  them  oi't«'n.  Ire  is  still  better,  if  it 
may  be  had.  Vpply  wet  cups  to  th«>  nape  of  I'c  neck,  and  mustard 
draughts  to  the  soles  of  the  fret,  —  at  the  same  time  applying  tight 
ligatures  aroimd  the  limbs,  to  prevent  the  blood  from  n^turniiig  rap- 
idly in  the  veins.  Tlu'  ligatures  should  l)e  gradually  n>moved  when 
the  patient  recovers  his  eonseiousness.  Also  administer  c.  stinmlating, 
purgative  injection  (^46),  and  plaeu  two  drops  of  cn»to«i  oil,  rubbed 
up  with  a  little  pulverized  loal  wugar,  far  )>a(k  upon  the  tuMigur.  Re- 
peat the  injection  every  tifteen  nunule>.  till  the  Ik)w«'Is  are  thoroughly 
moved. 

If  tho  patient  be  old,  and  the  pulse  small  and  fe«'hle,  with  no  ful- 
ness or  beating  of  the  temporal  arterit's,  or  swelling  of  tin-  veinn  of 
the  neck  and  forehead,  the  (H)untenan«-e  l*«  «ng  |>intlif(i.  and  the  ^+kin 
bloodless  and  cool,  \hv.  cup|)ing,  purging,  and  applying  the  ligaturt; 
nmst  be  omitted.  In  this  case  it  will  be  bctT.-r  to  appiv  wartii  Ha  > 
nels  and  hot  bricks  to  the  surface,  and  administer  annnonia  aru 
CAmphor  ('2^:})  (135)  int«*rnally. 

To  prevent  Inture  attacks,  gentle  tonics  should  fce  and,  and  the 
skin  should  be  kept  healthy  by  daily  bathing  and  itmtiBn.  The  bow- 
els nmst  not  be  permitted  to  become  costive.  T%b  diet  should  be 
light,  chiefly  vegetable,  and  almost  tyitin-ly  so  in  l*ot  weather.  The 
food  should  be  well  ch«>wed.  Tlu>  mind  shouhl  ix-  kept  cheerftil  and 
hojH'ful,  and  free  from  great  excitement.  The  sexual  passion  nhouki 
he  rwtrainvd,  and  very  mrelv  indulged.    Intoxicuiting  drinks  should  b« 

21 


i 


162 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


abandoned,  if  used,  and  all  tight  cravats  be  discarded  from  the  neck. 
Direct  rays  of  the  hot  sun  in  summer  should  be  carefully  shunned. 
No  food  should  be  taken  for  three  hours  before  retiring,  and  a  mat- 
tress only,  of  some  degree  of  hardness,  should  be  slept  upon,  —  the 
head  being  always  well  elevated.  To  these  precautions,  T  would  add, 
dipping  the  feet  every  night,  before  retiring,  in  cold  water;  and,  if 
any  tendency  to  cold  feet  be  experienced,  dusting  pulverized  cayenne 
in  the  bottoms  of  the  stockings. 

Sunstroke.  —  Coup  De  Soleil 

This  is  much  like  apoplexy;  in  fact,  it  is  a  kind  of  apoplexy.  It 
occurs  in  warm  climates,  or  in  very  hot  days  in  temperate  regions,  by 
exposure  to  the  sun. 

It  begins  by  headache,  thirst,  dizziness,  and  sometimes  difficult 
breathing  and  bilious  vomiting.  The  patient  drops  down  senseless, 
as  in  apoplexy,  and  unless  immediate  relief  is  obtained,  soon  dies. 

Treatment  —  Take  the  patient  immediately  into  the  shade,  and 
employ  about  the  same  remedies  as  for  apoplexy. 

Palsy.— Paralysis. 

Palsy  is  a  loss  of  the  power  of  voluntary  motion  and  feeling,  one 
or  both  coming  on,  sometimes  gradually,  but  more  often  suddenly, 
and  extending  at  one  time  to  a  part,  at  another  time  to  the  whole 
body.  It  is  a  kind  of  station-house  on  the  way  to  apoplexy,  where 
passengers  stop,  not  merely  to  stay  over  night,  but  to  rest  many  days, 
or  even  yerrs. 

A  great  injury  inflicted  upon  the  brain,  either  by  pressure,  or  other 
cauHe,  will  induce  a  complete  loss  of  motion  and  feeling,  and  this  ex- 
ti^nding  to  the  whole  structure,  brings  likewise  a  loss  of  conscious- 
ness, which  is  apoplexy.  A  smaller  degree  of  pressure,  or  a  less 
injury  u|X)n  the  saitu'  brain,  would  occasion  a  loss  of  motion  only,  or, 
if  a  loss  of  feeling  were  experienced  also,  it  would  only  extend  to  a 
part  of  the  body,  and  consciousness  would  remain.  This  would  hf 
palsy.  Tlie  disease  is  like  apoplexy  in  kind,  but  stops  short  of  it  in 
degree. 

Hemiphlegia. 

When  palsy  affects  an  entire  half  of  the  body,  dividing  it  through 
the  centre  of  the  face,  neck,  body,  etc.,  from  head  to  foot,  it  is  called 
hemiphlegia.  It  is  more  nearly  allied  to  apoplexy  than  any  other 
form  of  the  disease,  and  is  generally  ushered  in  by  pretty  well-marked 
apoplectic  symptoms. 

Symptoms.  —  Sometimes  there  are  no  premonitory  symptoms  ;  but 
often  before  the  attack  there  are  (lushed  face,  swelling  of  the  vein? 
about  the  head  and  neck,  vertigo,  a  sense  of  fulness,  weight,  and 
•ometimes  pain  in  the  head,  ringing  in  the  ears,  drowsiness,  indistinct 


M 


DISEASES  OF  THE  BKAIN  AND  NERVES. 


163 


articulation  of  words,  or  even  loss  of  speech,  confusion  of  mind,  loss 
of  memory,  and  change  of  disposition, —  amiable  persons  being  made 
sullen  and  peevish,  and  irritable  ones  tnild  and  simpering.  After  the 
attack,  the  countenance  generally  acquires  a  vague  expression  ;  the 
mouth  is  drawn  to  one  side ;  the  lower  lip  on  the  palsied  side  hangs 
down,  and  the  spittle  dribbles  away.  The  speech  is  altered,  and  the 
mind  is  generally  impaired. 

In  some  instances,  the  patient  recovers  in  a  /onger  or  shorter  time* 
in  others,  little  or  no  improvement  takes  place,  and  the  patient,  aftei 
remaining  helpless,  often  for  a  long  time,  dies  either  from  gradual 
exhaustion,  or  suddenly  from  apoplexy. 

Crtiisfs. —  llemiphlegia  and  paraphlegia,  are  caused  by  pressure 
npon  the  brain,  by  the  etl'nsion  u|H)n  it  of  blood  or  water,  by  a  tumor, 
by  iTH'chanical  mjnries,  by  the  striking  in  of  eruptions,  and  by  intem- 
perance in  eating  and  drinking.  Paraphlegia  often  results  from  dis- 
•ase  or  injury  of  the  spinal  marrow. 

Paraphlegia. 

This  form  of  palsy  divides  the  body  transversely,  at  the  hips,  and 
confines  itself  to  the  lower  extremities,  and  to  the  parts  about  the 
pelvis. 

Symptoms.  —  When  it  arises  from  affections  of  the  brain,  it  is  at- 
tended by  pain  in  the  head,  giddiness,  drowsiness,  dimness  of  sight, 
and  impaired  memory.  Numbness  is  sometimes  felt  in  the  upper 
extremities  as  a  forerunner  of  this  form  of  palsy.  At  first  there  is  a 
slight  stiffness  and  awkwardness  of  the  motions  of  the  legs,  which 
continue  to  increase  till  a  cane  is  needed  to  balance  the  body  and 
make  it  steady.  From  a  paralysis  of  the  neck  of  the  bladder,  the 
stream  of  urine  grows  more  feeble,  and  finally  dribbles  away  involun- 
tarily. The  bowels  are  for  a  time  costive,  but  when  the  circular 
muscle  which  closes  the  fundament  becomes  palsied,  the  feces  pass 
without  consent  of  the  will. 

When  disease  of  the  spinal  cord  is  the  cause  of  the  complaint,  it 
is  apt  to  come  on  gradually,  languor  and  weakness  are  felt  in  the 
knees,  the  legs  are  not  easily  directed  in  walking,  —  being  thrown 
across  each  other,  causing  tripping  and  stumbling.  By  dcgre**."*  the 
loss  of  power  increases  in  the  thighs  and  legs,  until  at  length  the 
whole  lower  extremities  become  palsied  and  useless. 

Local  Palsy. 

Palsy  is  called  local  when  it  is  confined  to  a  single  limb,  or  muscle, 
or  locality.  One  of  these  forms  is  called  facial  palsy.  It  affects 
one  half  of  the  face  only,  and  is  a  good  specimen  of  these  affections. 
It  removes  all  power  of  expression  from  one  half  of  the  face,  and 
leaves  the  features  still,  blank,  and  unmeaning.  With  the  affected 
side  of  the  face,  the  patient  cannot  laugh,  or  weep,  or  frown,  or  ex- 
press any  feeling  or  emotion,  while  the  features  of  the  other  side  are 
in  full  play.  Among  the  ignorant,  who  do  not  comprehend  the  extent 
of  the  evil,  the  droUness  of  the  expression  excites  laughter. 


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Shaking  Palsy. 

The  nature  of  this  form  of  palsy  is  well  expressed  by  its  name. 

Symptoms. —  The  first  symptom  of  this  complaint  is  a  weakness 
and  tremor  of  the  head  or  hand.  In  about  a  year  the  other  hand,  or 
the  lower  extremities  become  affected ;  and  the  patient  begins  to  lose 
his  balance  in  walking.  Then  the  trembling  becomes  per|>etual ;  no 
limb  or  part  remains  still.  Reading  and  writing  are  no  longer  possi- 
ble, and  the  hand  cannot  even  carry  the  food  to  the  mouth.  The 
balance  cannot  be  maintained  in  walking ;  there  is  a  tendency  to  fall 
forwards,  and  to  avoid  it,  the  patient  is  obliged  to  run  or  move 
quicker,  and  upon  the  toes. 

At  a  later  period,  the  tremor  continues  during  sleep ;  there  iai  in- 
creased weakness ;  the  body  is  bent  forward,  the  speech  becomes 
indistinct,  swallowing  difficult,  and  the  bowels  torpid.  At  last,  the 
urine  and  feces  pass  involuntarily,  and  delirium  and  coma  bii.ig  life 
to  a  close. 

Lead  Palsy. 

In  this  disease  the  muscles  of  the  forearm  are  palsied,  so  that  the 
wrists  "  drop,"  as  it  is  said,  and  the  hands  hang  down  when  the  arms 
are  stretched  out.  It  is  caused  by  the  gradual  introduction  of  lead 
into  the  system.  It  is  a  disease,  therefore,  peculiar  to  painters, — 
particularly  those  who  use  carbonate  of  lead,  or  white  lead,  as  it  is 
called.     It  is  generally  the  sequel  of  painter's  colic. 

Treatment.  —  A  sudden  and  severe  attack  of  palsy  vequires  ther 
same  treatment  as  apoolexy.  When  the  bowels  are  obstinately  con- 
stipated, they  must  be  purged  by  seammony  and  croton  oil  (31)  (32,) 
and  by  injections  (246). 

When  all  the  symptoms  of  determination  of  blood  to  the  head 
have  disap|)eared,  and  the  disease  has  become  strictly  chronic,  ex- 
citing remedies  must  be  employed,  as  frictions,  stimulating  liniments, 
blisters,  stimulating  baths,  cold  affusion,  and  electricity.  Among  the 
internal  remedies,  strychnine  has  the  best  reputation  (85)  (86).  The 
tincture  of  the  poison  oak  is  well  recommended  (284).  An  altera- 
tive (145)  should  likewise  be  ysed. 

Apply  counter-irritants  along  the  track  of  the  spine,  such  as  blis- 
ters, the  moxa,  the  compound  tar  plaster,  and  the  pitch  plaster. 

At  first  the  diet  should  be  light ;  but  after  the  more  active  symp 
toms  have  disappeared,  it  should  be  nutritious^  and  sometimes  stimu- 
lating.    Flannel  under-clothes  should  always  be  worn  next  the  skin. 


For  lead  palsy,  the  best  remedies  are  iodide  of  potassium,  or  sul- 
phuret  of  ^xitassium.  The  dose  of  either  of  these  is  from  three  to  ten 
grains,  three  times  a  day,  dissolved  in  water,  one  ounce  of  the  salt  to 
six  ounces  of  water,  and  taken  in  simple  syrup.  The  affected  limb 
should  also  be  soaked  an  hour  each  day  in  a  gallon  of  water,  with 
half  an  ounce  of  sulphuret  of  potassium  dissolved  in  it. 

Hydrophobia. — Rabies. 

Thk  bite  of  the  mad  dog,  or  mad  wolf,  or  other  hydrophobic  ani- 
mal, is  the  most  dangerous  of  all  poisoned  wounds,  because  it  is  apt 
to  be  followed  by  a  disease  for  which  there  is  no  certain  remedy. 
Fortunately,  the  human  subject  is  not  as  susceptible  to  the  effects  of 
the  poison  as  some  of  the  lower  animals;  for  only  about  one-tenth 
of  those  bitten  are  attacked  by  hydrophobia.  ; 

Syiii|itoiiis. —  Tlie  interval  between  the  bite  and  the  appearance  of 
the  disease,  varies  from  twelve  days  to  two  months.  The  wound 
heals  like  any  other  bite  of  a  similar  animal.  After  a  time,  the  scar 
begms  to  have  darting,  lancinating  pains,  which,  if  it  be  a  limb  that 
was  bitten,  run  up  towards  the  body.  Sometimes  it  feels  cold,  or 
stiff,  or  numb,  or  becomes  red,  swelled,  or  livid,  and  occasionally 
breaks  ojX'n,  and  discharges  matter.  The  patient  feels  a  strange 
anxiety,  is  depressed  in  spirit,  has  an  occasional  chill,  and  disturbed 
sleep,  and  spasmoilic  twitches.  The  pulse  is  above  its  natural  state, 
both  in  quickness  and  strength,  and  the  nervous  system  is  very  im- 
pressible. The  senses  are  all  more  acute  ;  trifling  noises  produce 
agitation,  and  the  eyes  are  so  disturbed  by  the  light  that  the  patient 
sometimes  hides  himself  in  a  dark  place.  The  appetite  is  lost.  This 
is  the  first  stage. 

Thirst  now  appears,  and  he  attempts  to  drink.  But  the  moment 
water  ap[)roaches  his  mouth,  a  spasmodic  shudder  come's  over  him  ; 
he  pushes  it  back  with  horror ;  the  awful  fact  of  his  condition  flashes 
upon  him ;  and  he  cries  out,  "  What  1  have  dreaded  has  come  upon 
me." 

Thenceforward  he  can  swallow  no  fluids;  complains  of  pain  and 
stiffness  about  his  neck  ;  is  thrown  into  convulsions  by  the  sight  of 
water,  or  even  the  sound  of  liquids  agitated  in  a  vessel,  or  by  a  breath 
of  air  blowing  upon  him,  by  a  bright  light,  or  the  glare  of  a  mirror. 
His  throat  is  full  of  a  viscid,  glairy  matter,  which  he  continually  tries 
to  clear  away.  Thus,  between  convulsions,  in  which  he  struggles, 
and  sometimes  strives  to  bite  his  attendants,  and  comparative  still- 
ness, during  which  he  suflers  great  depressioii  of  spirits,  he  passes 
three  or  four  days,  and  then  dies  either  in  a  spasm,  or  from  exhaus- 
tion. 

Treiitiiieilt. —  Cut  off  the  bitten  part,  or  apply  dry  cupping,  or  auc- 
tion, at  once.  Also  the  caustic  potash.  The  internal  remedies  here- 
tofore employed  have  had  little  success.  Perhaps  nothing  now  known 
promises  more  than  to  keep  the  patient,  for  a  long  time,  under  the 
influence  of  chloroform  or  ether.     The  tincture  of  scullcap,  in  two  or 


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three  dram  dosrs,  will  allay  the  nervous  agitation,  and  ia  always 
worth  using.  It  has  been  proposed  to  elear  the  throat  of  the  tough 
mucus  by  cauterizing  it  with  a  strong  solution  of  nitrate  of  silver 
(219),  applied  with  a  sliower  syringe.    The  remedy  is  worthy  of  a  trial. 

Some  of  the  Western  physicians  declare  thi;  red  chicUweed,  or 
scarlet  pimpernell,  to  be  an  absolute  reint'dy  for  this  disease,  and  cite 
some  quite  remarkable  cases  of  its  success.  Four  onn<'«'s  of  this 
plant,  in  tin;  dried  state,  are  directetl  to  be  boiled  in  two  (piurts  of 
strong  l)eer  or  ale,  until  the  licpiid  is  reduced  one  half.  'The  li(|uid  ia 
to  be  pressed  out  and  strained,  and  two  drams  of  laudaniiiu  added  to 
it.  The  dose  for  a  grown  person  is  a  wine-glassful  every  morning 
for  three  mornings.  A  larger  dose  is  reipiired  if  the  diseas*'  have 
begun  to  show  itself;  and  if  the  case  be  fully  developed,  the  whole 
may  be  taken  in  a  day.  The  wound  is  to  be  bathed  with  the  same 
decoction.  The  medicine,  it  is  said,  produces  profuse  sweating.  It 
is  worth  a  trial. 

Consi(lerai)le  has  been  said  of  late  of  a  remedy  used  in  some  parts 
of  Europe,  and  said  to  be  ert'ectual.  It  is  tlit;  "golden  cenotides" 
(celoHia  aurufu),  or  common  rose  ln'ctle,  found  in  large  (piantities  on 
all  rose  trees.  A  similar  insect  is  said  to  infest  the  geranium  |)lant. 
When  collected,  they  are  dried  and  powdered  ;  and  given  in  this 
form,  relieve  excitement  (so  it  is  said)  of  the  brain  and  nerves,  and 
throw  the  patient  into  a  sound  sleep- 

Muscular  and  Nervous  Derangements  from  Wounds. 

In  some  persons,  a  very  small  local  injury  will  produce  violent  dis- 
turbance of  the  nervous  system.  Some  will  faint  and  be  thrown  into 
(K^nvulsions  and  vomiting  from  causes  scarcely  grc^ater  than  the  prick 
of  a  needle ;  and,  before  Morton  gave  the  world  the  boon  of  ether,  it 
was  not  very  uncommon  for  persons  to  die  under  the  knife  of  the 
surgeon.  One  of  tlu;  most  serious  disturbances  from  wounds,  of  a 
nervous  and  nmscular  character,  is 

Locked  Jaw.  —  Tetanus. 

Tnis  is  spasmodic  contraction,  with  rigidity,  or  stiffness,  of  the 
voluntary  muscles.  Sometimes  this  rigidity  is  partial,  at  other  times, 
universal  throughout  the  system. 

Tetaims  is  produced  by  two  causes,  exposure  to  cold  (idiopathic), 
and  bodilij  injuries,  |)articul:irly  the  injur//  of  a  nerve  (traumatic 
tetanus).  This  last  is  the  most  frequent,  —  perhaps  the  only  form  of 
the  complaint. 

The  Syiiiptoiiis  are  long-continued,  violent  and  painful  contraction 
or  cramp  of  the  voluntary  nmsdes.  At  first  there  is  difficulty  and 
uneasiness  in  turning  the  head,  with  inability  to  open  the  mouth 
easily,  —  then  the  jaws  close  gradually,  but  with  great  firmness;  swal- 
lowing now  becomes  difficult,  and  a  pain,  starting  from  the  breast- 
bone, pi(!rces  through  to  the  back,  —  probably  caused  by  cramp  of  the 


DISEASES  OF  THE  BRAIV  AND  NERVES. 


lOT 


diaphragm  or  midrifl!  The  cramps  now  extend  to  the  musele«  of  the 
body,  the  limbs,  the  face,  the  tongue,  ete.,  which  continue  in  a  state  of 
rigid  spasm, —  being  swelled  and  hard  in  the  centre,  —  till  the  disease 
yields,  or  the  patient  dit's.  At  times  the  abdominal  muscles  are  so 
tense  as  to  make  the  belly  as  hard  as  a  board.  Occasionally  the 
patient  is  drawn  backward  into  th(!  shape  of  a  hoop,  so  as  to  n-st  on 
jiis  head  and  beds  (rpist/iofonos) ;  at  other  times  he  is  drawn  forward 
in  the  shape  of  a  ball  {cinprostho/onos).  All  the  contractitms  are  at- 
tended with  intense  pain.  It  is  th«?  racking  of  the  entire  body  with 
c-ramps  like  tho.se  which  sometimes  attack  the  calf  of  the  leg.  So 
violent  are  thi^  contractions  that  the  teeth  are  sometimes  broken  l)y 
th<Mn,  and  the  tongue  is  often  badly  bitten.  In  the  m«'an  time,  the 
appearance  of  flu?  sntVerer  is  frightful.  TIh;  lbrelu*ad  is  wriuUi-d,  tin* 
Itrow  knit,  the  eye-balls  motionless  and  staring,  tlu;  nostrils  spread, 
the  corn«'rs  of  the  mouth  drawn  back,  the  .set  teeth  exposed,  and  all 
the  features  tixed  in  a  ghastly  grin. 

TlTUtlllcilt.  —  The  only  known  remedies  for  this  dist'ase  are  chloro- 
form and  eth(>r,  taken  either  into  the  stomach,  or  by  inhalation,  in 
(juantities  siillicient  to  control  the  spasm,  and  to  be  pursued  as  long 
as  tln'y  continue  to  o<;cur.  The  eostiveness  must  hv  reMU)ved  by  one 
or  two  dro])3  of  croton  oil,  administered  in  a  s|)oonful  of  gruel. 

Epilepsy.— Epileptic  Fits. 

Thi«  disease  has  been  sometimes  called  the  fulling  sickness,  but 
generally  passes  under  the  more  vague  title  oi  Jits. 

S>lll|)toill.s.  —  The  disease  is  charaeteriztid  by  a  temporary  loss  of 
consciousness,  strong  spasms,  and  intervals  between  the  tits.  The 
attack  is  sudden,  generally  without  warning,  and  attended  with  a  loud 
cry,  ■when  the  patient  falls  down,  is  senseless  and  convulsed,  strug- 
gles violently,  breathes  with  embarrassment,  has  a  turgid  and  livid 
face,  foams  at  the  mouth,  bites  his  tongue,  has  a  choking  in  the  wind- 
pipe, and  app(v,irs  to  be  at  the  point  of  death.  Presently,  in  from  five 
minutes  to  half  an  hour,  and  by  degrees,  these  symptoms  diminish, 
and  at  kfngth  cease;  and  the  patient  falls  into  an  apparent  sleep.  In 
a  short  time  more  he  recovers,  and  is  apparently  well.  The?^e  attacks 
come  again  anil  again,  and  at  irregular  intervals. 

This  is  the  worst  form  of  the  disease  ;  there  is  another  class  of 
cases  in  which  the  syinptoms  an>  much  lighter,  —  there  being  no  tur- 
gescence  of  tlu^  face,  no  foaming  at  the  mouth,  no  cry,  no  convul- 
sions ;  but  merely  a  sudden  and  brief  suspension  of  consciousness,  a 
fixed  g;'/>\  .  feeling  of  confusion,  or  a  totter,  from  all  of  which  the 
recovery  is  .-,ieedy.  . 

Caust'-,  —  These  are  numerous,  —  as  worms,  disturbance  from  indi- 
gestible lood  in  the  stomach  and  bowels,  difficult  teeth-cutting,  ner- 
vous initation,  either  direct  or  by  sympathy,  sexual  excesses  and 
masturbation,  disease  or  injury  of  the  brain  or  spinal  marrow,  gall 
(tones  in  the  excretory  duct  of  the  liver,  stone  or  gravel  in  the  kid- 


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DISEASES  OF  THE  BRAIN  AND  ^ERVES. 


neys  and  bladder,  fright,  distress  of  mind,  pass.<on,  great  loss  of  blood, 
and  many  others. 

Treatment. —  But  little  can  be  done  during  the  fit,  except  to  protect 
the  patient  from  being  injured  by  the  violence  of  the  convulsions. 
To  do  this,  place  a  piece  of  leather,  cork,  or  other  substance  not  too 
hard,  between  the  back  tefcth  to  prevent  the  tongue  from  being  bitten. 
Remove  the  neckcloth,  and  unbutton  the  shirt  collar.  If  the  stomach 
and  bowels  are  suspected  to  be  overloaded,  give  an  injection  (246). 

The  treatment  during  the  intervals,  must  depend  on  the  cause  of 
the  disease.  If  worms  be  the  cause,  expel  them  ;  if  the  attacks  be 
excited  by  difficult  teething,  lance  the  gums ;  if  by  uterine  disturb- 
ances, search  out  the  nature,  and  give  the  treatment  recommended 
under  the  proper  head ;  if  masturbation,  command  it^  entire  discon- 
tinuance as  the  only  hope  of  relief;  if  the  complaint  arise  from  in- 
digestible food,  great  attention  must  be  given  to  the  diet  and  general 
health. 

In  all  cases,  indeed,  the  diet  should  be  carefully  regulated,  being 
light,  nutritious,  and  easy  of  digestion.  The  sleep  should  be  taken 
at  regular  hours,  and  daily  exercise  in  the  open  air  be  insisted  upon. 
The  bowels  must  be  kept  regular,  by  the  food,  if  possible  ;  if  not,  by 
mild  laxatives.  Apply  along  the  spinal  column  195,  once  a  day, 
rubbing  it  well  in  ;  also,  now  and  then,  mustard  poultices. 

In  addition  to  these  remedies,  give  pills  of  iron  and  quinine  (72), 
one  after  each  meal,  —  also  oxide  of  zinc  (270),  which  is  one  of  our 
very  best  remedies.  Of  the  pills,  one  should  be  taken  three  times  a 
day. 

We  'an  seldom  go  amiss  in  giving  medicine  calculated  to  relieve 
nervous  irritation,  and  to  build  up  the  general  system.  For  this  pur- 
pose, the  valerianate  of  quinine,  and  the' extract  of  black  cohosh  (79) 
are  well  adapted.  Citrate  of  iron  and  strychnine  (316),  is  a  very 
valuable  remedy. 

It  is  said  that  a  black  silk  handkerchief  thrown  over  the  face  of  a 
person  in  a  fit,  will  immediately  bring  them  out  of  it.  It  is  an  ex- 
periment easily  tried;  and  having  seen  it  in  a  respectable  medical 
journal,  I  give  it  for  what  it  is  worth. 

Catalepsy.— Trance.— Ecstasy. 

Cataleptic  fits  are  simph  what  is  known  to  all  the  world  under 
the  name  of  trance ;  and  ecstasy  is  a  modification  of  the  same  ner- 
vous disorder.  It  is  a  state  in  which  the  mind  becomes  so  intensely 
absorbed  in  something  outside  of  its  earthly  tenement,  that  it  with- 
draws all  control  over  the  body,  and  all  apparent  connection  with  it, 
—  leaving  it  as  if  dead.  There  is  a  very  light  ticking  of  the  heart, 
just  perceptible  to  a  cultivated  ear,  but  the  breast  does  not  rise  and 
fall  with  breathing,  the  features  are  all  inexpressive  and  still,  the  eyes 
are  wide  open  and  motionless,  apparently  staring  after  the  departed 
intellect ;  and  the  body  and  limbs  are  entirely  passive,  —  remaining 
unmoved  where  they  are  placed  by  others,  however  tiresome  aiici 
uncomfortable  the  position.     In  a  word,  a  person  in  catalepsy  is,  in 


''iSSIi 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


169 


appearance,  like  a  marble  statue,  or  like  a  human  b<  dy  suddenly 
turned  to  stone,  or,  like  Lot's  wife,  to  a  pillar  of  salt.  There  is  as 
little  feeling,  or  thought,  or  consciousness,  as  if  the  bowl  had  been  in- 
stantaneously broken  at  the  cistern,  and  the  apparent  death  were  real. 

It  is  a  peculiarity  in  this  disease  that  the  patient,  on. recovery  from 
a  fit,  takes  up  the  thread  of  conscious  life  just  where  it  was  broken  by 
the  attack.  Thus,  if  she  were  lifting  a  cup  of  water  to  the  mouth, 
ehe  would  hold  it  steadily,  with  the  mouth  open,  till  the  return  of 
consciousness,  and  then  place  it  to  the  lips,  as  if  no  interruption  had 
occurred ;  or,  if  conversing,  and  in  the  midst  of  a  sentence,  the  unfin- 
ished words  would  be  uttered  at  the  end  of  the  fit,  even  though  it 
tfhould  last  many  days. 

Persons  in  a  cataleptic  fit  have  much  the  appearance  of  one  in  the 
mesmeric  state  ;  ana  the  statue-like  position  in  which  an  attack  fixes 
a  patient,  reminds  one  of  the  manner  in  which  thc^  psychologists,  so 
called,  \/ill  arrest  a  man  under  their  influence,  and  make  him  immov- 
able, with  one  foot  raised  in  the  act  of  stepping. 

The  disease  attacks  females  much  more  often  than  males. 

The  premonitory  symptoms  are  much  like  those  of  epilepsy,  and 
the  treatment  should  be  about  the  same. 

Saint  Vitus's  Dance.  —  Chorea. 

This  disease  is  cliiefly  confined  to  children  and  youth  between  the 
ages  of  eight  and  fourteen.     But  few  cases  occur  after  puberty. 

Symptoms.  —  Th3  complaint  affects  mostly  the  muscles  and  the 
hmbs.  It  excites  curious  antics,  —  such  as  we  should  suppose  would 
occur  if  a  part  of  the  muscles  of  voluntary  motion  had  hatched  a 
mimic  rebellion,  broken  away  from  the  control  of  the  will,  and  in 
sheer  mischief  and  wantonness,  were  tripping  their  fellow  muscles, 
and  playing  tricks  with  the  patient.  A  few  of  the  muscles  of  the 
face  or  limbs  begin  their  mischievous  pranks  by  slight  twit(;hes,  which, 
by  degrees,  become  more  energetic,  and  spread  to  other  parts.  The 
face  is  twisted  into  all  kinds  of  ridiculous  contortions,  as  if  the 
patient  were  making  mouths  at  somebody.  The  hands  and  arms  do 
not  remain  in  one  position  for  a  moment.  In  attempting  to  carry 
food  to  the  mouth,  the  hand  goes  part  way,  and  is  jerked  back,  starts 
again,  and  darts  to  one  side,  then  to  the  other,  then  mouthward 
again ;  and  each  movement  is  so  quick,  and  nervous,  and  darting,  and 
diddling,  that  ten  to  one  the  food  drops  into  the  lap.  If  the  attempt 
be  made  to  run  out  the  tongue,  it  is  snatched  back  wiih  the  quick- 
ness of  a  serpent's,  and  the  jaws  snap  together  like  a  fly-trap.  The 
lower  limbs  are  mi  a  state  of  perpetual  diddle  ;  the  feet  shuttle  with 
wonderful  diligence  upon  the  ^oor,  as  if  inspired  with  a  ceaseless 
desire  to  dance. 

It  is  supposed  by  some  that  the  disease  consists  in  a  partir\l  palsy 
of  a  part  of  the  muscles.  The  will  in  that  case  not  being  able  to 
control  the  palsied  muscles,  when  it  commands  the  others  to  move, 
their  action  is  not  balanced,  and  they  twitch  the  face  and  limbs  into 
all  the  capricious  and  fantastic  ^^apes  we  witness. 


I'!    i 


W, 


iin 


170 


Dir,EASES  OF  THE  BRAIN  AND  NERVES. 


Others,  and  probably  with  more  truth,  hold  that  the  seat  of  the 
disease  is. in  the  cerebellum  or  little  brain.  It  is  supposed  to  be  one 
of  the  functions  of  this  organ  to  preside  over  and  regulate  the  loco- 
motion,—  that  it  holds  the  office  of  chief  engineer,  and  that  its  duties 
are  to  keep  the  muscles  in  subjection  to  the  will.  The  combined  and 
consenting  action  of  several  muscles  is  needed  for  every  movement. 
It  is  the  business  of  the  cerebellum  to  maintain  this  oneness  of  pur- 
pose and  action  —  to  see  that  no  muscl'j  flinches  so  as  to  disturb  the 
l.armony  of  the  movement.  When  the  cerebellum  is  diseased,  all  is 
confusion, — just  as  the  locomotive  runs  from  the  track  when  the  en- 
gineer is  smitten  with  palsy. 

The  disease  is  not  dangerous,  but  when  it  continues  for  many 
years,  it  is  apt  to  weaken  the  mind,  and  it  sometimes  very  nearly 
destroys  it. 

Causes. —  Whatever  excites  and  weakens  the  nervous  system,  as 
powerful  emotions  of  the  mind,  overworking  the  mind,  reading  excit- 
ing novels,  eating  too  much  meat,  fright,  striking  in  of  eruptions,  self- 
pollution,  etc. 

Treatment.  —  In  the  first  place,  remove  all  causes  of  excitement- 
Take  the  patient  from  school,  and  require  some  sort  of  cheerful  out- 
door exercise,  daily.  Take  away  all  books,  and  be  caieful  not  to  do 
anything  to  occasion  anger,  or  fear,  or  any  kind  of  injurious  excite- 
ment. 

In  the  second  place,  regulate  the  diet,  —  making  it  more  animal 
and  stimulating  if  it  has  been  too  low,  and  more  vegetable  and  cool- 
ing if  it  has  been  too  high. 

In  the  third  place,  if  the  iibove  changes  have  not  been  sufficient  for 
the  purpose,  open  and  regulate  the  bowels  with  some  gentle  physic 
(30)  (34)  for  a  few  days. 

In  the  last  place,  build  up  the  nervous  system  with  oxide  of  zinc 
pills  (270),  t'lree  a  day ;  or  iron  (73)  (80),  or  black  cohosh,  scullcap, 
etc.  (79),  or  the  compound  valerian  pill  (81).  Sulphate  of  zinc  (82) 
will  sometimes  succeed,  when  the  oxide  fails ;  and  where  there  is 
scrofula,  the  iodide  of  zinc  is  to  be  used. 

To  these  remedies  should  be  added  the  shower-bath,  begining  with 
tepid  water,  and  making  it  a  little  colder  every  day.  If  the  show(>i- 
bath  frightens  the  patient,  or  is  not  otherwise  well  borne,  take  the 
sponge  bath. 

Chronic  Chorea. 

This  can  hardly  be  said  to  amount  to  a  disease.  It  consists  rather 
in  uncouth  tricks,  arising  from  some  slight  disorder  of  particular 
muscles,  and  grown  into  a  fixed  habit,  such  as  shaking  of  the  head 
every  three  to  twenty  seconJs,  repeated  squinting  of  the  eyes  in  con- 
nection with  a  peculiar  knitting  of  the  eyebrows,  wrinkling  of  the 
nose,  shrugging  of  the  shoulders,  lifting  the  ears  up  and  down,  or 
even  moving  the  whole  scalp  back  and  forth.  These  movements  are 
commonly  made  without  a  consciousness  of  it ;  and  generally  there 


DISEASES  OF  THjfl  BRAIN  AND  NERVES. 


171 


is  no  power  to  suspend  them  without  a  painful  eflbrt  which  cannot 
be  easily  continued. 

No  medical  treatment  is  of  any  avail.  These  tricks  can  only  be 
corrected  by  great  watchfulness  and  effort  on  the  part  of  the  person 
sutfering  from  them,  and  in  many  cases,  not  even  by  such  means. 

Cramps. 

Cramp  is  experienced  in  the  calves  of  the  legs,  the  thighs,  the 
stomach,  the  breast,  the  womb,  etc.  It  is  a  very  painful,  sudden,  and 
violent  contraction  of  one  or  nion;  muscles.  Thv  part  is  sonietimes, 
as  tiie  phrase  is,  "drawn  up  into  knots."  Wlicn  it  attacks  the  btom- 
acli,  it  is  a  very  dangerous  atl'cction.  Women  are  subject  to  it  about 
the  third  or  fourth  month  of  pregnancy. 

C-'ailses.  —  Drinking  cold  water  when  very  hot  and  perspiring,  ex- 
t)osure  to  damp  night  air,  debility,  indigestible  food,  and  excesses  in 
c'ating  and  drinking,  and  particularly  overstraining  the  muscles. 

Trentllieut. —  Moderate  the  excessive  labor  and  straining  of  the 
muscles  which  produce  the  cramps.  "When  an  attack  occurs  in  the 
legs,  tie  a  cord  or  handkerchief  tight  around  the  leg  above  the  affected 
muscle.  This  will  generally  produce  instant  relief.  Also  rub  the 
part  with  spirits  of  camphor,  or  paregoric,  or  laudanum. 

When  it  occurs  in  the  stomach,  a|)ply  warm  fomentations,  or  what 
is  better,  a  mustard  paste  (165).  Then  make  one  grain  of  morphine 
into  four  pills,  and  give  ono.  If  this  does  not  bring  relief,  repeat  it 
in  half  an  hour.  The  bowels,  if  confined,  should  be  opened  with  an 
injection. 

Cramps  of  the  limbs  which  afflict  women  in  the  family  way,  can 
only  be  mitigated,  not  cured,  till  after  confinem>^nt.  As  a  palliative, 
high  cranberry  bark,  scuUcap,  etc.  (87),  will  be  found  useful. 

Pain  of  the  Nerves. — Neuralgia. 

This  disease  affects  one  tissue  only,  —  the  nervous;  and  has  one 
symptom,  —  pain. 

In  upop/e.r/j,  the  nerves,  rendered  powerless  and  senseless  by  an 
external  force,  are  like  a  man  under  a  bank  of  earth  which  has  slid 
down  upon  him.  In  palsy,  they  are  suddenly  bereft  of  feeling  and 
motion  by  a  blasting  scourge  within,  —  as  one  is  smitten  down  by  a 
pervasive  charge  from  a  magnetic  battery.  In  epilepsy,  the  nerves 
are  grasped  and  for  a  time  held  senseless  by  an  unseen  power,  in 
which  they  struggle,  as  a  man  strives  in  the  folds  of  the  anaconda. 
In  catalepsy,  they  are  suddenly  Stiffened  into  senseless  strings,  for 
snch  automatic  use  as  the  bystander  may,  for  the  time,  choose  to 
make  of  them.  In  chorea,  they  are  set  to  dancing  by  an  invisible 
exhilaration,  as  a  man  is  crazed  by  brandy. 

In  neuralgia,  the  nerves  are  neither  crushed,  nor  collapsed,  nor 
restrained  for  a  time,  nor  stiffened,  nor  exhilarated.  They  simply 
have  their  sense  of  feeling  intensely  exalted;  they  are  filled  with  pain. 


1  1 


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M 


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Illtv^ 


(l* 


The  pain  is  generally  of  a  peculiarly  darting,  piercing  character.  The 
patient  sometimes  calls  it  tearing  paiu.  It  comes  on  in  sudden  par 
oxysms,  with  intervals  of  freedom  between.  The  attacks  are  some 
times  like  an  electric  shock,  and  are  so  agonizing  as  to  bring  a  tern 
porary  loss  of  reason.  Occasionally  there  is  great  tenderness  of  th« 
parts  affected,  and  some  fulness  of  the  blood-vessels  in  the  neighbor 
hood  ;  but  generally  the  signs  of  inflammation  are  all  absent,  excep 
pain. 

Neuralgic  pains  occur  in  almost  every  part  of  the  system.  One  of 
the  most  familiar  forms  of  the  disease  is  known  under  the  name  of 

Tic  Douloureux. 

It  occurs  in  those  branches  of  the  fifth  pair  of  ncrvef?,  wMch  go  to 
the  face.  (See  Fig.  82.)  Sometimes  one,  sometimes  all  of  'he  three 
branches  are  affected,  but  more  often,  no.  82. 

the  middle  branch  only.  When  the  up- 
per brand'  is  the  seat  of  the  disease, 
the  pain  is  in  the  forehead,  the  brow, 
the  lid,  and  som<rtimes  the  ball  of  the 
eye.  The  eye  is  generally  closed  dur- 
ing the  j)ain,  and  the  skin  of  the  fore-  _- 
head  is  wrinkled.  When  the  aifection 
is  iir  the  middle  nerve,  the  puin  is  pre- 
ceded by  a  pricking  sensation  in  the 
cheek,  and  twitching  of  the  lower  eye- 
lid. Soon  it  spreads  in  quick  and  pierc- 
ing pangs  over  the  cheek,  reaching  the 
lower  eye-lid,  the  sides  of  the  nostrils, 
and  the  upper-lip.  If  in  the  lower 
branch,  it  sends  its  lightning  shafts  to 
the  chin,  the  gums,  the  tongue,  and 
even  up  the  cheek  to  the  ear. 

Face-Ache. —  There  is  a  species  of  nervous  pain  called  face-ache, 
which  does  not  quite  amount  to  tic  douloureux,  but  is  nevertheless 
very  afflictive.  It  occurs  principally  in  the  jaw,  which  seems  to  be 
filled  with  pain.  No  one  spot  seems  to  be  more  aftected  than  an- 
other. From  the  jaw  the  pain  often  goes  to  the  whole  head,  but  it 
has  not  the  stabbing  intensity  which  generally  characterizes  neuralgia. 
It  often  proceeds  from  defective  teeth. 

Hemicrania. 

This  is  a  neuralgic  pain,  confined  to  one  side  of  the  head,  —  gen- 
erally the  brow  and  forehead.  Sickness  of  the  stomach  often  attends 
it,  and  in  many  eases,  it  is  periodical,  —  coming  on  at  a  certain  hour 
every  day,  and  lasting  a  given  time,  and  then  passing  away. 

It  may  be  caused  by  whatever  debilitates  the  system,  as  hysterics, 
suckling  an  infant  too  long,  or  low  diet.     In  fever  and  ague  districts, 


DISEASES  OF  THE  BRAIN  AND  NLRVES. 


173 


it  is  frequently  produced  by  miasm.  In  many  instances,  the  cause 
cannot  be  discovered. 

Sciatica. 

This  is  a  pain  beginning  at  the  hip,  and  following  the  course  of 
the  sciatic  nerve.  Oceapiionally  it  is  an  inflammatory  complaint; 
sometimes  is  connected  witli  an  affection  of  the  kidney ;  but  fre- 
quently it  is  a  purely  neuralgic  or  nervous  pain  ;  and  I  have  therefore 
thought  it  best  to  place  it  here,  with  nervous  diseases. 

Beside  the  various  forms  of  neuralgia  now  noticed,  the  discise 
occurs,  —  sometimes  with  great  severity,  —  in  the  female  breast,  in 
the  womb,  in  the  stomach,  in  the  bowels,  in  the  thighs,  in  the  knee, 
and  even  in  the  feet.  In  many  of  these  cases,  the  disease  is  not  where 
the  pain  is  felt,  but  in  the  brain  or  spinal  marrow,  and  consequently 
the  true  source  of  the  complaint  very  often  escapes  detection.  An 
excellent  Episcopal  clergyman  in  northern   New  York,  the  Rev.  M. 

B ,  with  whom  I  studied  Latin  and  Greek  preparatory  to  college, 

had  a  neuralgic  pain  in  the  knee  so  intense,  persistent  and  exhaustive, 
that  the  limb  had  to  be  cut  off  at  the  thigh  to  save  his  life. 

Treatment. —  This  must  be  as  diversified  as  the  causes  of  the  dis- 
ease. 

For  tic  douloureux,  and  some  other  forms,  give,  internally,  Valeri- 
ana.-^ of  ammonia  (88) ;  also  89,  90,  91,  92,  93,  310. 

Foi  external  use  in  lie  douloureux,  and  other  neuralgic  affections, 
the  prescriptions  188,  19G,  197,  198. 

For  the  face-ache,  above  mentioned,  muriate  of  ammonia  (134),  in 
half  dram  doses,  is  a  very  valuable  remedy. 

When  the  disease  is  caused  by  miasm,  and  has  a  periodic  character, 
like  ague,  it  must  be  treated  with  quinine  (67)  (79),  and  if  there  be  a 
low  state  of  the  blood,  iron  (72)  (93)  must  be  given  at  the  same 
time. 

The  shower  bath,  exercise  in  the  open  air,  and  whatever  else  will 
build  up  the  general  health,  must  be  used  according  to  circumstances. 

Derangement  of  Mind.— Insanity. 

Most  writers  on  this  disease  have  attempted  a  definition  of  it.  I, 
have  never  seen  one  which  suited  me.  Here  is  mine.  Insanity  is  a 
wrench  of  man's  nature,  which  sets  his  intellectual  and  moral  faculties 
awry  in  their  relations  with  the  external  world. 

In  a  state  of  mental  and  moral  health,  he  looks  straight  at  the  out- 
ward world,  and  sees  it  as  it  is ;  insanity  gives  him  an  angidar  con- 
nection with  it,  and  he  sees  it  as  it  is  not ;  its  objects  have  all  changed 
their  relative  places ;  objects  at  the  right  in  the  panorama  of  life  have 
moved  to  the  centre,  or  gone  quite  over  to  the  left ;  while  things  at 
the  top  have  gone  to  the  bottom,  and  those  in  the  lowest  places  have 
taken  the  highest.  With  the  thoroughly  inaane,  the  world  has  gone 
back  to  chaos. 


% 


-\\ 


l^iiiil 


174 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


I  ,, 


These  persons  have  their  sensibility  very  much  altered  and  per- 
verted. Errors  of  the  senses  and  illusions  cheat  them.  In  many 
cases,  they  cannot  read  because  the  letters  are  mingled  in  a  confused 
mass.  They  often  do  not  recognize  their  freinds,  and  regard  them  as 
strangers  or  enemies. 

They  become  awkward  in  the  mechanical  use  of  their  hands,  and 
their  touch  loses  the  power  to  correct  the  errors  of  the  other  senses. 
Hence  they  are  cheated  in  regard  to  the  size,  form,  and  thickness  of 
bodies. 

They  are  haunted,  at  times,  with  smells  which  have  no  existence, 
and  they  hear  voices  distinctly  speaking  to  them  from  clouds,  or  from 
trees ;  and  these  voices  have  the  familiar  tones  of  a  friend,  relative,  or 
enemy. 

The  insane  lose  the  power  of  comparing  ideas.  They  associate 
things  the  most  unlike,  and  often  in  a  ridiculous  way. 

They  also  lose  the  control  of  themselves,  and  come  under  the 
dominion  of  their  passions ;  and  then  they  will  do  acts  which  they 
themselves  disapprove.  One  of  strict  integrity,  of  unblemished  mor- 
als, and  of  excellent  standing,  becomes  insane,  and  immediately  steals 
what  he  does  not  want,  makes  infamous  projxjsals,  and  indecent  ges- 
tures, and  is  in  every  respect  the  opposite  of  his  past  self. 

The  insane  often  become  averse  to  those  who  were  previously 
among  the  most  dear  to  them.  For  acts  of  kindness,  they  repay 
abuse.  They  fly  from  their  best  friends.  This  is  the  result  of  their 
fear  and  jealousy ;  for  they  are  very  cowardly  and  jealous.  This  alien- 
ation from  friends  is  almost  a  characteristic  of  insanity,  and  is  one  of 
its  saddest  features.  The  moral  affections  are  always  disordered, 
perverted,  or  aimihilated  in  insanity.  So  much  is  this  a  leading  fea- 
ture of  the  disease,  that  it  is  only  when,  the  insane  begin  lo  recover 
their  moral  affections,  when  they  begin  to  wish  to  see  theii  children 
and  friends,  to  fold  them  once  more  in  their  arms,  and  to  enter  the 
family  circle  and  renew  its  joys,  that  we  can  count  upon  any  certain 
signs  of  a  cure. 

The  insane  have  a  thousand  strong  fancies  in  regard  to  themselves. 
One  thinks  himself  inspired  of  God,  and  charged  with  the  conversion 
of  the  world ;  while  another,  equally  sincere,  believes  the  devil  has 
entered  into  him,  and  that  the  pains  of  hell  are  aheady  taking  hold 
of  him,  and  he  curses  God,  himself,  and  the  universe.  Still  another 
is  the  "  monarch  of  all  he  surveys,"  and  much  more  ;  he  governs  the 
WOTld,  and  directs  the  stars.  One  has  all  knowledge,  and  affects  to 
teach  the  wisest.  Another  is  proud,  and  withdraws  from  his  fellows, 
bidding  them  not  to  come  into  his  presence  without  proper  acts  of 
homage,  —  calling  himself,  it  may  be,  a  king. 

There  are  five  kinds  of  insanity.  I  will  speak  of  each  of  them 
triefly. 

Melancholy. — Lypemania. 

Tins  is  characterized  by  moroseness,  .jar,  and  prolonged  sadness. 
The  melancholic  person  is  lean  and  slender,  with  black  hair,  and  a 


DISEASES  OF  THE  BKAIN  AND  NEKVES. 


175 


pale  and  sallow  couiitonance.  His  skin  is  brown  or  blackish,  and 
dry  and  scaly.  His  physiognomy  has  a  fixed  appearance,  the  muscles 
of  the  face  are  drawn  tight,  the  eyes  are  motionless,  and  directed  to 
one  point,  the  look  is  askance  and  suspicions,  and  thi;  general  expres- 
sion is  one  of  sadness,  fiar,  and  terror.  H(!  desires  to  pass  his  days 
in  solitude  and  idleness.  He  walks  as  if  aiming  to  shun  some  dan- 
ger.    His  eye  and  ear  are  on  the  watch  for  v\\\. 

These  persons  do  not  sleep  much.  They  are  kept  awake  by  fear, 
jealousy,  and  hallucinations.  If  their  eyes  close,  tliey  see  phantoms 
which  terrify  them. 

Their  secretions  are  disoidered.  The  urine  is  cither  abundan;.  and 
clear,  or  scanty  and  muddy.  They  sometimes  retain  their  urine  for 
days.  One  patient  did  not  dare  to  make  water  lest  he  should  drown 
the  world,  but  was  finally  persuaded  to  it  by  the  assurance  that  he 
would  extinguish  a  fire  which  was  devouring  a  city. 

Insanity  on  One  Subject.  —  Monomania. 

This  is  a  chronic  affection  of  the  brain,  not  attended  by  fever,  and 
characterized  by  a  derangement  of  the  intellect,  the  affections,  or  the 
will,  upon  one  subject  only.  The  patient  seizes  upon  a  false  princi- 
ple, and  draws  from  it  injurious  conclusions,  which  modify  and 
change  his  whole  life  and  character.  In  other  cases  the  intellect  is 
sound,  but  the  affections  and  disjxjsition  being  perverted,  their  acts 
are  strange  and  inconsistent.  These  they  attempt  to  justify  by  plau- 
sible reasoning. 

Mania. 

This  is  also  a  chronic  affection  of  the  brain,  generally  without 
fever.  The  countenance  of  the  maniac  is  sometimes  Hushed,  at  other 
times  pale.  The  hair  is  crisped  ;  the  eyes  injected,  shining  and  hag- 
gard. Maniacs  dislike  the  light,  and  certain  colors  horrify  them. 
Their  ears  are  sometimes  very  red,  and  are  disturbed  by  a  tingling, 
and  a  rumbling  sound.  Noise  excites  and  disturbs  theiu.  They  suf- 
fer from  false  sensations,  illusions  and  hallucinations  ;  and  their  ideas 
come  with  great  rapidity,  and  are  confused  and  without  order.  Their 
affections  are  in  a  state  of  turmoil,  and  their  judgments  are  all  erro- 
neous. 

Unlike  the  monomaniac,  their  delirium  extends  to  all  subjects. 
Their  entire  intellect,  affections  and  will,  are  a  chaotic  wreck. 

Dementia. 

Here  is  another  chronic  affection  of  the  brain,  without  fever,  in 
which  the  sensibility,  the  intellect,  and  the  will,  are  all  weakened. 
Demented  persons  have  not  the  power  to  concentrate  their  minds  on 
anything,  and  can  form  no  correct  notions  of  objects.  Their  ideas 
float  after  each  other  without  connection  or  meaning.  They  speak 
without  any  consciousness  of  what  they  are  saying. 


1 

i 
I 


m 


'■i'l:      '. 


176 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


Many  of  them  have  lost  their  memory,  or,  like  old  persons,  they 
remember  nothing  recent,  —  forgetting  in  a  moment  -^"t  ia  just  said 
or  done. 

The  demented  have  neither  desires  nor  aversions ;  neither  iiatred 
nor  love.  To  those  once  most  dear  to  them,  they  are  totally  iudifler- 
ent.  They  meet  friends  long  absent  without  emotion,  and  part  from 
their  dearest  ones  without  a  pang.  The  events  of  life  passing  around 
them,  awaken  in  them  no  interest,  because  they  can  connect  them- 
selves neither  with  the  past  nor  the  future  ;  they  have  no  remem- 
brances, nor  hopes.  Their  brain  is  inactive  ;  it  furnishes  no  ideas,  or 
sensations.  They  are  no  longer  active,  but  passive  beings ;  they 
determine  nothing,  but  yield  themselves  to  the  will  of  others. 

They  have  a  pale  face,  a  dull  eye,  moistened  with  tears,  an  uncer- 
tain look,  and  a  physiognomy  without  expression.  They  sleep  pro- 
foundly, and  for  a  long  time,  and  have  a  voracious  appetite. 

Idiocy. 

Idiocy  is  the  condition  in  which  the  intellectual  faculties  have 
never  been  manifested.  We  are  not  to  infer  disease  from  it,  any  more 
than  we  infer  it  in  the  lower  animals  from  the  absence  of  intellect. 

In  idiocy  there  is  no  mind,  because  the  brain  is  not  large  enough 
to  be  the  organ  of  intelligence.  It  always  dates  back,  therefore,  to 
the  beginning  of  life.  Everything  about  the  idiot  betrays  a  defective 
organization.  The  demented  person,  the  monomaniac,  etc.,  once  had 
intelligence  ;  the  idiot,  never.  They,  in  many  cases,  may  be  cured ; 
he  is  hopelessly  incurable.  They  had  blessings  which  have  been 
taken  from  them  ;  to  him,  none  were  ever  given.  They  were  once 
the  pride  and  hope  of  their  friends  ;  ho,'from  his  birth,  was  the  smit- 
ten and  blasted  one  of  his  family.  He  never  reaches  an  advanced 
age,  —  rarely  living  beyond  thirty  years. 

These  remarks  are  sufficient  to  show  the  difference  between  idiocy, 
and  other  forms  of  mental  derangement.  In  the  other  forms  of  in- 
sanity there  are  brains  enough,  but  they  are  diseased;  in  this  there  ia 
no  disease ;  the  smallness  of  the  brain  is  the  primal  and  fatal  defect. 

This  form  of  mental  derangement  is  caused  by  a  defective  develop- 
ment of  the  brain.  That  the  other  forms  are  produced  by  disease  of 
the  brain,  there  can  be  no  doubt. 

Some  have  supposed  insanity  to  be  a  mental  disorder  merely,  hav- 
ing nothing  to  do  with  the  body.  They  might  as  well  suppose  the 
delirium  of  fever  to  be  a  disease  of  the  mind  only. 

Insanity  is  an  unsoundness  of  the  brain  and  nerves  which  proceed 
from  it,  in  every  instance.  At  first  it  is  probably  only  excitement  of 
the  brain  ;  but  this,  long  continued,  becomes  a  chronic  indammation. 
The  brain  and  nerves  of  an  insane  person  are  undoubtedly  sore,  and 
hence  the  painful  thoughts  and  feelings  which  afflict  them.  When 
the  soreness  is  much  increased,  they  are  violent  and  furious ;  when 
it  subsides,  they  are  calm.  In  consequence  of  this  inflammation 
and  soreness  of  the  brain,  an  insane  person  can  no  more  think,  or 
reason,  or  will,  or  feel  correctly,  than  a  person  with  an  inflamed 


{rii->i4HBji 


DISEASES  OF  THE  BRAIN  AND  NEUVES. 


177 


fltomach  can  digest  food  well,  or  than  one  with  inflamed  eyes  can 
see  well. 

f tllMCH  of  Intimity. —  Hereditary  predisposition;  painful  subjects' 
of  thought  or  feeling  long  revolved  in  the  mind  ;  injured  feelings 
which  cannot  be  resented,  mortified  pride,  perplexity  in  business; 
disappointed  affection  or  ambition  ;  great  political,  religious,  or  social 
ex(ritements ;  sudden  and  heavy  strokes  of  misfortune  in  the  loss  of 
property  and  friends;  and  in  general,  whatever  worries  th(!  mind  foe 
'I  long  time,  and  creates  a  deep  distress,  may  be  a  cause  of  insanity. 

But  one  of  the  most  prolific  causes,  and  worthy  of  special  mention, 
in  masturbation,  or  self-pollution,  —  a  vice  contracted  by  thousands 
of  young  people,  both  male  and  female. 

Beside  the  above,  I  may  mention  several  physical  causes,  as  con- 
vulsions of  the  mother  during  gestation,  epilepsy,  monthly  disorders 
of  women,  blows  upon  the  head,  fevers,  loss  of  sleep,  syphilis,  exces- 
sive use  of  mercury,  worms  in  the  bow  !.•*,  and  apoplexy. 

€hanceH  of  Cure.  —  Idiotism  is  never  cured. 

Melancholy  and  monomania  are  cured  when  recent,  and  do  not 
depend  upon  organic  disease. 

Dementia  is  sometimes,  though  seldom,  cured. 

Chronic  insanity,  of  long  standing,  is  not  easily  cured. 

Insanity  which  has  been  produced  by  moral  causes,  acting  sud- 
denly, are  generally  curable  ;  if  the  causes  have  acted  slowly  and 
long,  the  cure  is  more  doubtful. 

Excessive  study  causes  insanity  whieh  is  hard  to  cure. 

If  caused  or  continued  by  religious  ideas,  or  by  pride,  it  is  not  often 
cured. 

Insanity  caused  and  maintained  by  masturbation,  is  cured  with 
great  difficulty. 

TreatineHt. —  The  treatment  of  the  insane  is  now  almost  confined, 
as  it  should  be,  '.o  public  hospitals.  In  these  institutions,  all  the 
means  are  provided  which  humanity  has  been  able  to  devise,  to  lift 
from  these  unfortunate  beings  the  terrible  shadow  which  is  upon 
them.  Here  they  have  safety,  comfort,  recreation,  friendly  guardians, 
rest,  and  medicine. 

They  have  safety  from  the  annoyances  which  well-meaning  but 
mistaken  friends  at  home  almost  always  commit  in  contradicting,  and 
reasoning  with,  persuading,  and  threatening  them  ;  for  only  in  these 
humane  institutions  has  it  been  well  learned  that  to  do  so  is  no  wiser 
than  to  persuade,  scold,  or  threaten  a  neuralgic  pain  in  the  face,  an 
inflammation  in  the  stomach,  or  a  felon  upon  the  finger.  They  are 
safe,  too,  from  the  impertinent  scrutiny  of  neighbors,  the  hootings  of 
unthinking  boys  in  the  streets,  and  especially  from  the  causes,  what- 
ever they  are,  which  have  produced  the  disease.  And  so  far,  this  is 
just  the  treatment  they  want,  —  no  contradiction,  no  impertinent 
scrutiny  from  neighbors,  no  abuse  in  the  sl.reets,  and  a  withdrawal  of 
the  causes  which  have  produced  the  disease. 

In  these  institutions,  too,  they  have  comforts.     They  have  clean 

23 


Um 


i-iii^i 


■  i 


rooms,  p;alIories,  lodges,  bntliirifj^-rooms,  yards  nnd  jrardciis  for  cxprciHc 
and  walking,  safe,  (iiiiet,  \v»'ll-aircd  hcd-nunns,  and  clean  and  cotii- 
fortahlc  beds ;  clu'crliil  dining  rooms,  and  plain,  wliolcsom*',  and 
nutritions  food.      And  this,  liUrwisc,  is  tlw  treatment  they  re(|uire. 

They  have  reereation, —  dances,  eards,  haek-gaimnon,  ehe(juers, 
chess,  billiards,  nine-pins,  walking  parties,  riding  parties,  gardening, 
and  an  inchdgence  in  those  arts  of  painting,  music,  drawing,  and 
architecture,  for  which  they  may  have  a  taste.  And  such  recreations 
are  powerful  instruments  in  the  cure  of  all  disorders  of  the  nervous 
system. 

Here,  too,  they  have  friendly  guardians,  who  have  long  studied 
their  complaints,  and  have  imbued  their  souls  with  a  sympathy  which 
goes  down  into  the  deptlis  of  their  suft'erings,  and  allies  itself  with 
all  their  sorrows;  —  men  and  women  who  are  willing  to  act  the  part 
of  guardian  angels ;  to  b(^  their  friends  ;  who  know  how  to  gain  their 
confidence ;  and  who  use  the  influence  acquired  by  love,  in  leading 
them  back  towards  health  and  happiness.  And  this,  too,  in  curing 
the  insane,  is  of  great  consequence,  for  none  can  do  tiiern  good  till 
they  have  their  confidence,  and  this  can  be  gained  only  by  love  and 
wisdom. 

In  these  insane  asylums,  they  find  rest.  When  the  brain  is  hot 
from  inflamma<^ion,  and  tliey  are  raving  from  delirium,  they  are  here 
withdrawn  from  vhe  noisy  crowd,  and  shielded  from  the  rude  slioi^ks 
of  the  world.  If  need  be,  they  are  placed  in  solitary  rooms,  where 
silence  spreads  its  sootning  stillness  through  their  excited  brains.  And 
it  is  of  the  greatest  importance  that  the  sore  and  torn  feelings  should 
rest ;  for  rest  allays  excitement,  and  brings  sleep ;  and  without  a  proper 
amount  of  sleep,  rtjcovery  is  not  possible. 

Finally,  in  these  institutions,  they  receive  the  best  medical  treat- 
ment. They  have  warm  and  cold  bathing,  judiciously  administered  ; 
they  have  simple  cathartics  when  the  bowels  are  bound,  as  salts,  cas- 
tor oil,  and  magnesia;  tonics  for  debility,  such  as  quinine,  iron,  quas- 
sia, columbo,  and  chamomile  ;  and  quieting  medicines  for  their  ex- 
citement, such  as  opium,  morphine,  cicuta,  hyoscyamus,  belladonna, 
stramonum,  scuUcap,  and  valerian.  Prescription  74  is  a  combination 
much  used.  Here,  too,  broth,  gruel,  and  milk,  are  administered  by 
the  forcing  pump  to  such  as  take  a  fancy  not  to  eat,  —  an  expedient 
"which  has  saved  many  lives.  Fruits  of  all  kinds,  as  strawberries, 
cherries,  currants,  plums,  apples,  peach(!s,  and  grapes,  are  allowed 
freely.  Cold  water,  sweetened  or  otherwise,  is  the  drink.  To  these 
things  are  added  lively  conversation,  and  whatever  will  divert  the 
mind  from  reflection,  and  internal  imaginings  and  revery. 

Thus  I  have  indicated,  very  briefly,  the  treatment  which  the  insane 
receive  in  public  institutions.  That  the  chances  of  recovery  in  these 
humane  retreats  is  much  greater  than  at  home,  does  not  admit  of  a 
doubt.  When  it  is  not  convenient  to  send  an  insane  person  to  a 
hospital,  the  treatment  should  be  as  nesur  like  the  one  here  sketched 
as  circumstances  will  permit. 


'!)  '«■' 


Hypochondria. 

TiiK  cominoti  naiucK  of  this  disease  nrc  l<nr  sjn'rifs,  splvcn,  vapors, 
hfipOf  and  the  blues.  It  produces  constant  fear,  anxiety,  and  gloom. 
Jinsiness,  pleasures,  the  acupiisition  of  knowh-dge,  and  all  tlu^  ii>efnl 
|)nrsnits  of  life,  beeonio  insipid,  tasteless,  and  even  irksome  to  the 
hypochondriac.  Ills  mind  is  full  of  the  belief  that  sonu'thing  dread- 
ful is  about  to  befall  him.  lie  is  either  going  to  be  sick,  or  to  die  r 
lose  his  pro|)erty  or  friends.  II(!  has  no  mind  to  engager  m  any  busi- 
ness, nor  does  he  wish  to  go  anywhere,  or  to  see  anybody.  Night 
and  day  his  spirits  are  down  tt)  zero,  and  his  heart  has  a  load  too 
heavy  to  bear.  He  is  wholly  occupi<'d  witli  his  troubles,  and  his  feel- 
ings. He  thinks  he  has  various  diseases,  and  wears  oMt  his  friends 
by  talking  of  his  stdl'erings.  He  feels  of  his  pidse  if* en,  looks  at  his 
tongue  in  the  glass,  and  several  times  a  day  asks  a  ii\'  nd  if  lie  does 
not  look  pale  or  sick. 

The  external  senses  manifest  symptoms  of  dcf'igcment  as  well  as 
the  thoughts,  feelings,  emotions,  and  passions.  '  jere  are  roarings  in 
the  cars,  like  -y  waterfall,  or  the  noise  of  a  distant  carriage.  Floating 
black  specks,  jr  bright  sparks,  are  seen  before  the  eyes.  These  indi- 
cate a  slight  fulness  of  the  blood  vessels,  and  ])erhaps,  in  some  in- 
stances, sparks  of  electricity  ])assing  to  or  from  the  eye,  and  are  in  no 
proper  sense  subjects  for  the  alarm  Ihey  cause.  At  one  time  the 
person  will  feel  as  large  as  a  barrel,  at  other  times  not  larger  than  a 
whip-stock ;  the  head  will  feel  light  or  heavy,  large  or  small.  The 
skin  will  twitch  in  different  parts,  or  feel  numb,  or  have  the  sensation 
of  spiders  crawling  on  it.  '  The  smell  and  taste  become  perverted ; 
the  hypochondriac  will  smell  odors  and  flavors,  at  times,  where  there 
are  none. 

These  errors  of  the  senses  are  all  owing  to  some  slight  disorder  of 
the  organs  of  sense  ;  and  they  are  no  more  wonderful  than  that  the 
mind  should  perceive  personal  danger,  poverty,  and  death  itself,  when 
none  of  these  things  are  impending. 

These  persons  are  subject  to  fainting  turns,  when  the  breathing  will 
appear  to  stop,  the  body  become  cold,  the  face  pah; ;  there  will  be 
distress  in  the  region  of  the  heart,  which  will  apparently  stop  beating, 
and  the  person  will  feel  as  if  dying.  At  the  «ame  time  the  mind  will 
remain  clear.  These  nervous  spells  are  alarming,  but  pass  off'  with 
out  danger. 

These  persons  become  changed  in  their  moral  dispositions.  They 
are  jealous,  take  a  joke  as  an  affront,  and  feel  the  greatest  distress  at 
any  apparent  lack  of  attention  or  neglect  on  the  part  of  friends. 
They  put  the  worst  construction  upon  the  actions  of  friends.  They 
are  irritable,  fretful,  peevish,  and  fickle. 

The  complaint  is  distressing,  but  does  not  appea'-  to  shorten  human 
life. 

The  seat  of  the  disease  is  in  the  brain  and  nerves.  It  is  caused  by 
anxiety,  care,  disaippointment,  working  the  brain  too  hard,  diseases  of 


W'' 


t'i 


■;,!', 


",;•  i>!' 


nil 'm .. 


180 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


the  liver  and  stomach,  costiveness,  sedentary  habits,  excessive  venereal 
indulgence,  and  masturbation. 

Treatment. —  This  disease  is  more  easily  prevented  than  cured.  It 
would  be  almost  entirely  prevented  in  this  country  if  in  childhood  we 
were  all  taught  to  be  contented  with  humble  competence,  to  love 
active  labor,  and  to  think  it  honorable,  inst«!ad  of  struggling  after 
wealth,  and  falling  into  unhappiness  when  it  does  not  come. 

Remedies.  —  Of  all  the  remedies  for  this  complaint,  that  which  is 
most  important  is  active  employment  out  of  doors.  The  human 
body  was  made  for  motion.  Without  it  the  blood  cannot  be  dis- 
tributed to  the  several  organs.  The  senses,  —  the  eye,  the  ear,  the 
touch,- — should  be  much  in  communion  with  nature.  In  this  way 
they  are  strengthened.  Nature  is  their  great  physician.  Man  is  a 
creature  of  sensation  ;  and  if  too  much  occupied'  with  feelings, 
thoughts,  and  deep  reflections,  the  nerves  will  be  irritated,  and  begin 
to  give  deceptive  sensations.  A  very  nervous  man  should  fly  to  some 
active  occupation,  if  he  would  be  rid  of  suffering. 

The  open,  fresh  air  is  very  important  to  restore  the  system  to 
soundness. 

Temperance,  both  in  eating  and  drinking,  will  do  much  for  this 
class  of  patients,  yet  they  are  the  very  persons  who  eat  largely,  and 
they  often  fly  to  the  excessive  use  of  stimulants  to  drive  away  their 
sorrow.     By  so  doing,  they  aggravate  the  disease. 

Amusements  are  very  important  for  hypochondriacs.  Lively  com- 
pany, cheerful  and  witty  conv'  'vtion,  with  mirth  and  laughter,  lively 
songs  and  instrumental  music,  are  all  desirable  ;  and  so  are  gunning, 
fishing,  riding,  billiard-playing,  and  travelling. 

iVever  allow  these  patients  to  be  alone,  and  to  have  time  to  brood 
over  their  misery.  See  that  they  go  early  to  bed,  and  rise  betimes  in 
the  morning.  'J'he  warm  bath,  the  cold  shower,  or  sponge  bath,  with 
brisk  friction,  are  not  on  any  account  to  be  omitted.  The  diet  should 
be  light,  nutritious,  and  generous  ;  but  fats,  acids,  licjuors,  and  coffee, 
must  be  forbidden. 

But  little  medicine  will  be  required.  If  there  be  costiveness,  let  the 
cracked  wheat  be  eaten ;  if  this  do  not  answer,  a  little  rhubarb  and 
bicarbonate  of  potassa  (35),  or  leptandrin,  podophyllin,  etc.  (36),  may 
be  given  as  required  by  the  symptoms.  A  teaspoonful  of  calcined 
magnesia  once  a  day,  or  the  infusion  of  thoroughwort,  drank  cold, 
will  often  answer  an  excellent  purpose.  A  bowl  of  warm  mother- 
wort tea,  with  a  teaspoonful  of  spirits  of  camphor  in  it,  will  do  well 
in  fits  of  fainting  when  there  is  a  sensation  of  dying.  A  teaspoonful 
of  sulphuric  ether  may  be  given  at  the  sa.me  time.  If  there  be  debil- 
ity, tonics  are  sometimes  useful  (50)  (49)  (54)  (55). 

Hiccough. — Singultus. 

This  is  a  sudden,  jerking  spasm  of  the  midriff,  occurring  every  few 
moments  in  bad  cases,  causing  the  air  to  be  driven  out  of  the  Innga 


DISEASES  OF  THE  BKAIN  AND  NERVES. 


181 


with  such  suddenness  as  to  produce  a  noise  something  like  the  invol- 
untary yelp  of  a  .>uppy.  It  is  generally  caused  by  acidity  of  the 
stomach,  which  irritates  the  nerves  distributed  to  its  neighborhood, 
and  is  not  difficult  to  remove  ;  but  when  it  occurs  towards  the  close 
of  some  acute  and  grave  disease,  it  is  sometimes  a  sign  that  dissolu- 
tion is  at  hand. 

Treatment  —  Startle  the  person  suffering,  by  exciting  surprise,  or 
fear,  or  anger ;  or,  let  a  few  small  draughts  of  cold  wat«r  be  taken  in 
(|uick  succession  ;  or,  let  the  br(;ath  be  held  as  long  as  possible.  It' 
the  stomach  is  sour,  take  a  teaspoonful  of  bicarbonate  of  so<la,  dis- 
solved in  half  a  tumblerful  of  cold  water.  To  expel  wind  from  the 
stomach,  if  it  be  present,  take  some  warm  aromatic-essence  of  pep- 
permint, ether,  or  compound  spirits  of  lavender.  But  one  of  the 
most  effectual  remedies,  is  heavy  pressure  made  upon  the  collar  bones. 
It  is  simple,  and  very  effectual. 

Fainting. — Sifticope. 

Fainting  is  preceded  by  a  distress  about  the  heart,  a  swimming  of 
the  head,  sometimes  sickness  at  the  stomach,  coldness  of  the  hands 
and  feet,  and  a  loss  of  sight,  or  a  sense  of  things  growing  dark.  The 
breathing  diminishes,  the  pulse  becomes  small,  the  face  deadly  pale, 
and  the  patient  wilts  down,  and  becomes  more  or  less  unconscious  of 
what  is  passing  around. 

Whatever  causes  debility,  particularly  of  the  nervous  system,  will 
predispose  to  fainting.  Persons  much  weakened  by  disease,  faint 
easily,  —  especially  when  they  attempt  to  stand  still.  When  on  their 
feet,  such  persons  should  keep  moving.  Fainting  is  sometimes  in- 
duced by  sudden  surprizes  and  emotions,  by  violent  pains,  .by  the 
sight  of  human  blood,  and  by  irritation  of  the  coats  of  the  stomach 
by  indigestible  food. 

Treiltnieiit. —  Lay  the  patient  upon  the  back,  with  the  head  low; 
let  fresh  air  into  the  room  instantly,  and  a|)ply  gentle  friction. 
Sprinkle  a  little  cold  water  upon  the  face,  and  hold  spirits  of  cam- 
phor, ether,  hartshorn,  or  vinegar  to  the  nose,  —  rubbing  a  little  of 
the  spirits  of  camphor  upon  the  forehead,  and  about  the  nostrils.  As 
soon  as  the  patient  can  swallow,  give  a  teaspoonful  of  compound 
spirits  of  laveiuler,  with  ten  drops  of  water  of  ammonia  in  it. 

Persons  subject  to  fainting  should  not  go  into  crowded  assemblies 
where  the  air  is  bad ;  neither  should  they  vvear  tight  dresses,  or  allow 
themselves  to  get  excited.  Cold  bathing,  a  well-regulated  diet,  and 
vegetable  tonics,  will  do  much  to  break  up  the  habit. 

Dizziness  of  the  Head.— T'(?/Y/V/o. 

This  affection  makes  objects  which  are  stationary  appear  as  if 
moving,  or,  as  the  phrase  is,  "  turning  round."  When  seized  with  it, 
one  will  have  a  sensation  as  if  falling,  and  objects  about  him  will 
seem  to  be  in  motioh. 


& 


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i  -« 

1*11    i-  ! 


182 


DISEASES  OF  THE  ERAIN  AND  NERVES. 


It  is  caused  by  irritation  of  the  nerves  of  the  stomach  in  dyspepsia, 
by  long  application  of  the  mind,  by  a  weakened  nervous  system,  by 
hysterics,  and  by  a  fulness  of  the  blood-vessels  of  the  head.  When  it 
proceeds  from  most  of  these  causes,  it  is  not  dangerous ;  but  when 
caused  by  impending  apoplexy,  it  is  a  symptom  of  very  serious  im- 
port. 

.  Trentmeiit. —  Find  out  the  cause  and  remove  that,  and  the  dizzi- 
ness will  disappear.  If  it  come  from  dyspepsia,  eat  lightly;  if  from 
costiveness,  open  the  bowels  either  by  coarse  food,  by  daily  cold 
water  injections,  or  by  some  gentle  physic.  Avoid  coffee,  ardent 
spirits,  and  late  suppers,  and  take  much  exercise.  Keep  the  feet 
warm,  and  the  head  cool. 

Disturbed  Sleep.— Nightmare.  —  Incubus. 

In  this  complaint  the  sleep  is  disturbed  generally  by  soine  frightful 
image.  Whatever  of  an  alarming  ch'aracter  is  presented  to  trie  mind 
in  sleep,  causes  fear,  or  some  other  pai'iful  emotion,  the  same  as  when 
awake.  And  when  the  attempt  is  made  to  resist,  or  to  flee  from  the 
danger,  it  is  inetlectual,  because  the  muscles  are  locked  fast  in  sleep. 
The  fear  beijig  increased  by  the  inability  to  escape,  the  sleeper  makes 
all  sorts  of  horrible  noises,  indicating  distress  of  mind.  The  danger 
seen  is  as  real  to  the  sleej>er  as  if  he  were  awake,  and  he  tries  to  do 
just  what  he  would  if  awake.  Sometimes  the  sensation  is  that  some 
heavy  weight,  or  perhaps  some  horrible  monster,  is  upon  the  breast, 
nearly  pressing  the  breath  out  of  the  body. 

At  times,  the  power  of  motion  is  not  absent,  and  then  disturbed 
dreams  may  cause  one  to  talk,  or  to  rise  and  walk,  or  run.  Children 
will  laugh,  or  cry,  or  scream,  which  shows  that  their  minds  are  agi- 
tated by  different  passions.  Persons  \v\\q  idulge  gloomy  and  troub- 
lous thoughts  in  their  wakiug  hours,  are  apt  to  be  disturbed  with 
sleep-walking,  sleep-talking,  and  frightful  dreams,  as  of  falling  down 
precipices,  during  the  hours  for  repose. 

There  is  nothing  very  wonderful  about  these  disturbances  of  sleep. 
It  is  only  necessary  that  there  should  be  an  unusual  sensitiveness 
of  the  brain,  or  tliat  a  hearty  supper,  eaten  late,  should  irritate  the 
nerves  of  Uiv.  stomach,  and  that  distressing  thoughts  should  be  dwelt 
upon  during  the  day  and  evening,  in  order  to  produce  all  the  walk- 
ing, talking,  dreaming  of  hobgoblins,  shipwrecks,  fires,  and  polar  bears, 
which  distress  so  many  unfortunate  sleepers. 

In  night-walking  there  is  simply  a  little  more  wakefulness  than  in 
night-talking,  and  in  this  latter,  more  than  when  one  falls  from  a  high 
place,  and  in  this  perhaps  slightly  more  than  in  real  incubus,  when 
one  is  in  the  greatest  peril,  but  camiot  move  at  all. 

Treutiiieiit. —  When  sleeping  persons  groan,  or  make  any  noise 
indicating  nightmare,  shake  them,  and  they  will  come  out  of  it  at 
once.  As  these  troubles  are  often  caus(!d  by  a  weakened  state  of 
the  nerves,  much  out-door  exercise  should  be  taken.  The  diet  should 
be  simj)le,  and   well  regulated.     The  suppers  should   be  light,  and 


wm 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


183 


never  taken  late.  The  evening  should  be  spent  in  some  pleasant 
amusement,  which  will  diive  away  care ;  and  the  last  hours  of  wake- 
fulness be  occupied  with  pleasant  reflections.  One  afllicted  with 
nightmare  should  not  lie  upon  the  back,  nor  with  the  hands  over  the 
head.  Acidity  of  the  stomach,  and  costiveness,  if  they  exist,  should 
be  removed  by  the  neutralizing  mixture. 

Headaches. 

These  are  not  always  caused  by  disorders  of  the  brain  and  nerres, 
but  they  frequently  are,  and  this  seems  the  proper  place  to  speak  of 
them. 

It  is  unwise  ever  to  neglect  headaches.  They  are  sources  of  great 
suft'ering,  and  often  lead  to  serious  derangements  of  the  health  In 
childhood  they  have  a  more  serious  meaning  than  in  adult  life.  The^ 
often  indicate  the  approach  of  scarlet  fever,  or  measles,  or  of  other 
diseases. 

Headaches  are  more  common  among  the  civilized  than  the  uncivil- 
ized ;  more  frequent  among  females  than  among  males ;  among  those 
of  sensitive  feeling  than  among  the  more  obtuse ;  among  those  who 
think  much  than  among  those  who  think  little ;  among  the  sedentary 
than  among  the  active. 

Causes  of  Headaches.  —  They  are  dependent  on  various  causes,  as 
derangement  of  the  circulating  system,  of  the  digestive  organs,  of  the 
nervous  system,  etc.  Among  those  dependent  on  disturbance  of  the 
circulation,  are 

Plethoric  Headaches.  —  These  are  dependent  on  a  general  fulness 
of  blood  They  are  of  two  kinds.  One  is  occasional,  and  lasts  but 
a  few  hours.  The  other  lasts  for  days  or  weeks.  It  occurs  most 
often  in  the  night  or  morning.  Persons  whose  occupations  require 
stooping  have  it  most,  A  little  dizziness  is  generally  felt  on  rising 
up  from  a  stooping  posture.  It  is  brought  on  by  the  bad  air  of 
crowded  rooms,  and  is  attended  by  costive  bowels,  short  breath,  and 
a  white  fu/red  tongue. 

The  persistent  headache  is  accompanied  by  a  sense  of  fulness,  and 
sometimes  of  throbbing  over  the  brows  and  temples,  with  a  sensation 
of  dizziness,  and  of  mist  before  the  eyes.  The  surterer  fears  exertion, 
and  is  constantly  looking  for  a  rush  of  blood  to  the  head.  Nature 
sometimes  relieves  this  form  of  headache  by  a  diarrhcea,  or  by  bleed- 
ing from  the  nose. 

There  is  another  form  of  plethoric  headache,  diff"ering  slightly  from 
the  above,  in  which  there  is  too  much  blood,  and  it  is  made  too  fast, 
but  it  does  not  circulate  so  rapidly.  The  muscles  are  not  very  firm, 
and  the  heart  does  not  propel  the  blood  with  much  force.  This  form 
of  headache  is  cotmected  with  congestion. 

Headaches  of  Indig:estion.  —  These  are  caused  either  by  taking  im- 
proper articles  of  food,  or  by  eating  too  much  of  those  which  are 
proper.     The  sensation  in  the  head  is  not  always  a  pain,  but  boiae- 


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184 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


times  only  a  dull  weight,  attended  by  languor  and  disinclination  for 
exertion ;  a  tongue  white  in  the  centre,  and  pale  red  at  the  tip  and 
edges ;  cold  and  numb  fingers ;  slight  nausea ;  languid  and  feeble 
pulse ;  dim  and  indistinct  sight ;  eyes  aching  when  employed  ;  and 
difficulty  in  fixing  the  attention. 

Sick  Headache.  —  This  has  received  its  name  from  the  constant 
nausea  or  sickness  at  the  stomach  which  attends  the  pain  in  the 
head. 

This  headache  is  apt  to  begin  in  the  morning,  on  waking  from  a 
deep  sleep,  or  after  sleeping  in  a  close  room,  and  when  some  irregu- 
larity of  diet,  has  been  committed  on  the  day  before,  or  for  several 
previous  days.  At  first  there  is  a  distressingly  oppressive  feeling  in 
the  head,  which  gradually  merges  into  a  severe,  heavy  pain  in  the 
temples,  frequently  attended  by  a  sense  of  fulness  and  tenderness  in 
one  eye,  and  extending  across  the  forehead.  There  is  a  clammy,  un- 
pleasant taste  in  the  mouth,  an  offensive  breath,  and  the  tongue 
covered  with  a  yellowish-white  fur.  The  sufferer  desires  to  be  alone, 
and  in  the  dark.  The  hands  and  feet  are  cold  and  moist,  and  the 
pulse  feeble. 

Accompanying  these  symptoms,  there  is  a  depressing  sickness  at 
the  stomach,  which  is  increased  by  sitting  up,  or  moving  about.  After 
a  time,  vomiting  comes,  and  relief  is  obtained. 

Bilious  Ileailache. —  This  is  most  common  in  summer  and  autumn. 
It  afflicts  persons  of  dark  complexion,  with  black  hair  and  melancholy 
dispositions.  There  are  two  kinds  ;  one  is  due  to  an  accumulation  of 
bile  in  the  system ;  the  other  to  a  large  secretion  of  bile. 

In  the  first  variety  the  skin  is  dingy  and  sallow,  the  spirits  do- 
pressed,  the  bowels  costive,  and  there  is  wind  in  the  stomach,  with  a 
dull,  aching  pain  on  the  right  shoulder.  The  pain  is  in  the  forehead, 
eyebrows,  and  eyelids,  and  the  "  white  of  the  eye  "  is  a  little  yellow- 
ish. The  tongue  has  a  brown  fur,  and  h  cracked  in  the  centre. 
There  is  a  bitter  taste  in  the  mouth  on  waking  in  the  morning,  after 
restless  nights,  and  frightful  dreams. 

In  the  second  variety,  which  is  due  to  an  "overflow  of  bile,"  the 
symptoms  are  much  like  those  of  the  first  kind,  but  tiie  pain  is  not  so 
continuous.  In  addition  to  the  symptoms  named,  there  is  a  throb- 
bing, rending  pain  in  the  head,  the  skin  is  hot  and  the  face  flushed, 
the  limbs  are  sore,  and  there  is  a  luminous  lialo  or  ring  around  Objects 
looked  at,  and  a  feeling  of  giddiness. 

Nervous  Headaches. —  These  are  more  common  among  females 
than  males.  They  occur  most  frequently  among  persons  of  high 
susceptibility,  who  are  easily  elevated,  and  as  easily  depressed.  They 
are  often  coimected  with  indigestion. 

The  pain  is  usually  acute  and  darting,  and  is  made  worse  by  light, 
with  a  feeling  as  if  the  temples  were  being  "pressed  together,"  and  a 
"swimminess"  in  the  head.  There  is  sometimes  a  sense  of  sinking, 
w'th  a  dread  of  falling,  and  great  despondency  and  restlessness.  The 
bowels  are  generally  costive,  and  the  sight  dim.     The  pain  comes 


■-   "^<mi 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


185 


on  most  commonly  in  the  morning,  lasts  through  the  day,  and  abates 
in  the  evening. 

Hysteric  HeadachCt  —  There  is  a  nervous  headache  dependent  on 
the  hysterical  condition.  It  is  generally  confined  to  one  small  spot, 
frequently  over  the  eyebrow,  and  is  sometimes  compared  to  a  wedge 
or  nail  driven  into  the  skull. 

Headache  from  Exhaustion. —  Still  another  e«pecies  of  nervous  head- 
ache arises  from  extreme  exhaustion,  produced  by  great  loss  of  blood, 
by  diarrhoea,  or  by  over-suckling.  The  pain  is  generally  on  the  top 
of  the  skull,  and  is  often  compared  to  the  beating  of  a  small  hammer 
on  the  head. 

Brow  A(niC'  —  This  is  intermittent  in  its  character,  and  is  brought 
on  by  exposure  to  cold  and  moisture  in  damp  and  marshy  districts ; 
and  in  this  respect  is  much  like  ague. 

Me^ims.  —  This  is  most  frequent  among  females.  It  is  often  de- 
pendent on  the  same  causes  as  Brow  Ague,  and  is  also  produced  by 
long  and  exhausting  watching  over  sick  children,  distress  of  mind, 
and  indigestion. 

In  both  the  above  forms,  the  pain  is  intermittent,  seldom  lasting 
long,  but  being  of  a  sharp,  piercing  character,  like  that  of  tic  doulou- 
reux. The  pam  of  Megrims,  usually  begins  at  the  inner  angle  of  the 
eye,  and  extends  towards  the  nose  ;  the  parts  being  red  and  sore,  and 
the  eye-ball  tender.  In  Brow  Ague,  pain  and  great  tenderness  cover 
an  entire  half  of  the  head,  compared  by  the  patient,  sometimes,  to 
"  an  opening  and  shutting  of  the  skull."  It  begins  with  a  creeping 
sensation  over  the  scalp. 

Rlieunititic  Headaclies.  —  These  generally  affect  persons  who  have 
been  subject  to  rheumatism,  and  are  often  brought  on  by  uncovering 
the  head  when  sweating.  The  pain  is  usually  in  the  brow,  the  tem- 
ples, or  the  back  of  the  head,  and  is  dull  and  aching,  —  rather  an 
intense  soreness  than  a  real  pain  ;  and  the  painful  part  is  exces- 
sively tender  upon  pressure.  The  skin  is  moist,  but  not  hotter  than 
natural. 

Treatment.  —  In  considering  the  treatment,  I  will  take  up  the  same 
o  ,'      in  which  I  have  spoken  of  the  different  forms  of  headaclie. 

Plethoric  Headaclies. —  Not  much  medicine  should  be  taken  for 
tliese,  if  it  can  be  avoided.  A  diuretic  (131)  may  be  taken  twice  a 
clay,  and  an  occasional  dose  of  gentle  physic  at  niglit,  followed  by  (7) 
in  the  morning.     This  will  generally  give  great  relief. 

Meat  should  be  taken  but  once  a  day,  and  the  whole  diet  should 
be  spare,  the  appetite  never  being  fully  satisfied  All  spirituous 
drinks,  including  distilled  and  fermented,  should  be  let  alone,  and 
coffee  likewise. 

Much  exercise  should  be  taken  in  the  open  air.  The  hair  should 
be  kept  short,  and  the  head  elevated  during  sleep.  Bleeding  at  th« 
nose,  when  it  occurs,  must  not  be  too  suddenly  stopped. 


'11 


si. 


ll^'i^ 


:  t' 


m- 


f   :. 


186 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


Congestive  HeadacheSt  —  The  exercise,  diet,  mode  of  sleeping,  etc, 
should  be  the  same  as  in  plethoric  headaches.  In  this  complaint,  there 
if>  too  much  blood  in  the  head,  and  it  inclines  to  stagnate.  The  feet 
and  hands  are  cold ;  and  gloves  and  stockings  of  wool,  and  other  bad 
conductors  of  heat  from  the  body,  must  be  worn. 

Occasionally  a  little  gentle  physic  (319)  is  desirable  to  induce  the 
bowels  to  act  every  day.  If  there  is  great  debility,  iron  (71)  (74)  (75) 
(320)  will  be  required. 

Headache  of  Iiidiisrestioii. —  If  the  pain  come  immediately  after  a 
meal,  and  can  be  traced  to  something  eaten,  an  emetic  (2)  may  be 
taken,  if  the  person  be  tolerably  strong.  If  the  pain  come  oi;.  some 
hours  after  eating,  take  rhubarb  and  magnesia  (28)  (14),  (;r  Hnid 
magnesia.  When  the  system  is  debilitated,  take  a  warm  draught 
(322)  in  the  morning  after  a  light  breakfast,  or  twice  a  day,  a  bitter 
with  an  alkali  (323).  If  the  stomach  be  very  irritable,  bismuth,  at 
meal  times  (324)  (326).  "When  it  occurs  after  a  debauch,  take  recipe 
325. 

Sick  Headaclie.  —  When  it  results  from  food  taken,  a  draught  of 
warm  chamomile  tea,  or  a  little  weak  brandy-and-water,  will  generally 
give  relief.  If  the  sickness  continue,  soda  and  water,  with  a  little 
ginger  may  do  well,  or  a  mustard  poultice  upon  the  stomach  (165) 
may  be  required.  As  soon  as  it  can  be  kept  on  the  stomach,  a 
dose  of  physic  (326)  must  be  taken ;  and  if  relief  does  not  come  after 
the  operation  of  this,  give  a  bitter  and  an  aromatic  (327).  The  patient 
must  have  perfect  rest.  If  there  be  great  lack  of  tone  in  the  system, 
the  mineral  acids  (328)  (329)  will  be  excellent. 

The  diet  must  be  carefully  regulated,  as  in  plethoric  and  congestive 
headaches. 

Bilious  Headaclies.  —  These  are  generally  connected,  more  or  less, 
with  some  affection  of  the  liver. 

During  an  attack,  if  the  suffering  be  great,  attended  by  nausea, 
give  an  emetic  (2).  In  milder  cases,  give  recipe  (321).  If  there  bo 
costiveness,  give  recipe  (330)  at  night,  and  (7)  in  the  morning. 

A  few  doses  of  podophyllin,  leptandrin,  etc.  (34)  (36)  (39),  to  re- 
lieve the  liver  when  the  bile  does  notdow  fast  enough,  will  diminisli 
the  frequency  and  force  of  the  attack.  The  fluid  extract  of  dandelion, 
taken  for  some  time,  often  does  good  service. 

The  diet  should  be  light,  and  chiefly  vegetable,  and  exercise  in  the 
open  air  must  not  be  omitted.  The  daily  sponge  bath,  with  friction, 
is  excellent. 

Kenous  Headaclies.  —  The  first  thing  to  be  done  is  to  relieve  the 
pain,  and  this  may  generally  be  accomplished  either  by  preparation 
(331),  or  (332),  or  (333),  or  (88),  or  (93),  or  two  or  three  drops  of 
tincture  of  nux  vomica  in  a  spoonful  of  water,  taken  three  times  a 
day. 

In  simple  nervous  headache,  diet  is  of  the  greatest  importance ;  in 
hysterical  cases,  exercise ;  in  headaches  from  exhaustion,  tonics  (81) 
(79)  (63)  (73)  (64)  (61)  (60). 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


ISl 


Rheumatic  Headaches.  —  Take  a  light  diet,  with  but  little  animal 
food.  Wear  warm  clothing,  and  avoid  exposure  to  wet  feet  and 
dampness  generally,  and  go  to  a  mild  climate,  if  convenient. 

When  the  local  pain  is  great,  apply  hot  fomentations,  or  a  stimu- 
lating  liniment  (334),  or  a  mustard  poultice,  to  the  back  of  the  neck. 
Ill  the  beginning  of  the  treatment,  a  little  physic  at  night  (335)  ia 
useful. 

Before  closing  this  chapter  on  headaches,  let  me  enter  a  respectful 
protest  against  the  indiscriminate  use  of  the  thousand  and  one  reme- 
dies advertised  to  cure  headaches ;  for  in  a  great  majority  of  cases  it 
is  merely  a  symptom  of  some  other  disease ;  instance :  Indigestion, 
Fever,  Bright's  Disease,  Softening  of  the  Brain,  Diseased  Liver,  etc.  j 
aiid  the  use  of  these  remedies  serves  rather  to  increase  tbau  '^88611 
'he  difiicalty. 


:  oL  'IK' 


m 


DISEASES   OF  THE  THROAT. 


Thr  diseases  which  seat  themselves  in  the  throat,  and  in  the  great 
cavity  of  the  chest,  have  occupied  a  large  share  of  my  attention  for 
the  last  ten  years.  My  practice  in  these  complaints  has  been  large, — 
being  drawn  from  every  part  of  the  United  States,  and  the  British 
Provinces.  No  class  of  diseases  from  which  men  suffer  are  more  nu- 
merous than  these,  and  none  have  so  generally  baffled  the  skill  of  the 
profession.  For  this  reason,  I  wish  to  present  here  a  brief,  practical, 
and  common-sense  view  of  these  complaints,  which  shall  be  of  real 
value  to  the  thousands  of  families,  who,  I  trust,  will  consult  these 
pages. 

Increase  of  Tliront  Diseases. —  A  striking  increase  in  the  number 
of  throat  diseases  has  been  witnessed  within  the  last  few  years.  A 
person  suffering  from  any  of  them  will  find,  on  speaking  of  his  com- 
plaint, that  a  number  of  his  neighbors  are  afflicted  with  troubles  of  a 
similar  kind.  I  have  thought  that  in  some  of  their  forms  these  dk- 
eases  have  fastened  upon  the  throats  of  not  less  than  half  our  popu- 
lation. And  when  it  is  considered  that  they  are  the  natural,  and 
if  unmolested,  the  certain  harbingers  of  lung  disease,  it  is  wise  to 
make  a  note  of  the  above  fact.  As  I  shall  describe  them  in  the  nasal 
cavities,  the  pharynx,  the  fauces,  etc.,  they  all  have  a  natural  proclivity 
downwards.  From  these  upper  cavities  they  pass,  by  one  short  step, 
into  the  larynx,  —  the  cavity  where  the  voice  is  formed,  —  and  then, 
by  another  equally  short  and  easy  stage,  into  the  body  of  the  wind- 
pipe. It  is  a  singular  fact  that  their  progress  is  always  from  the 
upper  breathing  passages  downward,  and  never  from  the  lov/er  pas- 
sages upward.  They  afford  a  parallel  to  the  order  of  progression  in 
the  moral  world,  in  which  evil  tendencies  are  toward  a  lower  depth. 

A  mistake  Corrected.— -Before  describing  the  several  diseases  which 
belong  to  this  family,  T  wish  to  correct  the  mistake  which  so  generally 
classes  them  all  under  the  term  Bronchitis. 

They  all  consist  in  a  simple  inflammation,  acute  or  chronic,  either 
of  the  mucous  membrane  lining  the  several  cavities  to  be  spoken  of, 
or  of  the  small  glands  or  follicles  connected  with  that  membrane;  and 
each  disease  takes  its  name  from  its  particular  location.  Thus,  the 
inflammation  of  the  membrane  lining  the  upper  part  of  the  throat,  or 
pharynx,  is  called  Pharifngitis.     Inflammation  in  the  top  of  the  wind- 


DISEASES  OF  THE  THROAT. 


189 


pipe,  or  larynx,  is  Lari/ngitis.  In  the  windpipe,  or  trachea,  it  is  Tra- 
cldtis.  In  the  bronchial  tubes,  it  is  Bronchitis.  As  the  bronchial 
tubes  exi  t  nowhere  except  in  the  lungs,  below  the  division  of  the 
windpipe,  there  can  be  no  Bronchitis  in  the  throat.  Nevertheless,  it 
is  the  same  disease  with  Laryngitis  and  Pharyngitis,  and  difl'ers  from 
them  only  in  being  in  a  more  dangerous  place. 

As  the  windpipe  descends  into  the  chest,  it  divides  below  the  top 
of  the  breast  bone  into  two  brfinches,  one  going  into  the  right,  the 
other  into  the  left  lung.  These  branches  divide  and  subdivide  very 
minutely,  and  send  their  rainilicutions  into  every  part  of  the  pulmon- 
ary tissue.     Thus  situated,  Meckel  has  comparea  the  windpipe  to  a 

Fio.  83. 


hollow  tree  with  the  top  turned  downward,  —  the  larynx  and  trachea 
representing  the  trunk,  and  the  bronchial  tubes,  with  their  innumera- 
ble subdivisions,  the  branches  and  twigs.     (Fig.  82.) 

If  the  reader  will  now  understand  that  the  trunk  and  branches  of 
this  bronchial  tree  are  hollow  throughout,  and  lined  with  a  delicate 
and  smooth  mucous  membrane,  and  that  the  diseases  lo  be  described 
are  inflammations  either  upon  this  membrane  or  the  small  glands 
connected  with  it,  causing  swelling,  redness,  unhealthy  discharges, 
roughness,  etc.,  he  will  have  a  good  general  idea  of  them. 

Nasal  Catarrh. 

I  TAKE  these  diseases  in  the  order  of  their  location.  Nasal  Catarrh 
consists  in  inflammation,  which  begins  behind  and  a  little  above  the 
veil  of  the  palate,  and  extends  upward  from  thence  into  the  nose.     It 


,  Tii 


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190 


DISEASES  OF  THE  TIIHOAT. 


is  an  cxccrdinf^ly  troublesome  complaint,  and  alllicts  great  numbers. 
It  passes  nnder  the  name  of  Catarrh  in  the  IltMid. 

The  inflammation  is  not  confined  to  the  nasal  cavities.  It  extends 
frequently  to  the  air  cavities,  called  anf.nutis  and  sinuses,  which  cover 
a  considerable  portion  of  the  face,  and  extend  to  the  lower  part  of  the 
fon-hcad.  Persons  sometimes  feel  as  if  their  whole  face  were  involved 
in  the  disease,  and  were  almost  in  a  state  of  rottenness,  —  so  great  is 
the  amount  of  matter  discharged  from  th(!  head.  Such  free  discharges 
cainiot  be  wondered  at  when  we  reflect  that  all  the  air  cav'.ies  in  the 
face  are  lined  with  the  same  mucous  membrane  which  lines  the  nose, 
and  that  they  all  communicate  with  the  nasal  cavities. 

The  '^  horn  ail,"  among  cattle,  is  a  similar  inflammation  of  the 
inner  surface  of  horns;  and  the  "horse  distemper"  is  an  inflamma- 
tion of  the  air  cavities  in  the  head  of  the  horse,  and  is  much  the 
same  disease  with  our  catarrh  in  the  head. 

The  catarrh  often  creates  a  perpetual  desire  to  sivalhiv,  and  gives 
the  feeling,  as  patients  express  it,  "  as  if  something  were  sticking- in  the 
upper  part  of  the  throat^ 

When  the  inflammation  has  existed  a  long  time,  and  ulceration  has 
taken  place,  puriform  matter  is  secreted,  and  drops  down  into  the 
throat,  much  to  the  discomfort  of  the  patient.  Indeed,  this  is  one  of 
the  most  distressing  features  of  the  complaint,  as  this  matter  often 
descends  into  the  stomach  in  large  quantities,  causing  frequent  vom- 
iting, and  a  general  derangement  of  the  health.  Many  times  the 
suHerer  can  only  breathe  with  the  mouth  open.  Upon  rising  in  the 
morning  a  great  efibrt  is  required  to  clear  the  head  and  the  extreme 
upp^r  part  of  the  throat.  There  is  oc-^sionally  a  feeling  of  pressure 
and  tightness  across  the  upper  part  of  the  nose  ;  and  the  base  of  the 
brain  sometimes  suflers  in  such  a  way  as  to  induce  headache,  vertigo, 
and  confusion.  The  smell  is  frequently  destroyed,  and  sometimes 
the  taste.  The  inflammation  sometimes  gets  into  the  eustachian 
tubes,  the  mouths  of  which  are  behind  and  a  little  above  the  veil  of 
the  palate,  and  extends  up  the  lining  membrane  to  the  drum  of  the 
ear,  causing  pain  or  deafness,  and  occasionally  both.  In  addition  to 
this  catalogue  of  evils,  there  is  often  added  inflammation  and  elon- 
gation of  the  uvula  or  soft  palate. 

Treatment.  —  The  following  is  a  fair  illustration  of  my  mode  of 
treatment : 

On  the  12th  of  December,  1852,  Mr. ,  of  this  city,  came  under 

treatment  for  a  bad  case  of  catarrh  in  the  head,  complicated  with 
follicular  disease  of  the  pharynx,  or  upper  part  of  the  throat.  In 
addition  to  nearly  all  the  symptoms  mentioned  above,  he  had  a  stench 
from  the  nose  exceedingly  offensive  to  all  about  him.  So  much  had 
the  disease  worn  upon  him  that  he  had  become  bilious,  sallow,  de- 
jected, and  low  in  strength  and  flesh.  When  it  is  said  that  to  all 
this  were  added  a  cough  and  loss  of  appetite,  with  insidious  ap- 
proaches of  hectic,  it  will  not  be  surprising  that  his  friends  saw  the 
most  serious  results  impending,  even  though  assured  by  me  that  the 
disease  had  not  yet  taken  firm  hold  of  his  lungs.     The  first  thing 


(lone  for  him  was  to  cut  ofT  the  nvnla.  Five  days  after,  I  began  to 
blithe  tlie  wliole  nasal  cavity,  three  times  a  week,  with  a  siiower 
syring«',  by  pushing  the  smootii  bull)  up  behind  the  veil  of  the  palate, 
and  throwing  instantanet)iisly  a  most  delieate  shower  of  medicated 
jliiid  up  both  sides  of  the  septum.  The  upper  jjart  of  the  throat  was 
likewise  bathed  by  the  use  of  a  shower  syringe  made  expressly  for 
that  part,  and  the  larynx,  or  place  where  the  voice  is  formed,  by  a 
i)ng,  bent  instrument  made  to  reach  this  part  of  the  throat.  The 
solution  used  consisted  of  half  a  dram  of  crystals  of  nitrate  of  silver 
dissolved  in  one  ounce  of  soft  water. 

The  nitrate  of  silver  powder  was  inhaled  once  a  day  with  the  powder 
inhaler.  In  this  way  the  nasal  cavities  and  throat  were  kept  cleansed, 
and  the  articles  used  gradually  subdued  the  inllanuuation,  setting  up 
a  new  and  healthful  action  in  place  of  the  diseased  one.  The  stom- 
ach was  relieved  of  the  offensive  matter  which  had  daily  and  nightly 
gone  down  into  it,  and  the  system  of  the  poisonous  effects  of  its  absorp- 
tion. The  great  ('anger  which  threatened  the  lungs,  and  which  would 
soon  have  been  realized  in  their  destruction,  passed  away.  The  skin 
gradually  assumed  its  proper  color;  the  appetite,  ffesh,  spirits,  and 
strength  came  back,  and  Mr.  B.  has  been  since  in  the  enjoyment 
of  good  health,  pursuing  his  business  cheerfully. 

When  the  above  treatment  fails,  as  it  does  occasionally,  I.  am  in 
the  habit  of  changing  the  solution,  using,  souietimes,  a  weak  solution 
of  acid  nitrate  of  mercury,  twenty  drops  to  an  ounce  of  water.  In 
other  cases,  a  solution  of  sulphate  of  zinc  serves  a  good  purpose.  A 
dilution  of  the  tincture  of  arnica  flowers  is  a  preparation  of  some 
value  in  these  cases.  There  are  other  preparations,  too  numerous  to 
mention,  which  I  am  in  the  habit  of  using.  1  will  add,  that  the 
nitrate  of  silver  powder,  snuffed  once  a  day,  a  pinch  at  a  time,  is  far 
more  successful  than  any  other  snuff  ever  made. 

Inflammation  of  the  Pharynx. — Pharyngitis. 

This  is  an  inflammation  of  the  upper  and  back  part  of  t  throat, 
or  all  that  part  which  can  be  seen  when  the  mouth  is  stretched  open. 
It  cavises  a  redness  of  the  mucous  membrane  lining  the  part,  which 
is  deep  in  proportion  to  the  intensity  of  the  inllammation.  This 
complaint  is  generally  connected  with  the  one  I  am  »bout  to  describe; ; 
and  since  the  treatment  is  the  same,  the  reader  is  referred  to  what 
next  follows.  .  .  , 

Clergymen's  Sore  Throat. — Follicular  Pharyngitis. 

This  disorder  made  its  appearance  in  this  country  in  1830,  and  the 
attention  of  the  profession  was  first  drawn  to  it,  as  a  distinct  disease^ 
in  1832.  Some  have  supposed  its  origin  to  have  had  a  hidden  con- 
nection with  the  epidemic  influenza,  which  spread  over  the  civilized 
world  in  1830,  and  affected  all  classes  of  persons;  but  this  is  only 
conjecture.  In  its  early  developments  it  attracted  notice  chiefly  by 
its  visitations  upon  the  throats  of  the  clergy.     Hence  its  popular 


H^^ 


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Hij '  \ 

hk 

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192 


DISEASES  OF  THE  THROAT. 


name  of  Cler^ymen^s  Sore  Throat.  It  was  soon  found,  however,  to 
uttafk  all  classes  of  persons  indiscriminately,  whether  engaged  in  any 
calling  which  required  a  public  exercise  of  the  Toice  or  otherwise.  It 
was  noticed  more  by  public  speakers  and  singers,  on  account  of  the 
greater  inconvenience  it  gave  them. 

The  dis(!ase  consists  in  a  chronic  inflammation  of  the  mucous  fol- 
licles, or  glands  coimected  with  the  mucous  membrane  which  lines 
llie  throat  and  windpipe.  The  office  of  these  little  glands  is  to  secrete 
a  fluid  to  lubricate  the  air  passages.  When  inflamed,  they  spread  an 
acrid,  irritating  fluid  over  surrounding  parts,  which  excites  inflannna- 
tion  in  them.  Hence  a  general  inflammation  of  the  up|)er  part  of  th<' 
throat,  or  pharyngitis,  usually  attends  the  follicular  disease,  and  \ 
shall  speak  of  the  two  together.  This  inflammation  of  the  glands 
and  the  membrane,  being  neglected,  as  it  generally  is,  lingers  on  from 
month  to  month,  or  from  year  to  year,  making  in  some  cases  slow 
progress,  in  others  more  rapid,  —  made  a  little  worse  and  its  step 
slightly  quickened  by  every  fresh  cold,  and  finally  results  in  ulcera- 
tion. The  expectoration  thenceforward  becomes  puriform,  and  finally 
undistinguishable  from  that  of  consumption,  with  all  the  symp- 
toms of  which  the  patient  finally  dies.  Indeed,  before  its  nature  was 
understood  by  the  profession,  it  was  considered  the  most  fatal  form 
of  consumption,  because  it  could  be  afl'ected  only  in  a  very  small 
degree,  if  at  all,  by  medicines  taken  into  the  general  system. 

Inflammation  of  Mucous  Membrane  and  Glands  of  Larynx. 

Follicular  Laryngitis. 

A  FEW  strong  and  beautifully  forrried  cartilages  unite  to  form  a 
curious  and  convenient  box  or  cavity  at  the  top  of  the  windpipe, 
called  the  larynx.  Across  this  enclosure  are  stretched  two  remark- 
able cords,  called  the  vocal  ligaments.  They  are  from  half  to  three 
quarters  of  an  inch  in  length,  and  are  rendered  more  or  less  tense  by 
the  small  muscles  with  which  they  are  connected.  Just  above  these 
cords  are  two  cavities,  which,  with  the  ligaments,  act  an  important 
part  in  the  formation  of  the  voice.  Here  is  produced  the  sound,  which 
is  modified  and  articulated  by  the  tongue,  the  lips,  and  the  nasal  cav- 
ities. 

When  disease  reaches  this  cavity,  and  the  fluid  secreted  to  lubricate 
these  cords  becomes  acrid,  the  voice,  from  this  and  other  causes,  ia 
made  hoarse ;  and  when,  at  length,  these  ligaments  are  altered  \p 
structure  by  inflammation  and  ulceration,  the  voice  suflfers  a  gradual 
extinction.  I  have  treated  a  large  number  suffering  entire  loss  of 
voice,  and  am  happy  to  say  it  has  been  generally  restore.^,  where  the 
lungs  have  not  been  involved  in  the  disease.  There  is  often  also  a 
little  sensitiveness,  or  even  soreness,  in  some  cases,  in  the  region  of 
the  larynx,  which  may  be  felt  by  pressing  upon  that  prominence  in 
front  of  the  throat,  called  Adam's  apple. 


DISEASES  OF  THE  THROAT. 


193 


Inflammation  in  the  Windpipe. — Tracheitis. 

This  coiiipliiint  and  the  one  j)rccoding  it  diifer  only  in  their  locality 
from  those  described  in  the  u[)|)er  cavities ;  and  they  are  more  alarm- 
ing, because  two  removes  nearer  the  citadel  of  life,  lla^jpily,  we  know 
that  the  seat  of  these  disea-ses  may  be  easily  reached,  and  we  have  a 
shower  syringe,  constructed  by  me  in  1849,  so  arranged  as  to  pour 
the  remedial  agent  directly  upon  them,  without  any  lacerating  dis- 
turbance of  the  parts. 

NyiliptoiilS. —  The  approach  of  these  disorders  is  often  so  insidious 
as  hardly  to  attract  notice,  —  sometimes  for  months,  or  even  year.«ij 
giving  no  other  evidence  of  their  presence  than  \\\r  annoyance  of 
something  in  the  throat  to  be  s-' vallowed  or  hawked  up, —  an  in- 
creased .secretion  of  mucus,  and  a  sense  of  wearisomeness  and  loss 
of  power  in  iIh;  throat,  after  public  speaking,  singing,  or  reading 
aloud.  At  length,  u|)on  the  taking  of  a  severe  cold,  the  prevalence 
of  an  ej)i(lemic  inlluenza,  op  of  an  unexplained  tendency  of  disease 
to  the  air  ))assages  and  lungs,  the  throat  of  the  pati-^nt  suddenly 
becomes  sore,  its  secretions  are  increased  and  rend(*ret!  more  viscid, 
tlie  voice  grows  hoarse,  the  dilliciilty  of  speaking  is  aggravated,  and 
what  was  only  an  annoyance,  becomes  an  alllic  on.,  and  a  source  of 
alarm  and  danger.  These  diseases  clearly  belong  to  the  family  of 
consumption,  and  need  early  attention. 

Caus<'>. —  It  is  amusing  to  reflect  upon  the  theories  which  writers 
were  in  the  liabit  of  constructing,  a  few  years  since,  to  account  for 
the  throat  aft'ection  among  the  clergy.  It  was  attributed  by  some  to 
speaking  too  often,  by  others  to  speaking  too  loud.  One  class  of 
writers  thought  it  arose  from  high,  stiff  neck-stocks ;  another,  from  a 
strain  of  voice  on  the  Sabbath  to  which  it  was  not  accustomed  on 
other  days. 

The  cause  lies  deeper  than  any  of  these  trilling  things.  As  it  con- 
cerns ministers,  it  may  generally  be  expressed  in  two  words,  —  labor, 
anxiety. 

The  clerical  order  are  placed  just  where  they  feel  the  force  of  the 
high-pressure  movements  of  the  age.  They  are  the  only  class  of 
recognized  instructors  of  adult  men,  and  are  obliged  to  make  great 
exertions  to  meet  the  wants  of  their  position.  The  extremely  trying 
circumstances  in  which  they  are  often  placed,  too,  in  these  exciting 
times,  by  questions  which  arise  and  threaten  to  rupture  and  destroy 
their  parishes,  weigh  heavily  upon  their  spirits,  and  greatly  depress 
the  vital  powers.  And  when  we  add  to  this  the  fickle  state  of  the 
public  mind,  and  the  shifting,  fugitive  character  of  a  clergyman's 
dwelling  place,  and  the  consequent  liability  to  poverty  and  want  to 
which  himself  and  family  are  exposed,  we  have  a  list  of  depressing 
causes  powerfully  predispo  'ng  to  any  form  of  disease  which  may 
prevail. 

It  will  be  pardoned  me,  I  think,  if  I  suggest  here,  that  the  nature 
of  a  clergyman's  calling  is  of  so  serious  a  character,  that  he  some- 

25 


iir 


m 


194 


DISEASES  OF  THE  TIIUOA'l. 


^       .... 


'   ;  ' 


times  carries  himself  with  too  much  sedateness,  keeps  himself  too 
much  braced  up,  and  does  not  allow  himself  hours  enough  of  that 
cheerful,  light-hearted  abandon,  which  is  essential  to  the  health  of 
every  sedentary  man  of  mental  habits.  The  hard-thinking  and  hard- 
working minister,  who  will  retain  his  health,  and  .  ave  his  throat,  must 
have  some  moments,  at  least,  when  the  weighty  responsibilities  of  his 
olHce  arc  lifted  up  from  his  soul,  and  lie  becomes,  for  the  hour,  the 
jocund,  playful  lioy  of  earlier  days.  How  far  he  can  consistently 
relax  and  let  himself  down,  or  in  my  view  of  tiie  matter,  raise  him- 
self  up  to  the  simplicity  and  mirth  of  childhood,  lie  alone  can  be  the 
judge.  As  a  physician,  I  prescribe  ;  as  a  minister,  he  must  decide 
flow  far  my  prescri|)tion  can  be  foll-^vved. 

llesuliii<^  Sei'iiioiis. —  There  is  one  practice,  which,  tliough  it  has 
not  much  to  do  with  inducing  this  disease,  does  freciucntly  aggravate 
it  when  once  e  !ablished;  I  mean  the  habit  of  reading  sermons  from 
manuscripts, —  especially  when  it  is  done  in  a  sort  of  mechanical 
way.  Every  person  who  has  suffered  from  throat  ail,  has  doubtless 
noticed  that  to  read  aloud,  for  half  an  hour,  from  a  book,  occasions 
more  fatigue  and  irritation  in  the  throat  than  extcivporaneous  speak- 
ing, in  the  same  tones,  for  one  or  two  hours.  The  reason  is,  that  in 
the  latter  case  the  mind  conceives  the  thought  in  season  for  the 
organs  of  speech  to  fall  into  a  natural  attitude,  and  utter  it  with  ease. 
The  two  work  harmoniously  together,  —  the  instruments  of  articula- 
tion following  the  mina,  and  easily  and  naturally  uttering  its  concep- 
tions. Whereas  in  the  case  of  reading,  the  mind  itself  is,  at  least 
partially,  ignorant  of  what  is  coming  until  it  is  just  upon  it,  so  that 
the  organs  of  spe(;ch,  being  warned  of  what  is  to  be  done  only  at 
the  moment  their  service  is  required,  dq  their  work  under  a  perpetual 
surprise  and  constraint.  The  difference  is,  in  some  res|K'cts,  like  that 
between  walking  fre(>ly  at  large,  without  regard  to  wiiere  the  feet  are 
put  down,  and  being  obliged  to  step  exactly  in  the  footprints  of  some 
traveller  who  has  gone  before.  In  the  latter  case,  the  muscles  tire 
much  sooner,  because  they  work  in  fetters. 

I  have  thus  spoken  particularly  of  the  clergy,  though  it  is  not  by 
any  means  they  only,  but  all  classes  of  people  who  are  afflicted  wiili 
this  dangerous  malady. 

These  diseases  often  begin  with  a  cold.  But  colds  are  seldom 
taken  except  when  the  nervous  system  is  depressed,  so  that  they  are, 
in  fact,  to  be  traced  back  to  the  same  cause  which  I  have  assigned  to 
catarrhal  or  throat  complaints  themselves. 

These  Complaints  Worse  at  IViglit.  —  It  is  worthy  of  note,  that  all 
these  complaints,  and  many  others,  are  worse  during  the  night.  This 
is  easily  explained  when  we  remember  that  the  atmosphere  has  the 
least  amount  of  electricity  in  it  at  three  o'clock  in  the  morning, 
and  that  the  first  minimum  atmospheric  pressure,  which  happens 
twice  a  day,  occurs  not  far  from  tlie  same  hour.  From  three  to  four 
in  the  morning,  therefore,  the  neriu  -power  sinks  to  its  'owest  ebb ;  and 
those  diseases  which  owe  their  existence  to  anxiety,  overwork,  etc., 
■ulfer,  at  this  time,  their  greatest  daily  aggravation.     Death  occurs, 


DISEASES  OF  THE  THROAT. 


195 


too,  more  often  during  these  hours,  than  in  any  other  portion  of  the 
twenty-four. 

Treiltmenf.  —  Some  years  ago  these  diseases  were  thought  to  be 
incurable ;  and  by  all  the  appliances  of  medical  art  then  known,  they 
were  so.  But  time  has  brought  a  successful  method  of  treatment,  as 
well  as  a  clearer  knowledge  of  their  nature. 

This  treatment  consists  in  what  is  called  topical  nu'dieation,  or  the 
applying  of  the  medicine  directly  to  the  diseased  part.  The  medici- 
nai  ag(Mit  more  extensively  used  than  any  other  is  a  solution  of 
crystals  of  nilrale  of  silver.  This  substance  is  not,  however,  adapteJ 
to  ercry  case,  —  other  articles  succeeding  better  in  some  instances. 
Modern  chemistry  has  given  us  a  variety  of  agents  from  which  tin 
skilful  physician  may  select  a  substitute,  should  the  nitrate  of  silver 
fail. 

The  operation  of  applying  this  and  other  substances  to  the  air 
passages,  is  a  delicate  one,  retpiiring  tact  and  experience.  Surgeons 
had  supposed  it  an  anatomical  impossibility  to  introduce  an  inst  u- 
nient  into  the  larynx  ;  but  this  has  been  practically  demonstrated  to 
be  a  great  mistake. 

Insfruiiieilts. —  The  instrument  devised  and  used  by  Dr.  Horace 
Green  is  a  piece  of  whalebone,  bent  at  one  end,  to  which  is  attached 
a  small,  round  piece  of  sponge.  This,  dipped  in  the  solution,  is  dex- 
terously intrtKluced.  into  the  laryngeal  cavity,  and  applied  directly  to 
tiie  diseased  part. 

I  formerly  used  this  instrument  myself,  and  am  happy  to  know, 
that  notwithstanding  its  defects,  it  was  generally  successful.  Yet 
where  the  larynx  was  highly  inHamed,  with  a  swollen  and  ulcerated 
condition  of  the  epiglottis  and  lips  of  the  glottis,  I  am  sure  I  some- 
times had  the  singular  powers  of  the  nitrate  of  silver  put  at  defiance 
by  an  irritation  evidently  produced  by  the  sponge  of  the  probang. 
Upon  its  introduction,  in  such  case,,,  the  parts  contract  upon  and 
cling  to  it,  and  suflier  aggravated  irritation,  almost  laceration,  upon 
its  withdrawal,  however  carefully  eftected. 

Laryngeal  Shower  SjTinge,  —  Such  defects  in  the  probang  led  me 
to  contrive  an  instrument,  which  I  call  a  Laryngeal  S/iower  Syringe. 
It  is  in  the  form  of  a  syringe,  the  barrel  and  piston  of  which  are  made 
of  glass,  silver,  or  gold,  as  may  be  desired.  To  this  is  attached  a 
small  tube,  made;  of  silver  or  gold,  long  enough  to  reach  and  enter 
the  tliroat,  rnd  bent  like  a  probang,  with  a  g-lobe  or  bulb  at  the  end, 
from  a  quarter  to  a  third  of  an  inch  in  diameter,  pierced  with  very 
minu;e  holes,  which  cover  a  zone  around  the  centre  about  one-third 
of  an  inch  in  breadth. 

This  silver  bulb  I  daily  introduce  into  highly  inflamed  and  vdcer- 
ated  larynges,  generally  without  any  knowledge  of  its  presence  on 
the  part  of  the  patient,  until  the  contained  solution  is  discharged. 
The  instrument,  being  charged,  is  carried  to  the  proper  place,  when  a 
delicately  quick  pressure  upon  the  piston  causes  very  fine  streams  to 
flow  through  the  holes  in  the  form  of  a  delicate  shower,  and  all  sides 
of  the  walls  of  the  larynx  are  instantaneously  bathed. 


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How  Introduced.  —  The  introduction  of  this  instrament  into  the 
larynx  is  easy.  Upon  the  approach  of  any  foreign  substance,  the 
epiglottis  instinctively  drops  down  upon  the  entrance  to  the  larynx, 
guarding  it  against  improper  intrusions.  It  has  been  found,  however, 
that  when  the  root  of  the  tongue  is  firmly  depressed,  this  cartilage 
cannot  obey  its  instinct,  but  stands  erect,  its  upper  edge  generally 
rising  into  view.  Availing  himself  of  this,  the  surgeon  has  only  to 
depress  the  tongue  with  a  spatula,  bent  at  right  angles,  so  that  the 
Jeft  hand  holding  it  may  droj)  below  the  chin  out  of  the  way,  and  as 
the  epiglottis  rises  to  view,  slip  the  ball  of  the  instrument  over  its 
upper  edge,  and  then  with  a  quick  yet  gentle  motion,  carry  it  down- 
ward 2Lnd  fonvard,  and  the  entrance  is  made.  I  have  often  admired 
the  faithfulness  of  this  epiglottic  sentinel,  who,  when  overborne  by 
superior  force,  stands  bolt  upright,  and  compels  us  to  enter  the  sacred 
temple  of  speech  directl//  over  his  head! 

Pharyngeal  Shower  Syrnige.  —  For  washing  the  upper  part  of  the 
throat,  I  construct  the  instrument  with  a  sfraig-ht  tube,  with  holes 
over  the  outer  end  of  the  globe,  and  extending  to  the  centre.  This 
washes  instantaneously  the  fauces  and  pharynx,  but  does  not  throw 
the  solution  back  upon  the  tongue.  Its  main  advantage  over  the 
probang  is,  that  it  bathes  every  part  of  the  fauces  and  pharynx  in- 
stantaneously, r  nd  does  not  subject  the  patient  to  the  coughing  and 
gagging  which  fo'low  the  slower  and  rougher  process  of  drawing  the 
sponge  from  side  to  side  across  the  cavity  of  the  throat. 

Kasal  Shower  Syringe. —  Inflammations  in  the  back  passages  to  tho 
nose,  called  catarrh  in  the  head,  have  been  a  aost  inaccessible  by  any 
reliable  healing  agent,  and  consequently  incurable.  The  probang 
could  only  reach  a  short  distance,  and  occasioned  great  suffering.  I 
have  had  a  syringe  constructed  with  the  tube  bent  at  an  angle  of 
forty-five  degrees,  and  the  globe,  very  small,  pierced  with  a  few  fine 
holes  at  the  upper  end.  Carrying  this  globe  up  behind  the  velum 
palati,  with  a  single  injection  I  wash  both  passages  clear  through.  I 
have  had  the  pleasure  of  curing  a  large  number  of  bad  cases,  of  many 
years'  standing,  to  the  surprise  and  delight  of  the  patients. 

About  nineteen  twentieths  of  the  physicians  who  have  examined 
these  instruments,  and  so  far  as  my  knowledge  extends,  all  who  have 
used  them,  think  them  much  better  than  the  probang.  As  to  patients, 
I  have  yet  to  see  one  who  will  allow  the  sponge  to  be  used  after  try- 
ing both. 

Have  Superseded  the  Prohang.  —  In  my  own  practice  the  syringes 
have  superseded  the  probang  altogether.  My  reasons  may  be  briefly 
stated.  I  have  already  said  there  is  less  irritation  produced.  A  piece 
of  sponge  drawn  over  an  inflamed  surface,  especially  when  clung  to 
by  the  irritated  and  quivering  parts,  must  necessarily,  in  some  cases 
at  least,  aggravate  the  symptoms  of  disease.  To  this  consideration 
add  the  comfort  of  the  patient  during  the  operation.  It  is  so  quickly 
and  delicately  done  with  the  syringe,  that  it  is  scarcely  known  when 
the  act  is  performed.     The  straight  syringe  does  not  touch  the  throat 


DISEASES  OF  THE  THROAT. 


197 


at  all.  On  touching  the  probang  to  the  throat,  the  nitrate  of  silver 
unites  with  the  mucus  upon  the  surface,  instantly  covering  the  sponge 
with  an  albuminous  pellicle,  something  like  that  which  lines  the  shell 
of  an  egg,  preventing,  in  a  degree,  the  further  pressing  out  of  the 
solution,  and  rendering  its  contacts  with  other  parts  of  the  surface 
comparatively  powerless.  For  this  reason,  the  sponge  pushed  down 
into  an  ulcerated  bronchus,  as  Dr.  Green  recommends,  must  be 
utterly  valueless  as  a  remedial  agent.  Mopping,  as  it  does  in  its 
whole  course,  a  larynx  and  trachea,  lined  in  some  cases  with  puriform 
matter,  and  generally  with  mucus,  every  inch  of  its  descent  doubles 
the  gravity  of  this  objection.  Let  it  be  considered,  too,  that  in  apply- 
ing  the  remedy  to  an  ulcerated  larynx,  the  sponge  cauterizes  ths 
healthy  parts  above,  in  its  descent,  and  thus  unfits  itself  for  dcing 
much  for  the  diseased  part ;  whereas  the  syringe  retains  its  solution 
till  it  reaches  the  atiected  place,  and  then  pours  a  clean  shower  di> 
rectly  upon  it,  and  upon  no  other  part. 

Considering  these  manifest  advantages  of  the  syringes,  T  am  sur- 
prised that  any  physician  should  still  use  the  probang,  —  especially  ts 
one  of  these  instruments,  the  Nasal  Syringe,  accomplishes  an  object 
which  the  probang  cannot  effect  at  all,  not  even  in  a  rough  way.  I 
have  wondered,  too,  how  any  parent  can  allow  a  child,  sutiering  with 
croup,  to  be  tormented  by  having  a  sponge  pushed  down  its  throat, 
when  a  syringe  would  give  it  so  much  less  pain. 

1  will  mention  briefly  one  or  two  cases  ot  croup  and  diphtheria,  se- 
lected from  a  great  number  treated  by  me  for  the  last  few  years,  wfiere 
the  syringes  were  successfully  used,  after  several  attempts  to  use  the 
probang  had  been  made,  and  failed,  and  where  the  pain  caused  by 
using  was  so  small,  and  the  relief  so  instantaneous  and  complete,  that 
the  patients  were  anxious  for  my  return  to  use  it  again. 

On  the  25th  of  November  last,  I  was  called  to  see  a  little  boy  of 
Mr.  R.,  five  years  old,  who  had  had  an  attack  of  membraneous  croup 
some  days  previous;  and  when  I  saw  him  the  voice  had  sunk  to  a 
whisper,  and  the  cough  was  entirely  mutlled,  so  that  I  had  no  doubt 
of  the  fatal  termination  of  the  case,  and  expressed  my  opinion  to  that 
effect  to  the  astonished  parents.  The  probang  had  been  used  by  the 
physcian  in  attendance,  which  had  caused  so  much  suflcring  that  for 
the  two  days  previous  the  parents  had  prohibited  its  use.  It  had  w> 
doubt  increased  the  irritation,  besides  nearly  causing  strangulation. 

It  was,  therefore,  with  great  reluctance  that  they  consented  to  et 
me  use  the  syringe,  which  I  did,  to  the  great  relief  of  the  little  suf- 
ferer, and  to  the  entire  satisfaction  of  the  parents. 

The  strength  of  the  solution  of  the  crystals  of  the  nitrate  of  silver 
used  was  20  grains  to  the  ounce  of  water,  which  I  injected  freely, 
once  in  three  hours  for  the  first  day,  and  then  two  or  three  times  a 
day  for  two  or  three  days.      His  recovery  was  rapid  and  complete. 

I  will  now  mention  the  case  of  a  young  woman,  with  diphtheria, 
where  the  syringe  was  used  with  success. 

On  the  evening  of  the  10th  of  September  last,  I  was  called  to  see 
Miss  T.,  of  this  city,  who  had  an  attack  of  diphtheria  the  day  previ- 
ous.    Found  her  in  bed,  very  much  prostrated,  breathing  with  gr  ;at 


'5;  3 


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m 


1  :Mi 

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1         ! 


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't( , 


198 


DIoIiASES  OF  TlIK  THROAT. 


difficulty,  and  nttering  at  every  inspiration  a  croupal  sound,  which  at 
times  was  followed  by  a  short  convulsive  cough.  The  face  waa 
flushed,  pulse  124,  small  and  feeble,  and  she  complained  constantly  of 
a  sense  of  suffocation  and  of  great  distress  in  the  laryngeal  region. 

On  inspecting  the  throat,  the  fauces  and  the  pharyngeal,  membrane 
as  far  down  as  it  could  be  seen,  presented  the  appearance  of  a  high 
degree  of  inflammation.  One  of  the  tonsils  was  nearly  covered  with 
the  diphtheretic  membrane,  and  the  upper  and  back  part  of  the  throat 
were  thickly  studded  with  small  white  or  cream-colored  spots. 

The  physician  in  attendance  had  tried  first,  a  swab,  or  mop  as  she 
termed  it,  and  then  the  probang,  which  gave  her  so  much  pain  that  he 
was  obliged  to  give  it  up.  He  then  gave  up  the  case  as  hopeless.  At 
my  earnest  solicitation  she  consented  to  the  use  of  the  syringe.  "With 
a  solution  of  the  crystals  of  the  nitrate  of  silver,  of  the  strength  of 
60  grains  to  the  ounce  of  water,  I  injected  freely  the  fauces  and  the 
upper  part  of  the  cavity  of  the  larynx.  For  a  few  moments  the  dilK- 
culty  of  breathing  and  feeling  of  strangulation  was  increased,  but 
very  soon  a  large  amount  of  viscid,  ropy  mucus  was  discharged.  In 
the  course  of  half  an  hour  after  the  use  of  the  syringe,  the  symptoms 
Had  improved,  the  respiration  was  less  laborious,  so  that  in  a  short 
time  the  patient  obtained  some  sleep.  I  was  afterward  called,  n  she 
thought  herself  wor.se,  but  found  that  an  application  of  the  caustic 
ovith  a  syringe  was  all  that  was  required.  There  was  no  further 
trouble  with  the  case. 

Several  parties  in  this  country  have  got  up  imitations  of  these 
syringes,  and   have   made  them- 


selves liable  for  damages  under 


Fu».  H4. 


the  patent ;  but  they  are  pen-sons 
of  little  or  no  res|)onsibiIity,  and 
I  have  not  as  yet  brought  the 
law  to  bear  u|H)n  tlicin.  Those 
who  pnrehast'  and  use  thost'  imi- 
tations, should  bear  in  mind  ihat 
they  :ire  also  liable  for  damages, 
as  they  lie  in  a  case. 


[Patented  iMxember  6,  1853.] 


Figure  84  represents  these  syringr.i 


Mode  of  rsill^'.  —  The  glass  barrel  and  piston  of  my  instrument.s 
are  delieule,  but  they  need  not  be  broken.  I  handle  them  with  tin? 
t.ame  ease  that  I  do  a  spoon  in  feeding  myself,  and  not  in  a  very  dis- 
similar way.  The  last  three  lingers  are  placed  on  the  under  sitle  of  the 
barrel,  with  the  thumb  on  the  upper  side,  —  the  iiulex  finger  beintj 
poised  over  the  end  of  the  piston,  ready  to  drive  it  home  at  the  proper 
instant.  The  motion  of  the  piston  should  be  quick,  so  as  to  eaus( 
the  streams  to  leap  out  in  jets ;  yet  delicate,  that  they  may  not  im- 
pinge with  too  much  force  upon  the  diseased  surfaces. 

They  should  be  rinsed  with  water  immediately  after  being  used 
But  even  with  this  precaution,  a  small  residuum  of  the  nitrate  re- 
mains and  crystallizes,  and  after  a  time  partially  closes  the  holes. 
They  must  then  be  picked  out  with  the  |K>int  of  a  needle. 

When  the  silver  tube  becomes  detached  from  the  glass,  it  may  be 
fastened  on  with  common  sealing  wax  ;  first  melting  the  wax  and 


DISEASES  OF  THE  THROAT. 


199 


sticking  it  around  the  glass  ;  then  heating  the  silver  over  a  lamp,  and 
pressing  it  on. 

Amount  of  Solution  to  lie  Used.  —  The  amount  of  solution  to  be 
used  should  be  snnali.  Half  a  dram  is  enough.  The  piston  of  the 
syringe  need  b.'  drawn  up  only  from  ^n  eighth  to  a  third  of  an 
inch.  Strangling  is  not  often  produced  by  these  operations ;  but  to 
make  its  prevention  still  more  sure,  let  the  patient  be  directed  to  fill 
the  lungs  with  a  long  inspiration  while  the  operator  is  depressing  tha 
tongue. 

Strenj^h  of  Solution. —  The  strength  of  the  solution  in  ordinary 
cases  of  chronic  folliculitis,  etc.,  should  generally  be  about  forty  grain;i 
of  the  crystals  of  the  nitrate  of  silver  to  the  ounce  of  water.  But 
in  all  acute  diseases  of  the  air  passages,  it  should  be  considerably 
stronger,  —  varying  from  one  to  two  drams.  A  preparation  of  this 
strength  is  powerfully  antiphlogistic  and  sedative.  In  those  cases  of 
chronic  disease,  where  the  intlarnmation  is  of  a  low  grade,  and  the 
mucous  membrane  is  in  a  relaxed,  atonic  condition,  looking  either 
sodden  and  pale,  or  of  a  dark  color,  like  the  cut  surface  of  beef,  some 
days  exposed  to  the  air  (as  is  often  the  case  in  throats  of  liierary  dys- 
peptics), then  a  solution  of  fifteen  to  thirty  grains  to  the  ounce,  is 
sufficient.  This  strength  acts  as  a  stimulant,  and  is  well  suited  to 
throats  in  such  condition,  but  would  be  injurums  in  high  grades  of 
inflammation.  Catarrh  in  the  head  generalln  requires  only  about  this 
strength.  I  am  sorry  to  say,  the  topical  mode  of  treating  throat  a|]<'c- 
tions  has  been  in  some  places  injured,  in  tlie  public  estimation,  by  a 
lack  of  knowledge  and  judgment  on  the  part  of  the  operator,  in  choos- 
ing the  strength  of  his  solution. 

To  determine  the  proper  freqiiencif  of  the  operation^  also  requires 
judgment  and  experience.  In  an  ordinary  case  of  chronic  disease, 
the  treatment  may  begin  by  showering  the  throat  once  a  day  for  a 
week.  Then  the  operation  should  be  repeated  three  times  a  week, 
for  a  shorter  or  longer  period  ;  then  twice  a  week,  and  at  last  once  a 
week. 

Attendant  Diseases.  —  Among  the  persons  I  am  trtniting  for  diseases 
of  the  air  passages,  many  are  dyspeptic  and  suffer  with  drjrression  of 
spirits.  So  often  does  this  symptom  present  itself,  that  I  regard  it  as 
almost  one  of  the  pcujiiirities  of  throat  disease.  Persons  tints  de- 
pressed generally  have  the  dark  and  dingy  look  of  the  face  which 
indicates  functional  derangenient  of  the  liver.  They  are  ot'ten  ema- 
ciated, nervous,  hypochondriacal,  irritable  in  temper,  and  are  ex- 
hausted by  an  excessive  secretion  of  urea.  The  urine  of  such  per- 
sons is  always  acid,  and  loaded  with  crystals  of  oxalate  of  lime. 

An  explanation  of  this  fact  has  been  attempted,  by  supposing  that 
the  oxydation  of  carbon  (of  which  these  persons  have  a  superabun- 
dance), imperfectly  accomplished  in  inflamed  respiratory  organs,  is 
vicariously  effected  in  the  capillaries  of  the  kidneys,  —  oxalic  acid 
(C2.  02.)'instead  of  carbonic  acid  (C.  02.)  being  the  result. 

The  crystals  of  oxalate  of  lime  are  octahedral  in  form,  and,  in  the 
field  of  a  good  microscope,  a,re  beautiful  objects  for  inspection. 


mm 

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]  »ISEASES  OF  THE  THROAT. 


Lawyers,  clergymen,  statesmen,  and,  in  general,  those  who  labor 
hard  mentally,  witn  but  little  bodily  exercise,  and  who  have  a  great 
weight  of  care  resting  on  them,  are  the  persons  who  suffer  most  from 
this  complication.  Generally,  the  inflammation  in  the  throat  is  of  a 
low  grade,  and  must  not  be  treated  with  a  very  strong  solution  of 
nitrate  of  silver. 

Of  course  when  these  attendant  diseases  exist,  something  more  is 
needed  than  the  local  treatment.  For  the  troubles  just  described,  the 
treatment  for  hypochondria  and  dyspepsia  will  be  proper. 

Elongation  of  the  Uvula. 

The  uvula  is  the  small  teat-like  or  pendulous  organ  which  hangs 
down  from  the  palatine  arch,  just  over  tlie  root  of  the  tongue.  It  is 
very  apt  to  get  inflamed,  and  its  parts  becoming  relaxed,  it  stretches 
out  lengthwise,  so  that  its  lower  extrem-  j.,g  gg, 

ity  sometimes  rests  upon  the  tongue. 
(Fig.  85.)  When  this  happens,  it  flaps 
about,  backward  and  forward,  and  to 
the  right  and  left,  —  touching  the  throat 
at  various  points,  and  by  the  tickling 
sensation  produced,  exciting  a  most  in- 
cessant, uncontrollable,  and  racking 
cough.  Some  of  the  most  distressing 
coughs  I  have  ever  heard,  have  been 
produced  and  kept  up  by  this  cause 
alone.  Mmy  a  fatal  consumption  has 
begun  in  this  way.  When  long  in- 
flamed, it  often  gets  much  out  of  shape, 
being  sometimes  bent  nearly  double. 

Treatment.—  In  some  cases,the  uvula, 
thus  elongated,  may  be  reduced  back  to 
its  natural  size,  by  an  astringent  gargle, 
composed  of  an  infusion  of  white-oak 
bark,  with  a  little  alum  dissolved  in  it 
(232) ;  but  it  will  generally  stretch  out 
again  and  again,  upon  the  appearance 
of  any  fresh  cold,  and,  therefore,  the 
only  certain  cure  is  to  cut  it  off. 

To  do  this,  take  hold  of  it  with  a  pair 
of  common  forceps,  and  having  stretched 
it  down  a  little,  clip  it  off  above  the 
forceps,  with  a  pair  of  curved  scissors. 
Nearly  the  whole  of  it  should  generally  be  removed.  To  take  off  a 
part  only,  leaves  a  stump,  which  is  often  mure  objectionable  than  the 
whole  organ.  Its  removal  never  injures  the  speech  in  the  least.  In 
many  cases  of  nasal  catarrh,  this  organ  is  a  sort  of  diseased  centre, 
from  which  the  inflammatory  action  spreads  upward  into  the  nasal 
cavities,  and  no  medicine  or  power  on  earth  can  effect  a  cure  until 
thit)  offending  member  is  snipped  off. 


!  'if 'W 
)■', 


DISEASES  OF  TFP  THROAT. 


201 


Acute  Inflammation  of  the  Tonsils. —  TonsiliHs. 

The  tonsils  are  chiefly  a  collection  or  mass  of  small  mucous  folli- 
cles or  glands.  They  secrete  a  portion  of  the  fluid  which  keeps  the 
throat  moist. 

There  is  a  class  of  persons  who  sufler  about  every  winter,  some- 
times oftener,  with  an  attack  of  acute  inflammation  of  these  glands, 
which  causes  great  suft'ering  for  several  days.  The  trouble  begins 
with  a  slight  soreness  and  swelling  in  these  glands,  which  gradually 
increase  until  the  mouth  can  scarcely  be  opened,  and  the  act  of  swal- 
lowing is  attended  with  indescribable  suffering.  At  length,  in  from 
four  to  ten  days,  an  abscess  forms  and  breaks  in  one  or  both  glands, 
which  produces  immediate  relief. 

Treatment  —  The  inflammation  may  sometimes  be  cut  short  by 
thrusting  a  lancet  into  the  tonsils,  and  bleeding  them  freely,  and  then 
steaming  them  by  the  inhalation,  by  means  of  an  old  teapot,  of  the 
steam  of  mullein  leaves  and  hot  water.  But  the  only  cure  is  to  be 
found  by  cutting  off  the  tonsils,  after  the  inflammation  has  subsided. 
This  will  put  an  end  to  the  attacks  a      nee. 

Tonsils  vrhich  are  subject  to  these  periodical  attacks  of  acute  inflam- 
mation are  always  more  difficult  than  others  to  operate  upon,  as  they 
are  almost  invariably  bound  down  very  tight  to  the  throat,  and  cannot 
be  raised  up  for  convenient  excision. 

Chronic  Inflammation  of  the  Tonsils. 

In  many  of  the  fallicular  diseases  of  the  throat,  these  glands  are 
affected  by  a  chronic  inflammation,  and  are  found  enlarged,  and 
sometimes  very  much  hardened.  In  such  cases  they  secrete  a  thin, 
unhealthy, irritating,  fluid,  which  is  spread  over  the  throat,  increasing 
and  perpetuating  its  disease.  Much  of  this  secretion,  finds  its  way 
into  the  stomach,  and  thence  into  the  circulation. 

In  the  throats  of  many  young  persons  and  children,  these  glands 
are  permanently  so  large,  as  nearly  to  fill  the  fauces.  The  respiration 
of  many  children  thus  afflicted,  is  difficult,  and  when  asleep  they  can 
only  breathe  with  the  mouth  open.  The  defective  breathing  of  such 
children  often  occasions  contraction  of  the  chest,  and  thus  lays  the 
foundation  for  consumption.  From  these  diseased  parts,  the  inflam- 
mation  often  spreads  upwards,  into  the  posterior  nares,  and  many 
times  enters  the  eustachin  tubes,  causing  deafness  or  pain  in  the  ears'. 
Such  children  often  breathe  as  though  they  had  a  bad  cold  in  the  head. 
Their  health  and  safety  require  an  immediate  attention  to  this  state 
of  things. 

Iteatment  —  It  is  customary  to  attempt  to  reduce  enlarged  tonsils 
by  astringent  gargles,  by  repeated  applications  of  a  solution  of  nitrate 
of  silver,  and  by  other  remedies,  and  particularly  by  brushing  them 
over  with  the  tincture  of  iodine.  As  a  general  thing,  these  applica- 
tions are  useless,  ending  in  disappointment.     As  with  the  elongated 


Hi 


I, ;..;;* 


I . 


I' I 


III:::' 


■^\. 


uvula,  the  remedy  is  found  only  in  excision.  Cut  them  off.  The 
throat  seldom  gets  well  until  they  are  removed.  The  speediness  of 
the  recovery  after  the  removal  is  often  surprising. 

Improved  Tonsil  Instrnnieiit  —  For  the  excision  of  these  glands,  I 
found  the  same  lack  of  instruments  as  for  making  topical  applications 
to  the  throat.  The  only  one  which  had  any  c-laims  to  regard,  was 
the  guillotine  instrument.  It  had,  however,  no  facilities  for  drawing 
the  tonsil  forward.  Generally,  all  that  could  be  done  with  it,  was,  to 
trim  the  gland,  which  did  little  good,  for  it  became  again  enlarged. 
I  have  prepared  an  entirely  original  instrument-,  with  which  the  extir- 
pation of  these  glands  is  easy  and  expeditious.  It  has  two  cutting 
blades  in  the  shape  of  crescents,  ria.  86. 

which,      when      open,      leave      a  [Patented  January  1 7,  1854] 

proper  space  for  drawing  the 
tonsil  between  them.  Two  pol- 
ished guards  which  I  formerly 
had  made  of  steel,  but  now  of 
German  silver,  protect  the  upper 
and  the  under  surfaces  of  the 
crescentic  blades,  and  ruiuiing  back,  are  fastened  by  the  common 
rivet,  which  holds  together  the  shanks,  so  that,  when  open,  the  blades 
are  concealed  under  the  guards.  The  tenaculum  rests  upon  the  rivet, 
as  upon  a  fulcrum,  and,  dipping  between  the  blades,  takes  hold  of  the 
tonsil,  and  draws  it  up  for  excision.  Cutting,  as  these  blades  do,  the 
entire  circumference  of  the  gland  first,  and  at  the  same  instant,  and 
the  central  portion  last,  the  operation  can  never  fail.  The  entire  ton- 
sil, even  when  much  hardened,  is  swept  off  with  a  cleanness  and  ease, 
which,  at  the  first  trial,  surprises  the  'operator  not  less  that  the  patient. 
The  pain  of  removing  these  glands  is  so  trifling,  as  scarcely  to  be 
thought  of ;  and  the  piotence  that  evil  consequences  follow  their  re- 
moval, is  the  oflspring  of  great  ignorance  of  the  whole  subject. 

To  operate  easily,  take  the  instrument  in  the  rigiit  or  left  hand,  ac- 
cording to  the  side  to  be  operated  upon ;  take  the  forceps  in  the  other 
hand,  and  running  them  through  the  open  blades,  into  the  mouth  of 
the  patient,  take  firm  hold  of  the  tonsil;  then  slide  the  instrnmeiit 
down  over  the  forceps,  and  lifting  the  gland  up  between  the  bladi's 
cut  it  quickly  off. 

I  am  aware  that  a  few  irregular  practitioners,  who  stand  outside 
the  profession  that  they  may  act  without  responsibility,  have  declared 
that  mischievous  results  follow  this  operation  upon  the  tonsils.  Their 
reasons  for  so  declaring  are  manifest.  They  have  never  performed 
the  operation,  and  have  not  the  skill  to  do  it  if  they  would.  They 
expect,  too,  that  those  nervous  persons  who  dread  the  operation,  will, 
when  told  by  a  physician  that  it  is  necessary,  strive  to  evade  it  by 
seeking  their  advice.  Such  practitioners  are  shrewd,  but  neither 
honest  nor  wise.  Thej  defeat  their  own  purpose  in  the  end.  I  have 
again  and  again  had  patients  leave  me  when  this  operation  was 
urged  upon  them,  and  finally  return  and  submit  to  it,  after  nearly 
losing  their  lives  in  the  hands  of  dishonest  quacks.     A  few  of  these 


practitioners  have  taken  tlie  same  course  in  regard  to  the  use  of  ni- 
trate of  silver,  and  for  similar  reasons. 

Curability  of  Throat  Diseases.  —  I  have  dwelt  somewhat  upon  the 
preceding  forms  of  throat  disease,  not  so  much  because  they  have 
[)cv.n  a  speciality  with  me  for  the  last  ten  years,  as  because  they  pre- 
vail to  a  fearful  extent,  and  are,  in  thousands  of  cases,  but  the  nrst 
stages  of  fatal  disease  of  the  lungs. 

Jf  not  connected  with  lung  dii^ease  in  the  beg-inni  i^,  my  experience 
in  treating  them  enables  me  to  say,  emphatically,  they  are  generally 
curable. 

But  patients  often  put  the  question  to  me,  —  "  If  cured,  will  I  ever 
liave  the  complaint  again  ?"  My  answer  is,  —  "Unless  I  can  plant 
in  your  constitution  a  better  protection  than  your  Maker  put  there  at 
your  creation,  you  will  of  course  be  liable  to  a  second  attack."  But 
then,  where  the  lungs  have  been  entirely  free  from  disease,  I  have 
jiever  yet  seen  a  case  of  simple  throat  complaint  relapse  and  become 
dangerous  after  proper  treatment  with  the  syringes.  Let  not  those, 
therefore,  who  have  been  benefited,  but  not  entirely  cured  by  this 
treatment,  undervalue  what  has  been  done  for  them.  Even  in  such 
cases,  the  advantage  derived  to  them  amounts  to  just  the  value  they 
attacli  to  —  tlie  continuance  of  life. 

Dailj^ers  of  Deliiy.  —  In  closing  these  remarks,  l<!t  me  warn  the 
reader  against  the  dangers  of  delay.  Many  of  those  who  finally  seek 
my  services  in  these  complaints,  first  try  all  nostrums,  and  tamper 
with  their  disease  till  the  case  is  either  critical  or  hopeless.  Too 
many  wait  till  they  are  near  enough  to  the  engulfing  whirlpool  to 
hear  it  roar,  before  they  seek  in  any  practicable  way  to  escape  its 
dangers. 

Scarce  a  day  passes  but  cases  come  into  my  hands  which  at  first 
were  only  a  slight  inllaiinnation  of  the.  pharynx,  and  might  have  been 
cured  in  a  few  days,  but  which,  frgm  loiig  neglect,  has  gradually  crept 
down  the  windpipe,  spread  over  the  widely  distributed  mucous  lining 
of  the  bronchial  tubes,  and  thus  become  curable  only  in  a  partial  de- 
gree, and  after  long  and  tedious  treatment.  Hundreds  of  persons  in 
this  city,  and  thousands  in  New  England,  are  now  suHering  from 
slight  attacks  of  this  sort,  who  might  be  rid  of  the  allliction  in  a  week 
or  a  fortnight,  but  who  will  either  carelessly  give  it  no  attention  at 
all,  or  resort  to  useless  nostrums,  until  it  has  run  through  -its  primary 
stages  and  invaded  the  constitution,  and  will  finally  die  of  some  of 
the  forms  of  pulmonary  disease. 

Cases  Treated. 


In  July,  1852,  Professor 


of  W ,  Mass.,  a  distinguished 


teacher  and  composer  of  music,  called  on  me  to  obtain  relief  from 
laryngitis  and  tracheitis,  from  both  of  which  he  was  suffering,  in  con- 
nection with  bronchial  and  pulmonary  irritation.  A  year  previous  to 
this,  his  health  had  suffered  a  general  break-down  from  these  com- 
plaints.    He  had  soreness  in  the  larynx  and  trachea ;  a  severe  cough 


mj^ 


;»/ 


^h\u 


:a 


204 


DISEASES  OF  THE  THROAT. 


and  large  expectoration ;  he  had  hoarseness,  with  inability  to  sing : 
night  sweats ;  ennaciation  ;  general  debility  and  lowness  of  spirits  ; 
in  short,  the  whole  catalogue  of  symptoms  which  indicate  impending 
bronchial  consumption.  By  advice  of  physicians  and  friends,  he  went 
to  Europe  and  travelled  extensively.  Finding  no  relief,  he  pushed  on 
to  Africa.  On  reaching  Cairo,  his  disease  showed  the  first  abate- 
ment. Remaining  here  a  few  weeks,  he  found  himself,  as  he  thought, 
about  well.  But  on  reaching  Europe,  upon  his  way  home,  his  cougli, 
with  all  his  other  bad  symptoms,  returned,  and  after  a  year's  weary 
search  for  health,  he  came  to  the  wharf  at  Boston  in  about  the  sanu* 
condition  as  when  he  left.  It  was  at  this  moment,  that,  disheartened, 
and  expecting  to  die,  he  picked  up  the  Evening  Traveller,  the  first 
paper  that  met  his  eye,  and  saw  an  article  on  throat  diseases,  whiili 
brought  him  to  my  office.  Fortunately,  before  his  departure  for 
Europe,  Mr. had  bought  a  farm  in  W .  I  gave  him  an  in- 
strument, with  the  proper  medicines  to  inhale,  and  directed  him  to 
work  every  day  on  his  farm,  to  *he  extent  of  his  physical  ability,  and 
to  come  to  me  three  times  a  vN^eek  to  have  the  larynx  and  windpipi' 
showered  with  a  solution  of  nitrate  of  silver.  These  directions,  with 
others  relating  to  his  general  health,  he  followed  to  the  letter.  It  is 
enough  to  say,  that  all  his  bad  symptoms  gradually  subsided,  and 
upon  the  approach  of  the  following  winter  he  found  himself  nearly 
recovered.  In  accordance  with  my  advice,  however,  he  abstained 
from  professional  labor  until  the  following  spring,  since  which  time 
he  has  pursued  his  calling  diligently. 

In  1853,  Mr. ,  a  merchant  of  this  city,  came  to  me  with  two 

enormously  enlarged  and  hardened  tonsils,  with  which  he  had  been 
afllicted  for  a  long  time.  One  of  the-glands  had  been  operated  on  five 
times,  the  other  eleven  times,  by  one  of  our  best  surgeons.  But  the 
old  guillotine  instrument  used  was  not  large  enougii  to  permit  either 
gland  to  be  drawn  into  it,  and  only  small  pieces  could  be  shaved  oH'. 
The  consequence  was,  that  they  were  made  no  smaller  by  the  opera- 
tions ;  and  being  often  cut,  they  were  hardened  by  it,  and  had  taken 
a  very  obstinate  form  of  disease,  so  much  so,  that  the  patient,  though 
naturally  a  strong  man,  was  seriously  threatened  with  pulmonary  dis- 
ease. He  had  travelled  much  during  the  preceding  summer,  but  was 
in  no  way  improved  by  it.  1  had  a  large  instrument  made  expressly 
for  the  purpose,  through  which  the  glands  could  be  easily  drawn,  and 
cut  them  both  through  the  centre,  or  root,  removing  one  half.  A 
solution  of  nitrate  of  silver,  fifty  grains  to  the  ounce,  was  applied  to 
the  throat  three  times  a  week,  for  about  a  Hionth,  at  the  end  of  which 
time,  the  patient  was  dismissed  well,  and  has  remained  so  to  the 
present  time. 

In  February,  1852,  another  merchant  of  this  city,  Mr.  J.  A , 

came  under  treatment  for  a  well-marked  case  of  follicular  disease, 
with  nasal  catarrh  and  bronchitis.  Indeed,  the  lungs  were  on  the 
point  of  becoming  a  prey,  as  a  fine  rattle  was  plainly  distinguishable 
at  the  top  on  both  sides,  and  blood  was  raised  at  various  times. 


DISEASES  OF  THE  THROAT. 


205 


The  uvula  first  being  excised,  the  whole  throat  and  nasal  cavities 
were  showered  from  two  to  three  times  a  weelt,  for  two  or  three 
months,  every  bathing  bringing  away,  during  the  first  part  of  the 
treatment,  enormous  quantities  of  tenacious,  ropy  mucus.  To  this 
treatment,  with  inhalation,  and  constitutional  remedies,  the  disease 
yielded  slowly  but  surely,  and  Mr.  A.  has  a  good  prospect  of  pursuing 
his  profession  in  comfort  to  old  age. 

In  February,  1857,  I  was  inquired  of  respecting  the  pnidcnce  of 
nndertaking  to  get  a  young  niaii  to  Boston  from  one  of  the  northern 
tDwns  of  New  Hanq)shire,  who  was  supposed  to  be  rapidly  sinking 
ill  consum|)tioii.  After  hearing  the  ease  described,  I  decided  it  to  be 
a  safe  undertaking.  Though  fi'('l)l»%  lie  came  safely  in  two  days. 
He  had  the  most  incessant,  tearing,  and  destructive  cough,  I  ever 
heard.  The  moment  I  heard  its  peculiar  sound,  I  susj)ected  the 
source  of  the  trouble ;  f»nd,  seating  hliu  in  a  chair,  I  opened  his 
mouth,  and  found  the  uvula  enlarged  to  a  size,  and  stretched  down  to 
a  length,  which  I  had  never  witnessed  before.  It  was  lying  down 
upon  the  tongue,  as  in  cut  85,  which  is  a  good  representation  of  it. 
Without  giving  him  any  notice,  I  took  tlie  forceps  and  scissors,  and 
cut  it  off,  the  whole  of  it.  I  told  him  to  go  to  his  hotel,  and  come 
to  me  the  next  morning.  lie  entered  my  oilice  the  next  day,  cheer- 
ful and  laughing,  saying  he  had  not  coughed  any  all  night,  and  had 
slept  well,  —  a  thing  he  had  not  done  for  several  months.  In  two 
weeks,  he  could  walk  \\wvi'  miles,  and  I  sent  him  home  well.  But 
for  the  operation,  he  would  have  died  within  six  weeks. 

I  would  l)e  glad  to  add  a  great  number  of  cases  to  the  above ;  but 
these  are  all  for  which  I  have  room. 

A  Gold.— Influenza. 

A  SLIGHT  attack  of  the  disease  about  to  be  described,  affecting  only 
here  and  there  a  person,  and  lasting  only  for  a  few  days,  is  called 
a  cold.  When  it  affects  a  large  part  of  the  community  at  the  same 
time,  lasting  many  days,  or  even  weeks,  it  is  then  an  epidemic,  and 
passes  under  the  name  of  injluema.  In  this  latter  form,  it  sometimes 
spreads  over  a  whole  country,  and  has  at  times,  as  in  1832,  extended 
to  nearly  the  whole  civilized  world.  It  often  shows  marked  severity 
in  its  progress,  and  leaves  serious  results  behind. 

Symiitoins. —  A  tingling,  with  dryness,  and  a  sense  of  fulness  in 
the  mucous  membrane  of  the  nose,  are  among  the  first  indications  of 
an  attack  of  this  complaint.  Sneezing  is  a  common  symptom.  Soon, 
pain  is  felt  in  the  forehead,  and  breathing  through  the  nose  becomes 
difficult.  The  eyes  are  red  and  watery,  the  throat  is  sore  ;  there  is  a 
dry  ecugh,  hoarseness,  thirst,  general  lassitude,  chills,  and  a  desire  to 
get  near  the  fire.  The  mucous  membrane  of  the  nose,  throat,  wind- 
pipe, Rod  breathing  tubes,  is  inflamed,  red,  swollen,  and  sometimes 
painful. 

In  a  ihort  time,  water  begins  to  run  from  the  nose  and  eyes,  and 


'  'M-li 


%'■: 


ill     /■-  ■ 


206 


DISEASES  OF  THE  THROAT. 


the  cough  becomes  a  little  more  moist.  There  is  also  a  slight  (]]»' 
charg«!  from  the  throat  and  tubes,  whitrh  gradually  incn'aseH,  and,  at 
length,  as  the  disease  declines,  and  becomes  less  acute,  th<'  expectora- 
tion is  thick  and  yellow. 

Aching  of  the  back  an<l  limbs,  thirst,  loss  of  appetite,  (lashes  of 
heat,  and  chills  whenever  i\\v.  patient  is  exposed  to  air  a  little  cooler 
than  he  is  accustomed  to,  are  almost  constant  attendants  upon  thu 
disease. 

('lIllMeM. —  It  is  not  always  ea«y  to  say  what  the  causes  of  this  corn- 
plaint  are.  Fre(|nently,  it  can  be  traced  to  an  improper  exposiire  to 
cold  or  dampness;  but  in  a  great  majority  of  cases,  especially  wIkm 
it  takes  the  form  of  influenza,  the  causes  ar<'  not  obvious.  Tlw  y 
probably  exist  in  some  |)eculiar  states  of  the  atmosphere,  and  iu  a 
depression  of  the  nervous  system. 

The  inlluence  npoji  disease  of  the  difTerent  degrees  of  density  in 
the  air  which  surrounds  us,  and  of  other  circumstances  atTccting  it, 
have  not  been  nuich  studied.  Home  valuable  facts  will  be  drawn 
from  this  source  before  mar)y  years.  The  putting  upon  the  body,  or 
taking  from  it,  several  tons  of  pressure  every  time  the  barometer  rises 
or  falls,  must  have,  of  itself,  no  small  iuHuence  upon  its  health.  The 
comparatively  new  science  of  Physical  (Geography,  by  spreading  be- 
fore us  its  interesting  facts  in  regard  to  temperature,  storms,  atmos- 
pneric  currents,  etc.,  is  opening  the  way  for  the  physician  to  learn  a 
great  deal  more  about  the  causes  of  disease  than  he  now  knows. 

Treiltllient. —  In  mild  cases,  only  the  most  simple  treatment  is  re- 
quired,—  such  as  remaining  in  the  house  for  a  few  days,  soaking  the 
leet  in  warm  water,  taking  a  gentle  sweat,  drinking  warm  infusions 
of  flax-seed,  mullein,  slippery  elm,  or  warm  lemonade,  and  taking 
only  a  spare  vegetable  diet.  If  the  bowels  be  costive,  some  gentle 
physic  (34)  (41)  may  bo  used.  A  laxative  drink  (132)  will  likewise 
be  useful. 

When  the  attack  is  more  severe,  sweating  must  be  induced  by  de- 
cisive measures.  This  may  be  effected  by  the  spint  vapor  bath,  or 
by  putting  the  patient  in  bed,  puttinp;  bottles  of  hot  water  to  the  feet 
and  sides,  and  administering  warm  drinks,  and  the  compound  tinc- 
ture of  Virginia  snake  root.  Five  diups  every  hour  of  the  tincture 
of  veratrum  viride,  will  often  cat;.-p  very  free  perspiration,  and  will 
reduce  the  inflammation  upon  the  mucous  surface. 

An  emetic  is  sometimes  very  useful.  To  produce  vomiting,  use 
the  powder  of  ipecac,  ten  to  twenty  grains,  or  the  compound  tincture 
of  lobelia. 

It  soothes  the  inflamed  mucous  surfaces  very  much  to  inhale  the 
vapor  from  half  a  pint  of  hot  water,  with  five  drops  of  tincture  of 
veratrum  viride,  or  the  same  amount  of  the  tincture  of  aconite  root. 

If  the  cough  is  severe,  use  the  preparations  recommended  under 
bronchitis  and  consumption. 

In  the  latter  stages  of  the  disease,  if  there  be  debility,  —  as  there 
generally  is,  —  quinia,  iron,  nux  vomica,  etc.  (75),  should  be  taken ;  or, 
to  support  the  nervous  system,  the  extracts  of  scullcap,  and  boneset, 


■ill 


DISEASES  OF  THE  TllUOAT. 


207 


and  the  sulphate  of  quiiiiu  (81)  will  be  found  useful.     At  this  aiaga 
of  the  complaint,  the  diet  slioukl  lu;  mon^  liberal  and  nourit^hing. 

The  patient  nhould  not  venture  into  the  open  air,  until  the  unpleas- 
ant dense  of  chilliness,  peculiar  to  the  disease,  ceases  to  be  produced 
by  exposure.  • 

Acute  Inflammation  of  the  Epiglottis. 

This  is  the  disease  by  wliich  our  country  lost  its  most  loved  and 
distinguished  citizen,  George  Washington.  This  complaint  was  not 
understood  at  the  time  of  his  dcuith,  —  the  intelligent  pliysieians  who 
tittended  him,  sup|>osing  it  to  be  inilauuiiation  of  th(!  windpipe.  From 
their  very  ch-ar  description  of  the  symptoms,  we  now  know  it  to  have 
been  an  acute  iidlammation  of  the  epiglottis  and  glottis. 

From  the  rapid  inllammation  of  the  e|)iglottis,  water  is  etiused  into 
this  cartilage,  so  as  to  putF  it  up,  and  prevent  it  from  shutting  down 
in  the  a'^t  of  swallowing.  The  iips  of  the  glottis  are  swollen  from  the 
same  cause,  and  brought  so  near  to  each  oth«;r  that  air  passes  through 
to  the  lungs  with  great  dilHculty,  and  unless  relief  is  soon  obtained, 
the  patient  is  strangled. 

SviliptoillS.  —  The  disease  begins  with  a  severe  chill,  accompanied 
with  some  pain,  and  a  sense  of  stricture  or  tightness  in  the  upper 
and  fore  part  of  the  throat.  There  is  cough,  with  ditK(-ult  and  some- 
times painful  swallowing.  These  symptoms  are  soon  followed  by 
quick  and  laborious  breathing.  Speaking  aloiul  is  from  the  first  dilh- 
cult,  and  soon  becomes  impossible.  As  the  complaint  runs  its  rapid 
course,  the  breathing  grows  more  dillicult,  and  death  soon  results 
from  complete  strangulation. 

Treatment. —  Apply  immeiiiately  to  the  parts,  a  strong  solution  of 
nitrate  of  silver.  The  solution  should  be  of  the  strength  of  jiinety 
to  one  hundred  and  twenty  grains  to  the  ounce  of  soft  water.  It 
should  be  applied  every  hour  or  two  till  the  feeling  of  suffocation  sub- 
sides, and  should  be  done  with  the  laryngeal  shower  syringe,  though 
if  this  is  not  at  hand,  the  sponge  probang  may  be  used. 

While  this  local  treatment  is  being  employed,  liberal  dosci*,  from 
five  to  twenty  drops  of  tincture  of  veratrum  viride  should  be  given 
every  hour,  watching  the  efTect,  and  discontinuing  when  the  pulse 
sinks  too  low. 

Hot  fomentations  applied  externally,  and  filling  the  room  with 
iteam,  as  recommended  in  cases  of  croup,  would  be  useful. 


■    lis:' 


'Hk' 


■    t 


Mumps. — Parotitis. 

This  disease  appears  most  often  among  children ;  but  as  it  is  not 
confined  to  them,  I  have  not  placed  it  among  their  complaints. 

Symptoms.  —  It  begins  with  soreness  and  stiffness  in  the  side  of  the 
neck.  Soon  a  swelling  of  the  parotid  gland  takes  place,  which  is 
painful,  and  continues  to  increase  for  four  or  five  days,  sometimes 


hh^" 


]!  1  1 


208 


DISEASES  OF  THE  THROAT. 


becoming  very  large,  and  making  it  difficult  to  swallow,  or  open  the 
mouth  to  receive  food.  After  the  fourth  or  fifth  day  the  swelling 
subsides,  and  disappears  in  from  seven  to  ten  days. 

Both  glands  generally  swell  about  the  same  time,  but  sometimes 
the  swelling  appears  in  one  only  after  it  has  subsided  in  the  other, 
and  occasionally  the  swelling  is  wholly  confined  to  one  side. 

When  the  swelling  is  great,  there  is  heat,  and  sometimes  fp.ver,  with 
dry  skin,  quick  pulse,  furred  tongue,  constipated  bowels,  and  sc«»nty 
and  high-colored  urine. 

The  affection  is  sometimes  translated,  as  we  say ;  that  is,  in  fe- 
males, the  breasts  swell,  and  in  males,  the  testicles  become  swollen 
and  painful.  This  accident  generally  happens  in  consequence  of  tak- 
ing cold  from  some  imprudence. 

The  disease  is  contagious ;  that  is,  it  Is  communicated  from  one 
person  to  another. 

Treatment. —  In  mild  cases,  very  little  treatment  is  required.  Keep- 
ing the  face  and  neck  warm,  avoiding  exposure  to  cold  and  damp, 
drinking  warm  iiifusions  of  balm,  spearmint,  or  sage,  and  taking  oc- 
casionally, if  there  be  some  severity  of  symptoms,  four  to  six  grains 
of  Dover's  powder ;  or  the  compound  powder  of  jalap,  if  there  be 
costiveness,  is  about  all  that  is  required.  The  diet  should  consist  of 
rye  hasty  pudding,  or  brown  bread  and  sweetened  water. 

If  the  case  be  severe,  and  other  glands  swell,  physic  must  bs  freely 
used,  leeches  must  bo  applied,  and  cooling  lotions,  or  poultices. 
Sweating  must  also  be  induced  by  the  compound  tinctxue  of  Ver- 
giuia  snake  root,  or  by  '.  vapor  bath. 


-^ 


i 


uit*"'^ 


DISEASED   OF  THE   CHEST. 


Consnmption. — Phthisis. 

At  the  head  of  the  diseases  of  our  climate  stands  Consumption,- 
^t  their  head  both  as  it  respects  prevalence  and  fatality.  Small  pox,, 
yellow  fever,  and  cholera,  are  terrible  in  their  visitations ;  but  what 
are  all  their  aggregated  slaughters  compared  with  the  ct>aseless,  silent 
iiijiich  of  this  fell  disease,  which  steals  away  in  their  fresh  prime  the 
briglitest  and  the  best? 

Boston,  from  it;*  population  of  160,000,  loses  by  consumption  about 
iit'teen  per  wcu'k,  sixty-live  per  month,  or  about  seven  hundred  and 
eighty  [)er  annum.  An  equal  mortality  from  any  disease  not  often 
among  us,  would  send  our  citizens  in  terror  to  the  country,  and  cause 
the  stoutest  hearts  'o  feet  that  "  in  the  midst  of  life  we  are  in  death." 
Massachusetts  loses  about  6000  per  ammm  ;  New  England,  not  less 
than  20,000  ;  and  with  the  St.ite  of  New  Yovk  added,  the  victims  of 
this  single  disease  swell  to  40,000  a  year!  What  an  army!  Picked 
from  the  choicest!  All  sundered  from  l.fe  untimely,  and  leaving 
more  blight  and  sorrow  behind  than  would  perhaps  twice  or  thrice 
the  number  whom  any  other  pestilence  would  have  selected.  The 
magnitude  of  the  evil  places  the  question  of  the  remedy  before  all 
others  that  pertain  to  the  healing  art. 

nethodH  of  Exaniiiiiiiji:  the  Chest.  —  Before  speaking  further  of  con- 
snmption, I  propose  to  do  what  has  never  been  done,  namely,  to 
instruct  the  general  reader,  very  briefly,  in  the  method  of  examining 
the  chest  to  learn  ihe  existence  of  disease.  Perhaps  this  will  bo  a)n- 
sidered  a  departure,  in  some  slight  degree,  from  my  purpose  to  make 
this  entire  book  intelligibl':  co  the  general  reader.  If  so,  my  reply  is, 
that  there  are  tnani/  H.-iiool  teachers,  mechanics,  masters  of  vessels, 
and  farmers,  who  h^vre  inquiring  minds,  and  sagacity  enough  to  learn 
the  physical  signs  of  chest  disease,  and  to  make  them,  in  many  cases, 
practically  useful ;  and  that  even  readers  of  little  reflection  cannot 
fail  to  comprehend  a  |)ortion  of  my  explanations. 

Position  of  the  Ptitient. —  In  performing  percussion  upon  the  front 
of  the  chest,  the  patient  should  be  required  to  sit  in  a  square  position, 
with  thb  arms  hooked  over  the  corners  of  the  back  of  the  chair,  and 
the  head  thrown  a  little  back. 

27 


ill'' 


yi:    '■■  j  iS' 


:'.-■.  i.3 


'    I 


210 


DISEASES  OF  THE  CHEST. 


1 


Instrnment  with  which  to  Tlmmp.  —  The  index  and  middle  fingera 
of  the  right  hand  are  to  be  brought  together,  into  a  line,  and  used  as 
the  percussing  instrument.  The  blow  given  with  these  is  to  be  smart 
and  quick,  rather  than  heavy. 

Medium  to  Tliunip  Upon.  —  Either  the  index  or  middle  finger  of 
the  left  hand  is  to  be  pressed  firmly  upon  the  surface  of  the  chest  to 
be  percussed  or  struck,  and  thus  used  as  a  plcximitcr. 

Aiisciilttitioil.  —  Listening  for  the  purpose  of  hearing  within  the 
chest  the  sounds  produced  by  breathing,  talking,  coughing,  etc.,  is 
called  auscultation. 

liistniineiits  witli  which  to  Listen.  —  The  naked  ear  is  generally 
considered  best  for  hearing  low  and  delicate  sounds  ;  but  for  hearin^^ 
loud  and  rough  ones,  it  is  not  so  good  as  the  stethoscope,  repre- 
sented by  Fig.  87.  A.  still  better  instrument  is  the  double-eared  steth- 
oscope. Fig.  88.  It  magnifies  the  sounds  very  much,  and  is  apt  to 
confuse  an  examiner  not  accustomed  to  it;  but  wiieii  the  ear  is  onc«^ 
familiar  with  it,  the  aid  it  affords  is  very  valuable. 


Fiu.  87. 


Fio.  88. 


The  examiner  should  pass  from  side  to  side,  continually  compann'^ 
the  sounds  upon  one  side,  with  those  upon  tlic  other. 

The  patient  mui^t  be  calm,  and  the  exaniiner  in  no  hurry. 

Healtliy  Sounds.  —  To  become  skilful  either  in  percussion  or  aus- 
cultation, the  examiner's  ear  must  first  be  trained  to  healthy  sound.s. 

These  are  best  heard  in  the  child,  in  whom  they  are  louder  than  in 
the  adult. 

In  describing  the  healthy  sound?  in  the  different  regions  of  the 
chest,  I  shall  ref(!r  the  reader  constantly  to  Figs.  89  and  90. 

Clavicular  Region. —  This,  in  Fig.  89,  is  represented  by  1, 1.  Upon 
thumping  upon  the  collar-bones,  the  sound  given  out  at  th'^  breast- 
bone end  should  be  very  clear ;  less  clear  in  the  middle  ;  and  dull  at 
the  shoulder  end. 


DISEASES  OF  THE  CHEST. 


211 


SnlK'Invinn  Rp<cion.  —  This  is  ropros«Mif(Hl  by  2, 12,  and  lies  botworn 
Ihc  collar-hone  and  the  fonrtli  rih,  on  both  sidrs.  It  covers  a  eonsid- 
erable  j)ortion  of  the  upper  lobe  of  the  lungs.  The  sound  upon  strik- 
ing this  space  should  be  very  dear. 

Vio.  so.  Fio.  90 


The  Manininrr  Re<rion,  represented  by  3,  3,  extends  from  the  fourth 
to  the  seventh  rib,  on  each  side.  In  tiie  upper  part  of  this  region,  the 
healthy  sound  is  clear ;  but  at  the  bottom  of  it,  on  the  right,  the 
sound  is  deadened  by  the  liver ;  on  the  left,  by  the  heart. 

Tlie  Infra-Mammary  Reji^ion,  4,  4,  lies  between  the  seventh  rib  and 
the  edge  of  the  cartilages  of  the  false  ribs.  On  the  right  side,  the 
liver  makes  the  sound  dull ;  but  under  the  left  side  lies  the  stomach, 
w>  r!;  is  hollow,  and  the  sound  is  generally  quite  loud. 

iu.  *v?e  ^'Jtcriial  Rejrioii,  5,  fi,  7,  which  covers  the  breast-bone,  the 
:'<".!     I  i    jiMieniliy  clear. 

The  i  ?uury  Ut^.ioii,  8,  8,  is  in  the  arm-pits.  In  this  the  sound 
should  Ix'  clear. 

,    Tlie  Latenil  Region,  9,   ■»    is  immediately   bel«  w   the   al)ove,  and 
jields,  likewise,  a  clear  soun-i.  #' 

Tlie  Lower  Lateral  RejrhHi,  gives  a  dull  sound  on  tl«'  righ't  side,  and 
on  the  left  a  very  hollow  one. 
Fig.  90  represents  the  back  pr.rt  of  the  chest     In  l(H>king  at  this, 
' ree  the 

^js  iri'i;)!  Re|(ion,  represented  by  11,  11.  In  this  space  the  sound 
).  V  jU,  but  it  has  not  much  meaning.  » 

Th«»  Scapular  Region,  12, 12,  covers  the  part  occupied  by  the  shoul- 
der-blades.    It  gives  rather  a  dead  sound. 


:i.,. 


;■  !  1 


i 


ft 


m 


0 


The  Intra-Scapular  Rei^ion,  13, 13,  lies  between  the  shoulder-blades, 
on  each  side  of  the  back  bone.  If  the  patient's  arms  are  crossed,  and 
the  head  bent  forward,  a  clear  sound  will  be  obtained. 

The  Dorsal  Region,  14,  14,  covers  the  base  of  the  lungs,  and,  in 
health,  gives  a  clear  sound. 

Observation.  —  If,  now,  on  thumping  upon  the  chest,  we  find  a  dull, 
dead  sound  in  any  spot  where  a  clear  one  ought  to  be  yielded,  we  ara 
to  conclude  that  underneath  there  is  not  the  usual  quantity  of  air; 
but  we  cannot  tell  merely  by  percussing,  whether  tubercles  are  depos- 
ited there,  or  the  lung  has  become  solid  by  inflammation,  or  water 
<ias  been  poured  out  into  the  cavity  of  the  pleura.  This  point  must 
be  determined  by  auscultation,  etc.,  to  be  explained  gradually  as  we 
go  along. 

Auscultiitit  if  Breathing;. —  On  applying  the  ear  or  the  stetho- 
scope to  the  c.t  :o  sounds  are  heard  which  immediately  succeed 
each  other,  —  the  iler  is  produced  by  the  ingoing  breath,  or  inspira- 
tion; the  weaker  b^  the  outgoing  breath,  or  expiration.  These  sounds 
will  be  further  explained  as  we  go  along. 

Auscultation  of  the  Voice  and  Coui^h.  —  The  chest  of  a  healthy  per- 
son speaking,  communicates  to  the  ear  no  distinct  sound,  but  only 
a  vibratory  sensation,  called,  in  technical  language,  the  pectoral  fre- 
milus. 

Over  the  larynx  and  windpipe,  the  examiner  may  hear  natural  pec- 
torilocjuy;  between  the  shoulder  blades,  in  the  space  corresponding  to 
the  roots  of  the  lungs,  natural  bronchophony. 

Philosophy  of  Cliest  Sounds.  —  The  fulness  and  clearness  of  sound 
upon  percussion,  depends  upon  the  amount  of  air  in  the  chest. 

The  sounds  called  breathing  murmurs,  are  caused  by  the  expansion 
and  contraction  of  the  lir-cells  or  vesicles,  as  the  air  passes  in  and 
out ;  hence  they  are  called  vesicular  murmurs. 

The  friction  of  the  air  against  the  sides  of  the  windpipe  and  large 
bronchial  tubes,  causes  the  blowing  sound  heard  in  those  parts. 

In  children  a  larger  amount  of  air  enters  the  lungs,  and  the  air  vesi- 
cles are  expanded  with  more  force ;  hence  their  breathing  has  a  louder 
Bound,  which  is  called  puerile  respiration.  This  kind  of  breathing, 
heard  in  the  grown  person,  is  a  sign  of  disease. 

The  lung  tissue  is  a  bad  conductor  of  sound  ;  and  the  voice  is  ac- 
cordingly heard  only  over  those  parts  where  large  bronchial  tubes  are 
near  the  surface  ;  heard  elsewhere,  it  indicates  disease. 

Division  of  Consumption.  —  Consumption  may  be  divided  into  two 
kinds,  he  tubercular  and  the  bronchial.  The  former  has  a  constitu- 
tional, the  latter  a  local  origin. 

First  Stage  of  Tubercular  Consumption. 

Physical  Sig^ns.  —  Dulness  of  sound  on  and  under  the  collar-bones. 
Inspiration  shortened ;  expiration  augmented  both  in  duration  and 
intensity. 


Occasionally  a  pulmonary,  crumpling  sound.  Dry,  crackling  rat- 
tles. 

The  resounding  of  the  voice  increased  at  the  top  of  the  lungs. 

General  Symptoms.  —  A  sense  of  weariness  and  languor. 

Occasionally,  slight,  flying  pains  about  the  chest  and  shoulders. 

A  peculiar  sensitiveness  to  the  effects  of  cold. 

Breathlessness  on  moving  quick,  or  ascending  a  hill  or  stairs. 

In  many  cases  a  blue  lividity  of  the  lips,  and  roots  of  the  finger 
nails,  and  coldness  of  the  hands  and  feet. 

Occasionally,  in  females,  even  at  this  early  stage,  a  cessation  of  the 
monthly  turns. 

Observations.  —  The  formation  of  tubercles  almost  always  begins 
at  the  top  of  the  lungs.  Lpennec  and  others  thought  they  appeared 
oftenest  on  the  rifflU  siue  first ;  Louis,  Andral  Watson,  Sir  James 
Clarke,  and  others,  believed  they  appeared  more  often  on  the  left  side. 
Recent  investigations  show  that  they  were  all  mistaken.  Tubercles 
appear  first  about  as  often  upon  one  side  as  upon  the  other. 

The  pulmonary  crumpling  sound  is  caused  by  a  mechanical  ob- 
struction to  the  expansion  of  the  lungs.  It  is  generally  heard  only 
during  the  drawing  in  of  the  breath.  The  sound  is  like  that  pro- 
duced by  blowing  upon  very  fine  paper. 

Second  Stage. 

Physical  Si<j;iis.  —  Marred  dulness  of  sound  on  the  collar  bones,  and 
extending  below  them. 

Inspiratory  murmur  diminished  \\\  duration  and  intensity ;  expira- 
tory murmur  auif'mented  in  both. 

In  upper  lobes  of  lungs,  moist,  crackling  ratti  s,  succeeded  by  mu- 
cous rattles.     Also  bronchial  respiration. 

In  lower  lobes  of  lungs,  jjuerile  respiration. 

Sounds  of  the  heart  lu-ard  under  the  collar  bones. 

Bronchophony  heard  in  the  same  parts  as  bronchial  respiration. 

General  Syni]>tonis.  —  A  quickened  |)ulse ;  slight  fever  towards 
evening. 

Great  susceptibility  to  the  effects  of  cold,  and  liability  to  take  cold 
easily. 

Bowels  generally  costive. 

The  eye  Ikis  a  peculiar  whiteness  and  lustre. 

The  skin  and  mouth  become  dry  in  the  afternoon  ;  chills  occur 
about  midday,  followed  by  fever,  during  which  the  cheeks  are  Hushed. 

As  the  second  stage  advances  to  its  c'ose,  a  dry,  burning  heat 
afflicts  the  palms  of  the  hands  and  soles  of  the  /net. 

Night-sweats  occur  at  this  time. 

Oltservations.  —  A  hollow,  elastic  body,  containing  air,  gives,  when 
struck,  a  clear  sound.  The  dulness  of  sound  on  percussing  the  chest, 
arises  from  the  absence  of  air  in  the  air-cells,  —  these  having  been 
pressed  together,  or  obliterated  by  the  deposit  of  a  mass  of  tubercles. 


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The  destruction  of  these  cella  causes  the  cessation  of  the  respiratory 
murmur. 

Thio  dtage  of  the  disease  is  often  accompanied  by  an  inflammation 
of  the  mucous  membrane  lining  the  air  tubes.  The  air,  pushing  its 
way  through  the  mucous  secretions  in  these  tubes,  forms  bubbles,  the 
bursting  of  which  causes  the  rattle.  The  crepitant  rattle  is  produced 
by  inflammation  around  the  tubercles.  The  moist,  crackling  rattle  is 
caused  by  the  softening  of  the  tubercles. 

The  lungs,  rendered  more  solid  by  the  deposit  of  tubercles,  become 
better  conductors  of  sound  ;  and  this  causes  the  beating  of  the  heart 
to  be  iieard  as  far  off"  as  under  the  collar  bones. 

Bronchial  respiration  gives  the  idea  of  air  blown  through  a  tube  ; 
cavernous  respiration,  of  air  passing  into  a  large  enclosed  cavity. 

Third  Stage. 

Physical  Sij^iis.  —  In  this  stage  cavities  are  formed.     If  the  cavities' 
be   small,   and  considerable   tuberculated  lung  surrounds   them,  tho 
sound,  upon  percussion,  is  still  dull. 

If  the  cavity  be  large,  and  near  the  surface,  there  is  occasionally  a 
tympanitic  sound. 

Sometimes  a  sound  is  heard  like  striking  a  cracked  pot. 

Cjurgling;  cavernous  rattle;  cavernous  breathing;  aiii|)lioric  breath- 
ing; now  and  then,  metulic  tinkling;  pectoriloquy;  cavernous  cough. 

Geiienil  8yiliptoillS.  —  Great  loss  of  flesh,  and  weakness:  diarrh'ca 
and  night-sweats;  swelling  of  the  feet  and  legs;  sore  iiiondi;  and  rais- 
ing of  matter  with  specks  of  tubercle  in  it  like,  crumbs  of  cheese. 

Observatiuiis. —  The  gurgling  rattle  is  caused  by  air  displacing 
liquids,  and  the  forrMition  and  burstiiig  of  bubbles.  It  resembles  the 
sound  produced  by  l)l()wing  through  a  tube  immersed  in  soivp-suds. 

Cavernous  breathing  is  nothing  more  nor  less  than  tli'j  sound  pro- 
duced by  air,  breatlu-d  in  and  out,  entering  and  retiring  from  a  cavity. 
The  air  appears,  soinelinies,  to  one  listening  with  the  stethoscope,  as 
if  it  were  sucked  into  his  ear  during  inspiration,  and  blown  back 
again  during  expiration. 

Amphoric  respiration  is  simply  an  aii^metUalion  of  cavernous 
breathing,  and  results,  of  course,  from  an  increase  of  size  in  the 
cavity. 

In  pectoriloquy,  words  uttered  by  the  patient,  seem  to  pass  through 
the  stethoscope,  into  the  ear  of  the  listener.  The  cavity  should  be 
empty,  moderate  in  size,  and  have  dense  walls,  in  order  to  furnish 
the  best  specimen  of  this  sound. 

Air  suddenly  driven  backward  through  the  windpipe,  and  out  of  the 
mouth  and  nose,  by  smart  raps  upon  the  chest  over  a  cavity,  gives 
the  sound  of  the  cracked  pot.  It  is  best  heard  when  the  patient's 
mouth  is  partly  open.  The  same  sound  is  produced,  on  the  same 
principle,  by  locking  the  fingers  of  the  two  hands,  and  joining  the 
palms,  so  as  to  leave  a  small  space  or  cavity  between  them,  and  then 
expelling  the  air  from  that  cavity,  by  gently  striking  the  back  of  one 
hand  upon  the  knee. 


AlV'li^Si 


DISEASES  OF  THE  CHEST. 


215 


Causes  of  Consnmptioii.  —  Tlie  human  constitution  as  shown  by 
Liebig,  in  his  profound  work  on  Animal  Chemistry,  is  governed  by 
two  forces,  the  nervous  and  the  vegetative.  The  former  disposes  the 
particles  composing  the  body  to  a  state  of  motion  ;  the  latter  inclines 
them  to  a  position  of  rest. 

In  vegetative  life  there  is  motion  in  one  direction  only,  so  to  speak; 
that  is,  motion  which  tends  to  the  opposite  of  motion,  namely,  rest 
In  vegetables,  whose  life  is  wholly  under  this  power,  there  is  no  waste; 
for  here,  all  ultimate  particles,  having  once  taken  a  place  of  rest, 
remain  undisturbed.  In  a  tree,  a  layer  of  matter  once  deposited, 
always  remains.  Hence  there  is  g-roioth  as  long  as  the  tree  lives 
There  is  no  power  to  break  up  and  destroy. 

But  in  the  animal  body  there  is  motion  in  two  directions,  or  a 
circuit  of  motion.  Particles  which  under  the  vegetative  force  have 
been  put  to  resit,  are  perpetually  being  displaced  by  the  nervous  energy, 
and.  reduced  to  unorganized  amorphous  compounds,  to  be  burned  in 
warming  the  system,  or  cast  out  by  the  several  exi-rctory  processes. 

So  constant  is  the  action  of  these  two  forces,  that  John  Hunter 
compared  the  human  system  to  a  whirlpool,  into  which  the  particles 
of  matter  are  perpetually  poured,  under  the  influence  of  the  vegeta- 
tive power,  ami  out  of  which  they  are  as  constantly  whirled  by  the 
nervous  force. 

By  a  little  reflection  upon  tliese  antagonisms,  the  reader  will  see 
tliat  it  is  just  when  the  vegetative  force  transcends  the  nervous,  that 
the  body  increases  in  weight,  and  acquires  that  state  in  which  the 
blood  corpuscles  abound,  and  the  tendency,  if  to  disease  at  all,  is  to 
that  of  the  inflammatory  kind.  It  is  th'^  tonic  condition  of  the  sys- 
lom.  Nutrition  is  more  rapid  than  destruction.  New  particles  are 
laid  down  faster  than  old  ones  are  taken  up.     The  body  g-rows. 

On  the  other  hand,  when  the  nervous  force  overmasters  the  veg(^ta- 
tive,  when  the  outward  or  centrifugal  motion  of  the  whirlpool  prevails, 
then  it  is  that  the  bodv  is  attenuated,  the  blood  thinned  and  made 
serous,  and  the  consumptive  or  atonic  condition  is  established.  Noin^ 
there  is  too  uuieh  motion.  The  nutritive  particles,  instead  of  tending 
to  a  state  of  deposit  for  the  re-sni)piy  of  waste  matter,  become  fugi- 
tive in  their  habits,  perpetually  fleeing,  like  convicts  escaped  from 
prison.  Introduce  this  power,  in  excess,  into  \\w  vegetable  kingdom, 
and  the  matter  deposited  upon  the  tree,  instead  of  remainitig  to  swell 
its  bulk,  would  be  driven  otl"  by  the  nervous  force  ;  and  the  tree,  in- 
stead of  growing,  would  be  aiumally  lessened,  become  sickly,  and  die 
of  consumption. 

In  Tubercular  Consumption,  the  system  is  like  a  field  deluged  with 
a  flood :  nothing  can  take  root.  The  repeated  shocks  of  the  nervous 
battery  sent  to  the  absorbents  so  quicken  them  in  their  work  of  re- 
moving waste  matter,  that  they  dislodge  much  which  is  not  yet  worn 
out,  and  a?sist  in  casting  out  of  the  system  not  a  little  designed  to  be 
used  in  its  renewal.  A  healthy  deposit  is  thus  prevented,  and  nutri- 
tion is  at  an  end.  The  nutritive  arteries,  those  little  builders  of  the 
human  frame,  are  overmastered  by  the  stimulated  lymphatics ;  the 
constructive  material  is  wrested  from  them,  and  borne  beyond  their 


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216 


DISEASES  OF  THE  CHEST. 


reach,  and  the  body  wastes  from  want  of  nourishment.  The  blood 
becomes  thin  and  watery;  and  from, the  increased  serous  portion, 
chiefly  albumen,  are  depoited  upon  the  lungs  and  other  tissues  the 
albuminous  tumors  called  tubercles. 

Here  is  found  the  cause  of  that  peculiar  smallness  of  bone  and 
muscle,  and  thinness  and  tallness  of  person,  so  peculiar  to  consump- 
tives. The  absorbents,  under  the  power  of  a  very  active  nervous 
system,  take  down  "the  house  we  live  in"  faster  than  the  nutritive 
arteries,  confused  by  the  motion  around  them,  can  effect  its  recon- 
struction. It  is  simply  an  unbalancing  of  the  antagonistic  forces, 
which  build  and  pull  down  our  earthly  tenement.  The  men  that  de- 
molish  are  more  numerous  and  better  fed  than  the  artisan  builders. 

It  is  this  destructively  nervous  force  which  gives  to  consumptive 
persons  their  proverbial  mental  activity ;  which  causes  them  often  to 
dazzle  the  world  with  the  splendor  of  their  gifts,  and  to  bless  their 
friends  with  the  warmth  of  their  affections.  They  are  usually  the 
choice  spirits,  the  idols  of  their  relatives,  and  the  favorites  of  the  com- 
munity in  which  they  live.  Their  mental  movements,  and  the  exer- 
cise of  their  affections,  are  characterized  by  brilliancy  and  warmth. 
Of  all  persons,  they  are  best  fitted  to  enjoy  life,  and  tx>  impart  happi- 
ness. Loving  all,  they  are  by  all  loved  in  return.  They  are  speci- 
mens of  partially  etherealized  humanity,  stepping  lightly  across  the 
earth,  to  whom  friends  passionately  stretch  out  their  arms,  and  em- 
brace —  their  shadows ! 

These  views  will  appear  the  more  reasonable,  if  we  consider  that 
in  children  the  vegetative  power  is  very  active,  while  the  nervous- 
energy  is  comparatively  weak.  The  preponderance  of  the  former 
over  the  latter  causes  the  rapid  growth  of  children.  The  little  arterial 
builders  work  faster  than  the  lymphatic  demolisiaers.  This  explains 
why  so  few  children  die  of  consumption. 

But  from  the  age  of  seventeen  to  thirty-five,  when  the  vegetative 
power  is  losing  something  of  its  extraordinary  activity,  and  the  nerv- 
ous force  is  showing  its  highest  capabilities,  —  then  it  is,  as  this 
theory  indicates,  that  tubercular  consumption  does  its  dreadful  work, 
—  then,  that. the  outward  whirl  of  this  physiological  Maelstrom  casts 
upon  the  shores  of  mortality  so  many  thinned,  tjxhausted,  and  lifeless 
human  forms.  More  than  three  fourths  of  all  wlio  sink  under  this 
disorder  die  between  the  ages  just  named.  The  brain,  between  these 
points  of  time,  acquires  its  full  size  and  force. 

This  disease  prevails  most,  too,  in  those  countries  where  an  enlight- 
ened civilization  gives  to  the  nervous  system  its  fullest  development, 
as  in  Great  Britain,  France,  and  the  United  States,  and  in  those 
where  the  nutritive  process  is  most  retarded  by  a  relaxing  climate ; 
and  it  is  carcely  known  among  those  people  who  are  but  little  en- 
lightened and  have  small  brains,  and  among  those  who  live  in  high 
and  invigorating  latitudes.  As  the  most  enlightened,  however,  are 
generally  found  in  temperate  climates,  and  those  with  the  least  culti- 
vated brains  in  low  latitudes,  the  rule  is  not  perfectly  explained  by 
facts ;  yet  it  shows  itself  sufHciently  to  establish  its  validity,  and  to 
afford  another  proof  of  my  theory. 


blood 
ortion, 
ea  the 

le  and 
laump- 
ervous 
itritive 

recon- 
forces, 
hat  de- 
lers. 
mptive 
>ften  to 
53  their 
illy  the 
le  com- 
ic exer- 
varmth. 

happi- 
e  speci- 
•oss  the 
ind  em- 

jer  that 

nervous 

former 

arterial 

explains 

getative 
le  nerv- 
as  this 
ul  work, 
3m  casts 
i  lifeless 
uler  this 
en  these 

enlight- 
lopment, 
in  those 
climate ; 
little  en- 
e  in  high 
ever,  are 
ast  culti- 
ained  by 
y,  and  to 


DISEASES  OF  THE  CHEST. 


217 


Bronchial  Gonsumption. 

The  persons  exposed  to  bronchial  consumption  are  generally  of  an 
opposite  habit  to  those  described  above,  —  having  the  nervous  force, 
in  health,  well  subordinated  to  the  vegetative,  the  assimilation  good, 
and  the  blood  well  supplied  with  red  globules.  They  have  usually  a 
full  habit  and  an  active  circulation.  The  absorbents,  and  other  ves- 
sels in  the  lungs,  working  in  the  midst  of  a  large  amount  of  caloric 
evolved  by  an  energetic  respiration,  often  take  cold,  which  brings  on 
lung  fever  and  pleurisy,  and  these  lay  the  foundation  for  the  ultimate 
destruction  of  the  lungs.  For  the  same  reason,  the  skin  of  this  class 
of  persons  becomes  diseased,  and  more  often  the  inner  skin,  or  mu- 
cous membrane,  and  most  often  that  portion  of  mucous  membrane 
which  goes  down  into  the  lungs  and  lines  the  air  tubes.  It  is  inflam- 
mation of  this  which  constitutes  bronchitis,  and  which  lays  the  foun- 
dation for  true  bronchial  consumption. 

As  that  class  of  persons  who  are  exposed  to  the  tubercular  form  of 
the  diseijse  suffer  a  general  loss  of  carburetted  hydrogen  in  its  several 
forms,  colliquative  diarrhoea,  sweats,  increased  breathing,  and  all  con- 
ditions that  carry  fat  out  of  the  system,  so  those  who  sufler  from 
attacks  of  the  bronchial  type  of  the  disorder  are  generally  afflicted 
with  the  opposite  condition.     They  have  too  much  carbon. 

It  is  well  ascertained  that  carburetted  hydrogen,  accumulated  in 
the  system,  acto  as  a  poison.  And  that  class  of  bilious  persons  who 
are  subject  to  this  disease  often  have  their  excretions  badly  performed. 
For  this  reason,  carbonaceous  compounds  accumulate  in  the  system, 
and  give  rise  to  the  symptoms  of  morbid  poison  circulating  in  the 
blood.  This  led  Dr.  Madden  to  suspect  the  presence  of  such  poison 
in  the  blood  of  all  consumptive  persons.  He  saw  the  evidence  of  it 
in  numerous  cases,  and  not  distinguishing  the  one  class  from  the 
other,  he  inferred  its  presence  in  all. 

Constitutional  Difference. 

Thk  constitutional  dllFerence  between  the  two  forms  of  consumf)- 
tion  appears  to  be  this :  the  tubercular  type  is  usually  attended,  in  its 
origin,  by  a  tolerably  good  state  of  the  digestive  function,  in  connec- 
tion with  bad  assimilation  ;  while  the  bronchial  form  generally  has 
its  foundation  laid  in  coimection  with  bad  digestion,  accom|)ani(.'d 
with  healthful  assimilation.  In  the  former  case,  the  food  is  well  di- 
gested, the  pabulum  is  properly  prepared,  but  the  nutritive  arteries  do 
not  use  it  for  renewing  the  tissues.  In  the  latter  case,  the  digestion 
is  bad,  the  pabulum  poorly  elaborated ;  but  the  re-constructive  vessels, 
under  the  control  of  a  well-developed  system  of  organic  nerves,  use 
it  to  the  best  advantage.  In  the  one  case  there  are  good  hnck-makcrs, 
and  lazy  hxxck-hiyers ;  in  the  other,  the  reverse. 

It  happens,  however,  that  before  the  fatal  close  of  the  disease,  tu- 
bercular patients  usually  become  afflicted,  more  or  less,  with  bad 
digestion,  and  bronchial  patients  with  defective  assimilation ;  so  that, 


1^ 


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218 


DISEASES  OF  THE  CHEST. 


in  the  end,  they  present  us  with  much  the  same  class  of  symptoms. 
Starting  from  opposite  poles  in  life's  celestial  sphere,  they  meet  at 
the  culfninating  point  of  death,  and  disappear  under  identical  aspects 
of  the  heavens. 


Exciting  Causes  of  Tubercular  Consumption. 

Thr  preponderance  of  the  nervous  force  being  the  state  which  pre- 
disposes to  disease,  whatever  unduly  excites  the  nervous  energy  in- 
vites an  attack. 

These  causes  njlate,  mostly,  to  the  prolonged  exercise  of  the  intellect, 
the  passions,  and  the  sentiments. 

Few  are  aware  of  the  mischief  done  by  excessive  stimulation  of 
the  mind  during  the  most  active  period  of  life,  —  especially  if  th(i 
muscular  system  bo  left  half  developed.  Here  is  where  ambitious 
students  commit  gn^at  errors. 

The  constant  plying  of  the  riKMital  powers,  in  the  present  modes  of 
educating  children,  leads  to  a  dreadful  abridgment  of  human  life. 
Better  to  train  the  bodily  powers  first,  an(".  let  the  menriil  culture 
come  in  later  time.  lie  who  would  build  a  lasting  structure  must 
lay  a  solid  foundation. 

The  age  in  which  we  live  ai)onnds  in  the  causes  of  excitement.  The 
world  is  trembling  with  excess  of  mental  life.  The  pine  trees  burned 
by  the  steam  engine  are  scarcely  more  numerous  than  the  human 
constitutions  consumed  by  the  train  of  thought  it  has  set  on  fire. 

Nor  are  the  passions  and  sentiments  less  exercised,  or  less  destruc- 
tive. 

Briefly,  the  causes  of  consumption  embrace  all  those  things  which 
bring  a  destructive  force  against  the  digestive  and  assimilative  func- 
tions, as  insufficient  and  improper  food,  debaucheries,  night-watches, 
sedentary  habits,  anxiety  of  mind,  etc.;  rnd  those  which  act  injuri- 
ously upon  the  breathing  organs,  as  impure  air,  inflammation  of  tho 
lungs,  pleurisy,  measles,  hooping  cough,  etc. ;  and  such  as  disturb  tht; 
sweating  process,  as  insuflicient  clothing,  sudden  changes  of  temper- 
ature, sleeping  in  damp  sheets,  etc.  Tliese  exalt  the  nervous  force, 
or  depress  the  vegetative,  or  inflame  the  mucous  lining  of  the  air 
tubes,  or  the  substance  of  the  lungs,  or  the  membranous  sack  whicli 
encloses  them,  so  as  to  induce  one  form  or  other  of  consumption  on 
the  principles  I  have  explained. 

Can  Coiisiiiiiptioii  be  Cured  ?  —  In  many  cases  it  can.  It  may  he 
cured,  first,  by  tho  absorption  of  the  tubercles.  The  celebrated  John 
Hunter  shows,  in  his  work  on  the  blood,  that  the  absorbent?  vessels 
have  a  sort  of  elective  affinity,  by  which  they  take  up  and  remove  "  all 
adventitious  new  matter,  as  tumors,"  (tubercles  are  albuminous  tu- 
mors,) more  easily  "  than  those  parts  which  were  originally  formed." 
Were  this  not  so,  an  activity  in  these  vessels  equal  to  the  removal  of 
tubercles,  would  cause  them  to  waste  all  the  tissues,  and  aggravate 
rather  than  cure  cokisumption.  Probably  this  does  occur  where 
proper  hygienic  means  are  not  used  to  quicken  the  excretions.     This 


DISEASES  OF  THE  CHEST. 


219 


hygienic  treatment,  to  be  spoken  of  hereafter,  is  not  generally  em- 
ployed,—  certainly  not  as  eft'ectually  as  it  should  be.  Here  is  the 
source  of  Laennec's  fatal  remark,  so  often  quoted  and  so  widely  en- 
dorsed, that  "  nature's  efforts  towards  effecting  a  cure  are  injurious, 
and  those  of  art  are  useless."  Laennec's  position  cannot  be  true,  if 
Hunter's  statement  is  correct.  If  the  absorbents,  by  an  elective  in- 
stinct, take  up  adventitious  matter  rather  than  the  natural  tissues, 
then  the  reason  why  they  reverse  this  rule  in  consumption  is,  that  by 
a  weakened  state  of  the  constitution,  the  ultimate  particles  are  not 
well  put  together,  and  are  more  easily  taken  apart  than  those  of  the 
adventitious  tubercular  tumors  ;  and  if  we  would  restore  these  vessels 
to  their  natural  activity,  we  must  improve  assimilation,  and  knit  the 
aiiloving  molecules  into  a  firmer  brotherhood.  We  must  make  the 
(lesh  hard,  so  that  the  absorbents  cannot  pick  it  to  pieces.  Do  this, 
and  "nature's  etlbrts  to  effect  a  cure,"  will  not  "be  injurious." 

A  second  form  of  cure  is  the  reestablishment  of  the  assimilative 
function,  the  building  up  of  the  general  heallli,  the  arresting  of  tlu; 
tubercular  deposit,  the  reducing  of  tubercles  already  formed  to  an  in- 
'jolent  state ;  and  then,  by  a  strict  observance  of  the  laws  of  health, 
keeping  them  in  that  condition  through  life. 

A  third  mode  of  cure  is  the  healing  of  the  cavities  after  the  tuber- 
cles have  softened,  broken  down,  and  been  expelled  in  the  form  of 
expectoration. 

A  fourth  method  of  cure  is  a  change  of  tubercles  to  calcareous  mat- 
ter. 'J'liese  calcareous  tubercles,  Laennec  says,  "are  conseciuent  to 
tuberculous  affections  that  have  been  cured.^''  And  Andral,  at  one 
time,  hoped  to  learn  how  to  etlect  cures  by  changing  tubercles  to  "the 
calcareous  phosphate." 

I  have  had  several  cases  of  cure  by  this  last  method,  and  have 
quite  a  collection  of  calcareous  substances  which  my  patients  have 
coughed  up,  —  one  of  which  was  raised  in  my  presence  by  a  lady 
who  was  a  few  years  before  in  hopeless  consuni])tion,  but  is  now  in 
good  health. 

Treatllieilt.  —  This  should  be  of  two  kinds,  local  and  general. 

The  local  treatment  of  consumption  is  by  the  inhalation  of  vapora 
and  powders  into  the  lungs.  It  has  been  |)rii('tised,  more  or  less,  by  in- 
dividuals, for  many  years,  partieularly  in  Europe ;  hut  for  some  unac- 
countable reason,  the  profession  generally  have  never  used  i*  -ud  do 
not  know  much  about  it.  I  had  the  honor,  some  years  age  '  '  bring 
it  freshly  before  the  American  public,  in  some  articles  written  for 
popular  reading,  since  which  time  it  has  been  rapidly  gaining  public 
confidence,  and  is  now  attracting  much  attention.  Conveying  the 
remedy  directly  to  the  diseased  parts,  it  strikes  the  common-sense 
mind  as  eminently  reasonable  and  necessary. 

I  shall  speak  of  inhalation,  therefore,  very  earnestly,  not  as  a  pallia- 
tive  of  consumption  only,  but  as  far  more,  as  a  remedy.  After  long 
and  patient  use,  my  experience  allows  me  to  say,  that  I  know  it,  in 
many  cases,  to  be  such ;  and  knowing  this,  I  should  be  crimhisl  not 
to  press  it  upon  the  public ;  for  it  is  the  great  multitude  of  sufferers, 


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pressing  fast  through  the  gate  of  death,  who  need  to  hear  words  of 
hope. 

Connunptlon  a  General  Disease.  —  It  is  not  denied  that  consump- 
tion is  a  general  disease,  needing  constitutional  treatment ;  but  it  has 
also  a  local  development  in  the  lungs,  first  in  the  form  of  albuminuud 
tumors,  called  tubercles,  and  then,  after  the  softening,  breaking  down, 
and  discharge  of  these,  in  the  more  formidable  shape  of  ulcerous  ciiv- 
ities,  which,  beginning  at  the  summit,  devour  the  lungs  down  to  the 
base.  Can  it  be  reasonable  to  apply  no  remedy  directly  to  this  local 
disease  ?  Not  so  does  our  profession  deal  with  other  local  diseases. 
To  an  inflamed  skin  we  apply  pouhices,  cold  compresses,  solu- 
tions of  acetate  of  lead,  nitrate  of  silver,  etc. ;  to  leprous  or  scaly 
art'ections,  sulphuret  of  potash,  bichloride  of  mercury,  zinc  ointment, 
nitrate  of  mercury  ointment,  sulphur,  creosote,  etc. ;  to  weak  and 
inHamed  eyes,  sulphate  of  copper,  sulphate  of  zinc,  nitrate  of  silver, 
and  opium;  to  chronic  ulcers  upon  the  skin,  tannin,  pulverized 
rhubarb,  opium,  or  cinchona ;  and  to  an  inflamed  throat,  nitraie  of 
silver  and  other  articles.  These  are  but  specimens  of  the  thousand 
cases  in  which  we  use  local  remedies.  Why,  then,  when  the  mucous 
membrane,  which  lines  the  air  tubes,  becomes  inflamt'd  through  all  its 
branches,  should  we  neglect,  by  the  inhalation  of  medicated  vapor,  to 
apply  a  remedy  directly  upon  the  whole  inflamed  surface?  V'^v, 
when  tubercular  matter  is  beginning  to  be  de|)osited  upon  the  s  o 

of  the  air  cells,  and  of  the  small  bronchial  tubes,  should  not  the 
go  right  to  those  parts,  and  cause,  as  it  would,  the  immediate  expul- 
sion of  this  offending  and  dangerous  matter? 

Uneducated  common  sense  sees  the  reasonableness  of  these  sug- 
gestions at  a  glance.  Many  a  person,  with  pulmonary  disease,  dies 
of  suflbcation,  not  because  there  is  not  muscular  strength  to  expel 
the  matter  which  is  strangling  him,  but  because  the  huigs  below  the 
large  pellets  of  mucus,  which  plug  up  the  bronchial  tubes,  cannot  bn 
inflated,  and  have  therefore  no  means  of  driving  out  the  oH'ending 
substance.  Yet  a  proper  medicated  vapor,  drawn  in  with  the  breath, 
would  either  dissolve  the  mucus,  or  rouse  up  the  expiring  membrane 
to  cast  it  off. 

If  the  reader  were  to  place  one  end  of  a  stethoscope  directly  over 
the  disease  upon  the  breast  of  a  person  in  the  third  stage  of  consump 
tion,  and  should  then  ask  him  to  talk,  the  words  spoken  would  seem 
to  rise  up  through  the  instrument,  and  enter,  well  articulated,  into  his 
ear.  This,  in  technical  language,  is  called  pecloriloqvy,  —  a  word 
signifying  chest-talking.  It  implies  a  cavity  in  the  lung.  If  now  the 
patient  be  asked  to  cough,  a  gurgling  and  splashing  sound  will  be 
i  card.  This  denotes  that  the  cavity  is  partly  filled  with  fluid,  which 
iij  dashed  about  by  the  air  explosively  driven  through  it  by  the  portion 
cf  lung  below.  Here  we  have  an  excavated  ulcer,  with  all  its  filthy 
contents,  composed  of  pus,  mucus,  serum,  and  dissolved  tubercles, 
lying  in  it  day  and  night  to  aggravate  its  unhealthy  condition.  What 
more  reasonable,  what  more  necessary,  than  that  a  soothing,  altera- 
tive, or  astringent  vapor  should  be  drawn  into  this  cavity,  to  cause  its 


m 


sides  to  heal,  and  its  absorbents  to  remove  this  fluid  ?  A  surgeon 
who  should  permit  an  ulcer  upon  the  surface  of  the  body  to  remain 
ill  tliat  condition  without  a  local  dressing,  would  be  deemed  unfit  to 
practise  his  profession. 

Both  in  tubercular  disease  and  in  simple  bronchitis,  the  bronchial 
tubes  almost  aways  sutler  some  physical  change.  The  mucous  mem- 
brane lining  these  tubes  is  generally  softened.  At  other  times  the 
tubes  become  enlarged  through  their  whole  length,  so  that  many  of 
them,  from  the  size  of  a  (juill,  rciu-li  the  bigness  of  the  tinger  of  a  glove. 
In  still  other  cases,  the  straining  produced  by  congiiing  causes  a  tube 
lo  belly  out  at  some  point,  forming  a  sack,  which  is  generally  fdlcu 
with  mucus  or  purulent  matter.  At  still  other  times,  a  tubercle  will 
press  against  a  tube  so  as  to  flatten  it  and  convert  it  into  a  musical 
instrument,  the  air,  as  it  is  drawn  laboriously  through,  |)ro(lu{'iiig  a 
high  or  low  note,  according  to  the  size  of  the  pipe.  These  pliysieal 
(changes  are  all  produced  by  causes  which  the  inhalation  of  a  suitable 
vapor,  at  the  proper  time,  would  altnost  infallibly  remove.  How 
strange  that  this  remedy,  —  so  simple,  so  ellljctual,  so  easily  compre- 
hended, —  should  have  been  so  little  used  ! 

Right  at  this  vital  point  in  the  lungs,  where  the  blood  runs  in  a 
ceaseless  current,  —  where  the  whole  of  it  goes  even/  two  minules  to 
renew  its  vitality  l)y  contact  with  atmospheric  air,  —  we  have,  in 
llionsands  of  cases  daily  occurring,  inllamination  with  roughening  oi 
softening  of  membrane,  with  its  consequent  harsh  breathing;  we  have 
mucus,  tough  or  glairy,  to  impede  and  interrupt  respiration  ;  we  have 
tubercles  in  the  hard  or  soft  state,  adding  to  the  general  embarrass- 
ment, and  not  only  lessening  the  vitality  of  the  blood,  but  disturbing 
all  the  sympathies  of  the  system;  —  and  yet  the  practice  has  been, 
and  is,  to  attack  these  central  disturbers  of  life  only  through  the  cir- 
cuitous path  of  the  stomach,  lacteals,  etc. 

Since  1849,  my  undivided  attention  has  been  given  to  the  study 
and  application  of  this  mode  of  treatment.  This  is  two  years  in 
advance  of  any  other  physician  in  this  counky.  I  have  investigated 
faithfully  the  effects  of  the  various  substances  proposed  for  inhalation 
by  European  physicians,  and  have  explored  a  wide  field  of  new  rem- 
edies, not  before  used,  several  of  which  have  proved  to  have  qualities 
of  great  remedial  power. 

Thus  much  I  have  thought  it  proper  to  say  in  behalf  of  this  mode 
of  treating  consumption,  the  most  successful  yet  employed,  not  be- 
cause it  needs  defence,  but  because  the  great  body  of  the  profession 
are  ignorant  of  it,  and  what  is  worse,  are  indifferent. 

The  chief  remedies  I  employ  for  inhalation  are  the  following : 

Alterative  Inhalant,  composed  of  iodine,  six  grains ;  iodide  of  potas- 
sium, twelve  grains ;  tincture  of  ipecac,  one  ounce ;  tincture  of  bal- 
sam of  tolu,  six  drams ;  ethereal  tincture  of  conium,  one  and  a  half 
drams ;  alcohol,  half  a  pint.  These  are  to  be  mixed.  The  dose  ia 
one  to  two  teaspoonfuls,  to  be  inhaled  ten  or  fifteen  minutes,  in  about 
a  gill  of  hot  water. 

The  ethereal  tincture  of  conium  is  made  by  keeping  a  dram  of 
I     powdered  conium  in  one  ounce  of  sulphuric  ether  a  week. 


I 


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222 


DISEASES  OF  THE  CHEST. 


I   %^ 


The  abo'.e  inhalant  is  used  in  the  tubercular  forms  of  consumption, 
particularly  that  of  the  scrofulous  kind,  and  in  lany  cases  of  bron- 
chitis. 

Expectorant  Inhalant.  —  Take  pleurisy  root,  half  an  ounce;  squill, 
one  ounce  ;  ipecac,  two  drams ;  black  cohosh,  two  ounces ;  queen's 
root,  one  ounce  and  a  half;  American  hellebore,  two  drams  ;  diluted 
alcohol,  one  pint.  Grind  the  roots,  etc.,  and  add  the  alcohol.  Let  the 
whole  stand  one  week,  shaking  or  stirring  daily.  Draw  off  and  filter 
through  paper.  Two  teaspoonfuls  make  a  dose,  to  be  inhaled  same 
as  preceding. 

This  ?s  to  be  used  wher  the  cough  is  hard  and  dry,  and  the  expec- 
toration diificult.  It  makes  the  raising  easy,  lessening  the  soreness 
of  the  chest,  and  the  harshness  of  the  cough. 

S<M)tliinp:,  Febi'ifu»:e  Inhalant.  —  Take  belladonna  leaves,  half  an 
ounce ;  black  cohosh,  two  ounces ;  American  hellebore,  half  an  ounce  ; 
poke  root,  two  drams  ;  aconite  root,  one  ounce  ;  diluted  alcohol,  one 
pint.  Grind  the  roots,  etc. ;  add  the  alcohol.  Let  the  whole  stand 
one  week,  stirring  daily.  Pour. off,  and  filter  through  paper.  Dose, 
one  to  two  teaspoonfuls,  to  be  inhaled  as  the  preceding. 

Th'^  is  excellent  in  all  cases  where  the  skin  is  hot,  the  pu'se  quick, 
the  tongue  and  mouth  parched,  the  chest  sore,  and  the  system  suffer- 
ing during  the  whole  or  a  part  of  each  day,  from  a  general  feverish 
condition.     It  is  proper  iti  all  the  forms  of  chest  disease. 

Astrin<2;ent  Inhaliint.  —  Take  of  wild  indigo,  one  ounce;  catechu, 
half  an  ounce ;  Peruvian  bark,  one  ounce ;  golden  seal,  one  ounce  ; 
diluted  alcohol,  one  pint.  Mix,  and  let  the  whole  stand  one  week, 
Stirling  daily.  Drain  off,  and  filter  through  paper.  Add  two  drams 
of  creosote.     One  to  two  teaspoonfals  to  be  inhaled  as  preceding. 

This  is  to.be  used  when  the  expectoration  is  profuse  and  easy,  un- 
attended by  fever,  either  in  the  latter  stages  of  chronic  bronchitis, 
when  the  mucous  membrane  of  the  tubes  is  in  a  relaxed  condition, 
or,  in  the  third  stage  of  tubercular  dis<nse,  for  the  purpose  of  con- 
stringing,  cleansing,  strengthening,  and  healing. 

Antiseptic  Inhalant.  —  Take  wild  indigo,  one  ounce ;  belladonna 
leaves,  half  an  ounce  ;  diluted  alcohol,  one  pint.  Mix,  and  let  the 
whole  stand  one  week.  Pour  off,  and  filttir  through  paper.  Then 
add  solution  of  chloride  of  soda  two  ounces.  Dose,  one  to  two  k'a- 
spoonfrJs,  to  be  inhaled  as  the  preceding. 

This  is  used  in  cases  of  gangrene  of  the  lungs,  generally  distin- 
guished by  considerable  expectoration  liaving  a  very  fetid  smell. 

Anti-IIemorrliatric  Irhalant.  —  Take  witch-hazel  bark,  two  ounces ; 
black  cohosh,  four  ounces.  Grind,  and  add  one  pint  of  diluted  alco- 
hol. Let  the  mixture  stand  one  week,  stirring  daily.  Pour  off,  and 
filter  through  paper.  Add  to  this  two  drams  of  creosote.  Dose,  one 
to  three  t*;aspoonfuls,  to  be  inhaled  as  preceding. 

This  is  an  excellent  remedy  foi  bleeding  from  the  lungs.  Whjpn 
there  is  a  tendency  to  bleed,  it  should  be  used  for  a  long  time.  It 
may  frequently  take  the  place  of  No.  4,  as  an  astringent  inhalant 


:)I8EASES  OF  THE  CHEST. 


223 


Object  of  Inhalants. —  Being  vaporized  and  inhaled,  these  articles 
enter  every  air  cell  throughout  the  lungs.  Their  object  is  to  soothe  and 
mollify  inflamed  mucous  surfaces,  to  reduce  enlarged  bronchial  glands 
which  press  upon  neighboring  part?  suid  cixuse  bleeding,  to  stimulate 
the  absorbents  to  take  up  and  remove  tubercles,  to  dissolve  tubercles 
out  of  the  pulmonary  tissue,  to  cause  ulcerous  cavities  to  expel  their 
mattery  contents,  and  to  stimulate  their  sides  to  take  on  a  healing 
process.  They  should  be  used  from  three  to  six  times  a  day,  the  in- 
halation conrinuing  from  ten  to  fifteen  muuites. 

Other  Inhalants.  —  (Jreat  numbers  of  otl.?r  articles  have  been  used, 
\vi  ich  ]  have  not  space  to  describe,  I  will  mention,  however,  that 
the  following  are  sometimes  euiployed  with  advantage; : 

For  an  Expectorant  Inhalant,  take  alcohol,  four  ounces ;  tincture 
of  camphor,  half  an  ounce  ;  tincture  of  tolu,  two  drinis ;  naphtha, 
one  dram;  benzoic  acid,  thirty  gnjins;  oil  of  bitter  almonds,  four 
drops.     Mix. 

For  an  Anodyne  Inhalant,  take  alcohol,  four  oimces ;  naphtha,  one 
dram  ;  benzoic  ac'.d,  thirty  grains ;  chloroform,  twenty-five  drops ; 
tincture  of  henbane,  half  an  ounce.     Mix. 

Tor  an  Astringent  Inhalant,  take  alcohol,  four  oimces;  naphtha, 
one  dram  ;  benzoic  acid,  thirty  grains  ;  chloroform,  t)ne  dram  ;  tannin, 
eight  grains.     Mix. 

]ll<Mle  of  Inhalillif. —  For  inhaling  these,  a  sponge  is  fitted  into  a 
glass  cup,  to  which  a  flexible  tube  is  ;tti«ched.  A  small  (pjantity  of 
the  mixture  is  poured  upon  the  sponge,  and  the  vapor  arising,  is 
drawii  into  the  luiigs  through  the  tube. 

To  the  expectorant  inhalant  uiuy  be  added,  occasionally,  half  a 
dram  of  nitric  acid. 

These  latter  formidas  are  the  principal  ones  used  by  those  who 
practise  what  is  called  cold  inhalalion. 

Medicated* Vapor  Inhaler.  —  This  instrument  I  have  had  constructed 
of  britannia  (sometimes  of  silver)  and  glass.  Some 
have  adopted  the  mode  of  inhaling  from  a  sponge 
held  in  tlie  hand,  which  is  an  imperfect  Uicthod ; 
others,  that  of  inhaling  from  a  sponge  fastened 
upon  the  ch»'st,  which  amoujits  to  scarcely  any  in- 
halation at  all,  as  only  a  very  small  amount  of  the 
vapor  reaches  the  nostrils.  It  is,  moreover,  di. 
greeable  to  the  wearer  and  to  those  around,  fMd 
must  soon  ber^ome  extremely  filthy. 

Some  use  a  glass  bottle,  with  an  India-rubber 
tube  ;  but  India-rubber  soon  becomes  foul  inter- 
nally, and  might  produce  disease.  Avoid  Inhalers 
with  India-rubber  tubes. 

The  cut  91  represents  the  instrument  I  employ. 
The  tube,  to  which  the  mouth  is  applied,  passes 
through   the    cap,   communicating    with    the    air 
above  .he  fluid.     When  the  air  is  drawn  off*,  other  air  rushes  into  the 
long  tube  to  fill  the  vacuum,  and  breaking  out  at  the  bottom,  setn 


Fio  91. 


the  fluid  in  commotion,  causing  a  medicated  vapor  to  rise,  which  is 
drawn  into  the  lungs. 

Constitutional  Treatment  —  The  rapid  brearthing  in  consumption, 
creates  too  much  oxydation  of  the  blood, — so  much,  '  ^t  the  muscles, 
especially  the  heart,  are  usually  of  a  bright  red.  To  prevent  the  pa- 
tient from  being  literally  burned  up  by  oxygen,  the  blood  must  be 
de-oxydated  as  fast  as  possible. 

While  there  is  too  much  of  oxygen,  there  i»,  at  the  same  time,  a  defi- 
ciency of  carbon.  Hence  the  cold  hands  and  feet,  and  the  general 
inability  to  bear  frosty  weather.  The  little  nutritive  arteries,  in  these 
thin-blooded  persons,  stand  shivering  and  torpid  with  cold,  unable  to 
perform  their  allotted  function  of  nutrition.  There  is  not  fire  enough, 
and  fuel  must  be  had  in  the  form  of  carbon.  Hence  one  of  the  ad- 
vantages of  cod  liver  oil.  This  oil,  too,  as  carbon,  devours  the  oxy- 
gon of  the  blood,  and  prevents  its  destroying  the  patient.  This  idea 
also  explains  the  fact  mentioned  by  Bennet  and  others,  that  in  their 
post-mortems,  they  found  the  evidences  of  healed  ulcers  in  nunrerous 
persons  who  had  been  spirit-drinkers  while  living.  And  Liebig  helps 
the  explanation  by  saying  that  alcohol,  taken  into  the  system,  circulates 
in  a  free  state  in  the  blood,  and  devours  its  oxygen.  To  which  I  beg 
to  add,  that  the  malaria  of  intermittent  and  bilious  fever  districts,  has 
been  pretty  satisfactorily  proved  to  be  an  instable  organic  body,  con- 
sisting of  sulphur,  carbon,  and  hydrogen,  all  of  which  have  an  af- 
finity for  oxygen,  and  devour  it  in  the  system.  Consumption  is  not 
found  in  such  districts. 

As  I  am  here  treating  of  the  chemical  effects  of  remedies  (and  to 
this  test,  moijit  remedies  must  finally  come),  I  will  mention  that  tar- 
trate of  antimony  and  potassa  arrests  the  circulation  in  the  pulmonary 
arteries,  —  which  fact  gives  a  complete  and  luminous  view  of  its 
power  to  prevent  oxydation.  But  I  am  obliged  to  detract  from  its 
merita,  by  stating  that  it  also  retards  the  circulation  in  the  capillaries 
of  the  system  generally,  and  so  hinders  rfe-oxydation. 

Phosphorus.  —  There  is  an  article  which  has  more  recently  pie- 
sented  itself  to  the  notice  of  the  profession,  to  which  I  wish  to  invite 
special  attention.  I  refer  to  phosphorus.  This  agent,  for  a  time, 
challenged  our  notice  in  the  shape  of  phosphate  of  lime ;  but  we  could 
never  feel  sure  that  this  article  was  dissolved  in  the  fluids  of  the  body. 
We  now  use,  and  with  far  more  marked  eflect,  the  hypo-phosphite» 
of  lime,  soda,  potash,  and  iron.  These  are  used  in  the  form  of  the 
syrup  of  the  hypo-phosphites.  The  dose  is  a  teaspoonful  before 
each  meal.  The  eflect  upon  the  tubercular  d.isease  is  immediate  and 
Ratifying. 

Need  of  Phosphorus.  —  Cerebric  acid  contains  nitrogen  and  phos- 
phorus, and  is  the  peculiar  component  of  the  brain  and  nervous  sys- 
tem. By  combustion  and  the  changes  of  oxydation  in  the  brain,  the 
phosphorus  of  cerebric  acid  is  converted  into  phosphoric  acid ;  so  that 
every  act  of  the  brain  produces  phosphoric  acid.  How  rapid,  then, 
must  be  the  consumption  of  the  phosphoric  element  of  the  cerebric 


mmii^^m 


id  pho9- 
ous  ays- 
rain,  the 

so  that 
id, then, 

cerebric 


DISEASES  OF  THE  CHEST. 


225 


acid,  in  that  highly  active  and  excitable  state  of  the  nervous  system 
which  I  have  described  as  peculiar  to  consumption.  And  how  neces- 
sary in  order  to  save  the  brain  from  destruction,  to  meet  this  increased 
demand  for  phosphorus,  by  introducing  it  into  the  system. 

Mulder  r«'gards  the  fibrin  of  the  blood  as  the  carrier  of  oxygen ;  and 
by  this  oxydation,  the  fibrin  becomes  converted  into  the  binoxide  and 
tritoxide  of  proteine,  —  its  phosphorus  and  sulphur  (for  it  contains 
both),  being  converted  into  phosphoric  and  sulphuric  acids.  Adding 
phosphorus  and  sulphur,  therefore,  as  medicinal  agents,  would  seem 
to  be  the  proper  way  to  supply  the  fibrin  with  materials  destructive 
of  its  freight  of  oxygen. 

It  is  well  known  that  the  salts  of  phosphoric  acid  are  essential  for 
tlie  formation  of  azr  tic  compounds,  —  compounds  which  are  neces- 
sary to  sustain  animal  life.  It  should  be  remembered,  too,  as  collat- 
erally illustrating  this  fact,  that  the  tribasic  phosphates  o^  potash,  soda, 
lime,  and  magnesiu,  play  an  impo.'tant  part  in  the  growth  and  perfec- 
tion of  plants.  They  are  always  found  in  the  seeds  of  the  cerealia,  and 
no  mature  grains  are  produced  where  phosphates  are  absent  from  the 
soil.  For  the  production  of  abundant  grain  crops,  it  is  necessary  that 
these  salts  should  exist  in  the  soil,  or  be  applied  to  it  in  manures. 

It  is  known,  moreover,  that  in  all  chronic  diseases  distinguished  by 
wasting  of  the  tissues,  a  nmch  larger  quantity  of  phosphates  is  ex- 
creted by  the  kidneys,  than  in  the  normal  state.  Hence  there  is  no 
healthful  growth ;  and  the  human  organism,  like  the  soil,  exhausted 
of  its  phosphates  by  successive  croppings,  brings  nothing  to  perfec- 
tion, and  needs  to  have  its  drained  salts  re-supplied. 

I  cannot  but  call  attention  here  to  the  inorganic  substances  found 
in  healthy  human  blood.  According  to  very  careful  analyses,  by 
Scmidt : 


1000  parts  of  blood-corpuscles,  contain  : 


Chlorine,      -        -        - 
Sulphuric  Acid, 
Phosphoric  Acid,  - 
Potassium, 

Sodium,        ... 
Oxygen,    - 
Phosphate  of  Lime, 
Phosphate  of  Magnesia, 


1.686 
0.066 
1.134 
3.328 
1.052 
0.667 
0.114 
0.073 


1000  parts  i.  juo 
fibnn),  contain  : 
Chlorine,  -  ,  - 
Sulphuric  Acid, 
Phosphoric  Acid,  - 
Potassium, 

Sodium,        .        .        - 
Oxygen,    -        - 
Phosphate  of  Lime, 
Phosphate  of  Magnesia, 


san<Tiii',ig  Cserum  and 


3.664 
0.11 
0.1 9J 
0.SS3 
.S.341 
1403 
».Sll 
0.223 


Iron  ia  omitted.  Now,  I  venture  the  prediction,  that  out  of  theae 
figures,  mainly,  in  connection  with  those  which  represent  the  constit- 
uents of  the  saliva,  the  bile,  the  gastric  juice,  the  pancreatic  secretb  n, 
and  the  organic  compounds  of  the  blood  and  tissues,  are  to  bi>  evolved 
within  a  few  years,  a  correct  and  partially  demonstrative  system  of 
medication.  In  consumption,  all  the  inorganic  bodies  represented  by 
the  above  figures,  with  the  exception  of  oxygen,  are  deficient  in  quan- 
tity. By  reflecting  upon  the  proportions  of  theae  several  bodies,  par- 
ticularly upon  the  large  amount  of  chlorine  and  soda  in  the  plasma, 
and  of  potaaaium  in  the  corpuscles,  the  mind  can  hardly  fail  to  obtain 
useful  hints.     I  have  not  hesitated  to  make  one  of  these  hints  the 

29 


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m 

■il 

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■         1 
t 

■  1 

i 

1 

I'-! 


>- 

li  '    '' 

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I,.-;', 


Kl'.i 


1» 


1 


226 


DISEASES  OP  THE  CHEST. 


gronnd  of  a  very  free  use  of  alkalies,  —  particularly  in  the  form  of 
bathing. 

Su^r  of  Milk.  —  There  is  one  other  medicinal  article  which  I  deem 
worthy  to  be  made  prominent,  and  to  be  placed  side  by  side  with  cod 
liver  oil  and  the  hypo-phosphites.  I  refer  to  sugar  of  milk.  It  belongs 
to  t.h?t  class  of  non-nitrogenized  articles  which  Liebig  has  denominated 
supporters  of  resj)iration.  Its  great  affinity  for  oxygen  is  well  worthy 
to  be  taken  into  the  account,  in  considering  its  value  in  consumption. 
So  great  is  this  attraction,  that  with  ammonia  and  other  alkalies,  it 
has  the  power  of  reducing  some  of  the  mctalic  oxides.  When  taken 
into  the  stomach,  it  is  rapidly  absorbed  into  the  blood,  which,  being 
an  alkaline  fluid,  augments  its  great  de-oxydating  power  to  a  consider- 
able degree.  It  unites  rapidly  with  oxygen  after  entering  the  blood, 
forming  carbonic  acid  and  water.  A  part  of  it,  however,  does  not 
enter  the  blood  in  an  uncompounded  state,  but  is  changed  in  the 
stomach  into  lactic  acid ;  and  this,  in  the  blood,  becomes  an  alkaline 
lactate.  But  the  portion  thus  changed,  appears  also  verv  useful ;  for 
Lehmann  says  :  "  We  know  of  no  substances  which  could  better  act 
in  the  blood  as  food  for  the  rer^piration,  than  the  alkaiine  lactates." 

Corroborative  of  these  views,  is  the  fact  that  all  those  kinds  of 
milk,  such  as  goat's,  ass's,  etc.,  which  contain  the  largest  amount  of 
sugar  of  milk,  have  at  different  times,  and  in  various  countries,  ob- 
tained a  reputation  for  curing  consumption.  Goat's  whey,  in  which 
this  article  abounds,  and  from  which  it  is  largely  manufactured,  has 
been  celebrated  for  its  virtues  in  this  line.  Ancel  speaks  of  it  as  an 
excellent  remedy  ;  and  Pcreira  says,  "  Sugar  of  milk,  m  consumptive 
cases  and  chronic  diseases  of  the  digestive  organs,  is  a  most  valuable 
aliment." 

One  of  the  best  forms  of  taking  sugar  of  milk  is  tb.at  of  a  gruel, 
which  is  quite  palatable,  and  may  be  freely  eaten  by  consumptive 
persons. 

Tlie  Coui^li. —  The  best  article  1  have  ever  used  for  fiis,  is  the  "  Pul- 
monic Cherry  Cordial."  1  was  five  years  in  compounding  this  arti- 
cle to  suit  me,  and  I  believe  it  to  be  the  very  best  cough  preparation 
ever  made.     Dose,  from  one  to  two  teaspoonfuls.    See  page  710. 

When  a  more  quieting  effect  is  needed,  a  little  morphine  may  be 
added  to  this  preparation;  if  a  more  expectorant  influence  is  required, 
add  a  few  drops  of  the  tincture  ol  veratruni  viride.  For  the  great 
majority  of  cases,  it  will  be  found  to  be  right  without  any  addition. 
When  this  is  not  at  hand,  any  of  the  preparations  (108)  (112)  (10^>) 
(113)  (110),  etc.,  may  be  used. 

Mljflit  Sweats.  —  The  very  best  preparation  for  these  sweats,  is  a  com- 
pound of  the  oxide  of  zinc,  one  dram ;  extract  of  conium,  half  a  dram ; 
to  be  made  into  twenty  pills,  of  which  one  or  two  are  to  be  taken 
every  night     The  sponge  bath  also  does  murh  to  check  these  sweats. 

Diarrluea. — This  is  a  most  exhausting  symptom  in  the  latter  stages 
of  consumption.  The  only  remedy  which  lus  much  effect  in  control- 
ling it,  is  the  iris-nitrate  of  bismiUh.    This  should  be  given  in  doses  of 


^m  /'  li 


DISEASES  OF  THE  CHEST. 


227 


fi 


'll 


thirty  grains  immediately  after,  or  at  the  time  of  each  meal.  These 
doses  are  much  larger  than  used  to  be  given ;  but  they  will  do  no 
harm.     Given  to  rhis  extent,  I  find  the  bismuth  very  efl'ectual. 

Iron.  —  This  preparation,  in  some  of  its  forms  (316)  (73)  (61)  (84) 
(102),  is  almost  always  needed  in  consumption.  If  the  scrofulous 
habit  be  strongly  marked,  give  syrup  of  iodide  of  iron,  in  thirty-drop 
doses,  three  times  a  day.     It  should  be  taken  in  a  glass  of  water. 

External  Irritants. — These  are  needed  where  there  is  much  infl'^  h 
mation  ana  soreness  of  the  chest.  Blisters  should  very  t^eldom  oe 
used.  Croton  oil,  from  two  to  half  a  dozen  drops,  rubbed  over  the 
sore  part,  generally  answers  very  well.  Sometimes  the  mustard  paste, 
applied  to  the  extent  of  producing  redness,  two  or  three  times  a  week 
is  sufficient.  Nitric  acid,  reduced  with  water  to  a  strength  a  little 
above  the  strongest  vinegar,  answers  a  good  purpose  for  keeping  up 
an  irritation. 

Atmospheric  Inhalation.  —  It  has  been  said  by  Laennec  and  others, 
that  asthma  has  sometimes  the  effect  of  arresting  tubercular  con- 
sumption. Dr.  RaiTiadge  thought  this  was  efTected  by  "n  expansion 
of  the  vesicular  structure  of  the  lungs ;  and  he  reasoned  that  the 
same  expansion  by  i-iCchanical  means,  would  secure  a  similar  end. 
To  eflfect  this,  he  made  his  patients  take  long  breathe  through  a  tube 
constructed  for  the  purpose. 

It  is  manifest  that  the  philosophy  of  atmospheric  inhalation  was 
not  understood  by  Dr.  Ramadge,  nor  has  it  been  by  any  of  his  fol- 
lowers in  this  country. 

Rokitansky  thinks  the  tubercular  habit  depends  upon  the  excess  of 
fibrin  in  the  blood  ;  and  says  that  the  reason  of  consumption  being 
arrested  by  pregnancy  is,  that  this  condition  otters  a  mechanical  ob- 
stacle to  the  transmission  of  blood  through  the  lungs,  —  thus  prevent- 
ing its  excessive  oxydation,  and  keeping  it  in  a  venous  state.  This 
destroys  the  fibrinous  condition,  on  whicli  he  thinks  tuberculosis 
depends. 

Now  this  is  precisely  what  is  done  by  atmospheric  inhalation.  The 
trachea  divides  on  its  entrance  into  the  lungs,  into  two  branches  which 
again  divide  and  subdivide  until  the  tubes  become  smaller  than  can 
be  seen,  each  terminating  in  a  minuie  air-cell.  Over  this  entire  sur- 
face the  air  is  intended  to  be  brought  ir  ■>  communication  with  the 
blood  for  the  purpose  of  oxydating  it.  hy  forcible  inhalation,  the  air 
vesicles  are  inflated  to  the  extent  of  their  capacity,  by  which  means 
the  extreme  branches  of  the  pulmonary  arteries  are  so  ttattened  be- 
tween these  extended .  cells,  as  to  be  able  to  convey  but  a  small 
amount  of  blood,  and  but  little  is  oxydated.  This  furnishes  a  me- 
chanical obstruction  to  the  transmission  of  the  blood,  and  secures  the 
defibrination  of  which  Rokitansky  speaks. 

This  is  my  view  of  the  philosphy  of  atmospheric  inhalation.  The 
benefit  results,  not  from  a  larger  amount  of  oxydation,  as  is  gener- 
ally supposed,  but  from  a  smaller.  Asthma  does  the  same  thing  by 
producing  spasmodic  contract i»m  of  the  extreme  bronchial  tubes,  and 
preventing  air  from  entering  ti.    cells. 


"  .1'!' 


If  (13* 

Is'*! 


■x~ 


I^T 


228 


DISEASES  OF  THE  CHEST. 


The  same  end  is  gained  in  part  by  certain  kinds  of  employment,  as' 
glass-blowing,  playing  upon  wind  instruments,  and  the  like.  Writers 
of  distinction  mention  cases  of  recovery  front  incipient  consumption 
by  a  vigorous  use  of  the  lungs  in  singing.  Dentists  subject  their 
lungs  to  a  similar  process  of  expansion  in  the  use  of  the  blow-pipe; 
the  writer  has  known  several  instances  in  that  profession,  in  which 
recoveries  have  taken  place.  , , 

The  Conclusion  to  which  I  cume  is,  that  atmosphe^rjipi  inhalation 
may  be  used  with  great  advantage  in  some  cases,  but  should  never  be 
resorted  to  ex(;oi)t  under  the  direction  of  a  competent  physician.  In 
a  congested  stai*'  -r  the  lungs,  with  haemorrhagic  tendencies,  or  with 
inflammation  and  aoreness,  it  is  well  fitted  to  produce  fatal  bleeding, 
and  is  of  course  dangerous. 

Externnl  Vse  of  Water,  —  As  a  relaxation  from  severe  exertions, 
the  ancients  had  frequent  recourse  to  bathing.  Those  who  contended 
in  the  race,  throwing  the  javelin,  and  wrestling,  at  Rome,  plunged 
into  the  Tiber  while  warm  and  panting  with  their  efforts.  That  this 
promoted  prowess  and  physical  endurance,  none  can  doubt. 

Louis,  the  great  French  authority  on  pulmonary  diseases,  lays 
down  several  rules  to  be  observed  by  consumptive  patients,  and  par- 
ticularly mentions  cold  bathing. 

Few  things  give  tone  to  the  capillaries  of  the  skin  like  cold  water, 
systematically  applied.  It  rallies  the  powers  of  the  constitution,  and 
improves  assimilation.  And  by  it  another  object  is  gained  of  scarcely 
*ess  importance,  —  that  of  guarding  the  system  against  taking  cold. 
Those  in  the  daily  habit  of  applying  cold  water  to  the  whole  person, 
seldom  suffer  from  colds  and  catarrhs;  and  they  generally  become 
hardened  so  as  to  endure  the  assaults  of  the  eliements. 

Consumptive  persons  should  generally  use  the  sponge  bath,  with 
cold  water,  if  it  can  be  endured,  otherwise  the  tepid  bath,  to  be  fol- 
lowed, ill  all  cases  with  brisk  rubbing,  with  a  coarse  toWiei.  If  a  sisnae 
of  chilliness  and  discomfort  follows  the  bath,  a  large  portion  6f  the 
water  must  be  sque6zcd  from  the  sponge,  so  as  to  u!se  but  very  little, 
and  the  washing  must  be  speedy,  and  the  rubbing  more  lively  than 
usual, —  beginning  with  tepid  water,  and  gradually  lowering  the  tem- 
perature, till  it  can  be  borne  cold.  A  large  tea;spoonftd  of  saleractus 
to  each  quart  of  water  should  be  used. 

Diet. 

The  diet,  like  all  oth*ir  piurts  of  the  tfeatiiieht,  must  HaVe  referen'oe 
to  the  present  cdndition  of  the  patient.  If  the  disease  take  the  bron- 
chial form,  and  rapid  breathing,  and  other  conditions  calculated  to 
carry  fat  out  of  the  system  have  not  yet  supervented ;  or  if  the  patient 
have  thirst  and  hectic,  the  diet  must  be  spare  and  simple,  —  consist- 
ing chiefly  of  milk  and  farinaceous  substances. 

But  in  all  cases  where  the  disease  is  tubercular,  or,  being  bronchial, 
ha's  reachied  the  stage  of  emaciation,  the  very  earliest  moment  at 
which  the  fever  can  be  subdued,  sliould  be  improved  to  bbild  up  thb 


?fnm 


DISEASES  OF  THE  CHEST. 


229 


|;)fttient  with  a  generous  diet.  I  have  seen  cases  where  the  stuffing 
i^ometines  resorted  to  for  fattening  turkies  for  Thanksgiving,  would 
seem  io  be  almost  justifiable.  A  good  rule  is  to  give  the  most  gc-ner- 
ous  diet  that  can  be  taken  without  disturbing  the  stomach,  or  increas> 
ing  the  feverish  symptoms.  Animal  food,  with  a  good  quantity  of 
salt,  should  be  freely  taken.  Fat  meats,  if  well  received  by  the  st<"»m- 
ach  (and  they  generally  are  if  taken  cold),  are  particularly  useful 
The  same  is  true  of  sweet  butter  and  cream. 

Oat-Door  Exercise.  —  Without  exercise,  as  a  general  thing,  the  con- 
sumptive patient  will  die.  Exercise  involves  muscular  exertion, 
i^hich  is  attended  by  the  tension,  compression,  and  greater  compact- 
ness of  the  muscles  used.  This  connpression  of  the  muscles  within 
^e  sheaths  (fasciae)  which  enclose  them,  sends  out  their  blood,  and 
pushes  it  forward  towards  the  surface.  Reaching  the  extremities  of 
the  arteries,  the  blood  passes  through  capillary  tubes,  almost  incon- 

S^ivably  fine,  into  the  capillary  veins,  of  f  imilar  fineness,  whence  it 
ows  through  larger  and  larger  veins  back  to  the  heart.  At  the  mo- 
ment of  its  passage  from  the  capillary  arteries  to  the  capillary  veins, 
it  ceases  to  be  red  or  arterial,  and  becomes  purple  or  venous  blood. 
The  oxygen  in  the  arterial  and  the  carbon  in  the  veaous  blood  unite, 
forming  a  literal  combustion,  just  such  as  we  produce  in  our  stoves 
and  grates  by  bringing  together  the  carbon  of  the  wood  and  the  oxy- 
gen of  the  atmosphere.  By  this  combustion  our  bodies  are  warmed, 
and  the^  little  secreting,  exhalant,  and  other  ve'jsels,  are  raised  to  a 
temperature  that  enables  them  to  work. 

Every  muscular  contraction  and  compression  helps  pu^•<h  along  the 
venous  blood  in  larger  quantities  to  the  right  auricle  of  the  heart, 
which,  receiving  a/uller  supply  of  its  natural  stimulus,  contk-acts  more 
energetically,  forcing  the  fluid  into  the  right  ventricle.  Frotn  thence 
it  is  expelled  with  increased  eneigy  likewise  along  its  only  pathway, 
the  pulmonary  artery,  into  the  lungs.  Rushing  in  here  i.i  greater 
volume  than  natural,  a  demand  is  made  for  deeper  inspirations  of 
air  to  vitalize  and  fit  it  for  its  descent  by  the  pulmonary  vein,  to  the 
left  auricle.  Coming  here  also  as  the  natural  stimulus,  in  larger 
quantities  than  usual,  it  gives  increased  energy  to  its  own  propulsion 
into  the  left  ventricle,  from  whence  it  is  driven  out  through  the  arte- 
ries to  all  parts  of  the  pyslem,  by  the  powerful  strokes  of  that  strong 
muscle. 

Thus  it  goes  its  round,  urged  on  by  exercise,  parting  with  its  oxy- 
gen more  and  more  freely  in  the  capillaries,  giving  r  ::e  activity  to 
the  vessels  of  the  skin  and  other  tissues,  increasing  the  depth  and 
strength  of  breathing  by  carrying  more  venous  blood  to  the  lungs ; 
improving  the  digestion,  carrying  a  better  elaborated  pabulum  to  the 
nutrient  arteries,  and  causing  them  to  work  it  up  more  diligently  in 
renewing  the  tissues. 

Nor  is  this  all.  Every  wrench  of  a  muscle  forces  some  old,  worn 
out  particles  from  their  places,  allowing  none  to  remain  except  such 
as  are  firm,  and  able  to  bear  the  brunt  of  exertion.  The  flesh  of  those 
who  exercise  much  becomes  hard  and  enduring. 


M$' 


230 


DISEASES  OF  THE  CHEST. 


I  say  then  to  the  consumptive,  if  you  would  live  and  not  die, 
exercise,  exercise,  exercise.  It  is  the  first,  second,  and  third  thing. 
If  you  ask  for  the  modes  of  exercise,  I  say  take  it  on  foot,  out  of 
door,  every  day,  to  the  extent  of  a  small  amount  of  fatigue.  Don't 
be  frigljtened  by  a  single  cloud,  or  even  by  a  cohort  of  them.  You 
have  as  good  a  right  to  be  out  as  the  clouds ;  and  they  will  not  look 
more  angry,  but  rather  more  agreeable  from  finding  you  abroad  in 
their  company.  The  (dements  of  nature  are  at  war  with  organic  life. 
Against  them  the  vital  principle  has  to  maintain  a  perpetual  struggle ; 
and  he  who  loses  the  power  to  meet  and  gain  the  victory  over  them 
by  out-door  exercise,  is  beginning  to  die. 

Go  abroad,  therefore,  often.  Try  it  again  and  again.  Extend 
your  walk  a  little  every  day.  Stretch  it  out  to  the  distant  fields. 
Gather  flowers  from  the  top  of  tiie  hills  and  from  the  bosom  of  the 
vallies,  and  bring  them  home  as  trophies  of  your  \  iotory. 

If  not  able  to  begin  with  walking,  ride  as  oftt'ii  as  possible  in  a 
carriage.  The  jolting  of  a  vehicle  will  jog  the  olood  along  much 
better  than  no  exercise.  ■ 

Horseback  riding  is  still  better.  It  combines,  in  some  measure,  the 
passive  exercise  of  carriage  riding,  with  the  active  exertion  of  walk- 
ing on  foot. 

Numerous  other  modes  of  exercise  may  be  resorted  to  with  advan- 
tages. Dumb-bells,  adapted  in  size  to  the  strength  of  the  patient,  and 
used  with  caution,  are  highly  serviceable.  The  battledoor,  the  foot- 
ball, jnmping  the  rope,  pitching  quoits,  and  the  athletic  sports  of  the 
gymnasium,  all  have  their  appropriate  place.  The  greater  the  variety 
the  better,  as  by  it  all  parts  of  the  system  are  brought  into  play,  and 
both  the  mind  and  tliJ  muscles  get  the  change  which  they  need. 

It  is  hard  to  impress  patients  with  the  importance  of  this  subject. 
Say  what  you  will,  they  somehow  or  other  get  the  id(;a  that  a  mod- 
erate amount  of  exercise,  taken  whv.n  they  feel  like  it,  is  all  that  is 
required.  Fatal  mistake !  Whatever  the  physician  may  do,  the  pa- 
tient has  a  great  deal  to  do  for  himself.  He  must  strive  to  develop 
his  physical  powers  to  the  utmost.  He  must  train  himself  as  ruimers 
and  fighters  do  when  preparing  for  their  surprising  feats ;  for  he  is 
running  against  the  swiftest  disease  (or  the  surest  winner)  of  our  cli- 
mate, antl  lighting  with  the  elements. 

If  he  regards  lite  as  not  worth  this  exertion,  of  course  he  will  not 
make  it ;  but  I  beg  him  to  consider  that  without  it,  recovery  will  be 
uncertain,  and  in  many  cases,  impossible.  Do  as  I  have  directed,  and 
if  your  medical  attendant  is  skilful,  the  current  of  health  will,  in 
many  cases,  begin  to  flow  back  to  you.  Life  will  renew  to  you  its 
policy  of  insurance,  and  multiply  your  days. 


Travelliiijf.  —  Consumptive  patients  have  generally  been  sent  to  a 
southern  climate.  But  where  the  case  involves  dyspepsia  and  affec- 
tions of  the  liver,  low  latitudes  are  generally  unfriendly.  Liver  com- 
plaints are  the  bane  of  a  southern  climate,  and  a  sallow  complexion 
IS  the  inheritance  of  a  southerner. 

Tubercular  persona,  chilled  by  our  northern  climate,  are  sometimes 


T 


DISEASKS  OF  THK  CHEST. 


231 


temporarily  relieved  by  the  warmer  atmosphere  of  the  south.  Lat 
the  relief  is  only  temporary ;  for,  having  lost  the  power,  as  they  im- 
agine, to  bear  the  frowns  of  our  northern  sky,  they  are  dying,  and 
will  die  anywhere  unless  they  recover  this  power.  And  the  way  to 
retrieve  a  lost  advantage  over  an  enemy,  is,  not  to  retreat  to  a  point 
where  recovery  will  be  harder,  but  to  meet  him  at  once.  If  the  con- 
stitution cannot  bear  up  against  an  enemy  under  the  bracing  of  a 
northern  atmosphere,  it  will  be  still  harder  to  do  so  under  the  wilting 
of  a  southern. 

After  all,  the  objects  aimed  at  should  be  chanf^e  and  travelling.  The 
I  exercise  involved,  the  constant  exertion  required  in  getting  from  place 
to  place,  the  agreeable  sensations  produced  by  the  motion  of  cars 
'and  steamboats,  the  ever  varying  chiinge  of  sights  and  sounds,  and 
the  constantly  increasing  stock  of  one's  ideas  of  men  and  things, — 
\hese  are  wliat  rally  the  constitution,  and  open  anew  the  springs  of 
life. 

Especially  should  all  journeys  for  health  be  taken,  if  possible,  with 
an  object  in  view.  Let  the  consumptive  start  with  tlio  view  of  see- 
ing the  cave  of  Kentucky,  the  prairies  of  tiie  West,  the  great  lakes 
of  the  North,  the  falls  of  Niagara,  the  fortress  of  Quebec,  the  Sag- 
uenay  river,  the  doctor,  who  he  has  reason  to  think  will  cure  him, — 
anything  which  he  is  willing  to  make  exertion  to  see,  and  that  he  is 
sure  his  eyes  will  rejoice  in  beholding. 

I  have  thus  spoken  of  consumption  more  at  large  than  of  other 
complaints,  because  it  is  the  great  disease  of  the  world,  and  is  in- 
creasing with  the  advancement  of  civilization. 

Acute  Bronchitis. 

This  is  an  acute  inflammation  of  the  mucous  membrane  linuig  the 
air  tubes  in  the  lungs.     It  is  generally  quite  a  serious  disease. 

lMiy.sical  Siji,'lis.  —  The  sound  upon  percussion  is  generally  good.  If 
there  be  any  dulness,  it  is  conmionly  in  the  lower  and  buck  part  of 
the  chest. 

The  breathing  murmurs  are  sometimes  more,  sometimes  less  in- 
tense than  natural.     Occasionally  they  are  almost  extinct. 

In  the  early  stage,  sibilous  and  loud  rattles. 

In  the  more  advanced  stage,  mucrous  rattle. 

Now  and  then  sub-crepitant  rattle  accompanies  the  inward-drawn 
breath. 

General  Symptoms.  —  The  disease  begins  with  chills  followed  by 
fever;  tightness  across  the  chest,  difficulty  of  breathing,  hoarseness, 
loss  of  strength,  costive  bowels,  and  a  quick  and  hard  pulse.  Water 
runs  from  the  eyes  and  nostrils,  and  there  is  a  dry,  harsh,  croupy 
cough. 

After  a  few  days,  mucous  begins  to  be  raised.  This  expectoration 
gradually  becomes  more  copious,  and  is  opaque,  yellowish,  or  green- 
ish, and  occasionally  »treaked  with  blood.  This  mucus  is  very  ropy, 
and  adheres  to  the  vcsseL 


Min 

Ul!!.:.i.L 


232 


DISEASES  OF  THK  CHEST. 


There  is  more  or  less  pain  in  the  chest ;  pain  across  the  forehead^ 
which  is  increased  by  coughing;  and  a  pale  and  anxious  counte- 
nance. 

In  severe  cases,  the  tightness  across  the  chest  is  extreme,  with  a 
sense  of  suffocation,  causing  the  patient  to  call  for  the  opening  of  the 
windows.  There  is  great  difficulty  of  breathing ;  a  paleness  and  liv- 
idity  of  the  cheeks  and  lips ;  a  loud  wheezing  and  rattling  in  the 
throat,  followed  by  cold  sweat,  insensibility  and  death. 

In  children  the  disease  comes  on  like  a  common  cold^  attended  by 
a  sore  throat,  a  great  desire  to  drink,  but  a  disinclination  to  take 
food.  But  two  or  three  swallows  of  drink  can  be  taken  at  a  time 
for  want  of  breath.  The  phlegm  is  frequently  vomited  up  spontane- 
ously. 

Observations.  —  The  loud  and  sibilous  rattles  are  produced  by  simi- 
lar causes,  namely,  the  passage  of  air  along  tubes  whose  interior  is 
dry  and  rough  from  inflammation,  or  whose  calibre  is  contracted  or 
altered  in  form  by  the  swelling  of  the  membrane,  effusion  upon  \\s 
inner  surface  of  a  tough  mucous  substance,  or  a  pressure  upon  its 
external  surface  of  tubercles,  swollen  glands,  aneurismal  tumors, 
etc.  The  two  sounds  differ  mainly  in  the  key  upon  which  they  are 
pitched,  —  the  sonorous,  or  low-keyed,  coming  from  the  larger  tubes ; 
the  sibilous,  or  high-keyed,  from  the  smaller, — just  as  the  low  notes 
of  an  organ  come  from  the  large  pipes,  and  the  high  notes  from  the 
small  ones. 

The  sibilous  rattle  has  been  compared  to  the  chirping  of  birds,  the 
squeaking  of  puppies,  the  whistling  of  air  passing  through  a  key- 
hole, etc. ;  the  sonorous,  to  the  snoring  of  a  sleeping  person,  the  coo- 
ing of  doves,  and  the  sound  of  the  bass  string  of  the  violincello  rub- 
bed with  the  finger.  . 

Causes. —  It  is  generally  brought  on  by  a  sudden  cold,  by  changes 
of  the  weather,  and  by  inhaling  irritating  substances.  It  is  a  second- 
ary result,  too,  of  scarlet  fever,  measles,  small  pox,  hooping  cough, 
and  the  remittent  fever  of  infants. 

Treatment.  —  In  mild  cases,  give  warm  balm  or  flax-seed  tea,  hot 
lemonade,  or  other  similar  drinks,  —  at  the  same  time,  soaking  the 
feet  in  hot  water,  and,  on  retiring  to  bed,  apply  bottles  of  hot  water  to 
the  feet  and  sides,  to  produce  sweating.  If  the  bov.'els  be  costive, 
some  gentle  physic,  as  rhubarb  and  magnesia,  or  salts  and  senna,  may 
be  taken. 

In  the  case  of  infants,  an  emetic  of  wine  of  ipecac,  or  compound 
tincture  of  lobelia,  should  be  given,  and  followed  with  slippery  elm 
and  flax-seed  tea.  The  compound  tincture  of  lobelia,  with  tincture 
of  veratrum  viride,  may  be  continued  for  a  time  as  an  expectorant. 

In  more  severe  cases,  both  of  adults  and  children,  an  active  emetic 
is  required,  —  perhaps  the  compound  powder  of  lobelia  is  as  good  as 
any.  This  must  be  followed  with  tincture  of  veratrum  viride,  in  full 
doses,  so  as  to  reduce  the  pulse  at  once,  and  keep  it  down  to  the 
natural  standard.  This  is  one  of  the  very  best  articles  in  this  com- 
plaint, and  will  generally  very  much  lessen  its  violence  and  duration. 


,  the 

key- 

coo- 

t)  rub- 


hot 


)Ound 
ehn 


com- 
ation. 


DISEASES  OF  THE  CHEST. 


233 


If  there  is  much  difficulty  of  breathing,  the  air  of  the  room  must 
be  kept  moist,  as  recommended  in  croup. 

The  room  should  also  be  kept  warm,  —  decidedly  warmer  than  in 
the  case  of  other  fevers. 

A  gentle  perspiration  should  be  kept  up  by  small  doses  of  com- 
po^na  tincture  of  Virginia  snake-root,  and  by  frequently  bathing  t^e 
surface,  or  else  by  tincture  of  Teratrum. 

Mustard  should  be  applied  to  the  chest,  and  to  the  soles  of  the  feet 

iDhe  cough  may  be  managed  by  preparations  (104)  (106)  (llO), 
freely  given. 

The  diet  should  be  confined  to  barley-water,  toast-water,  apple> 
water,  rice-water,  and  a  solution  of  gum  arabic. 

Chronic  Bronchitis. 

This  is  an  inflammation  of  the  mucous  membrane  of  the  air-tubes, 
which  continues  a  great  length  of  time,  without  any  sudden  or  re- 
markable changes. 

Physical  Sifns.  —  The  percussion-sounds  are  similar  to  those  of 
acute  bronchitis.  When  a  bronchial  tube  is  dilated,  we  sometimes 
have  dulness  around  the  dilated  part. 

The  breathing  murmur  is  always  accompanied  by  a  mucous,  sono- 
rous, or  sibilant  rattle, — sometimes  by  a  subcrepitant 

When  dilatation  of  the  tubes  exists,  the  intensity  and  duration  of 
the  sound  of  the  ingoing  breath  is  decreased,  —  of  the  outgoing 
increased. 

In  this  state  of  the  tubes,  we  also  have  cavernous  breathing,  bron- 
chophony, sometimes  pectoriloquy,  and  bronchial  or  cavernous  cough. 

General  Symptoms.  —  A  cough  is  generally  present,  which  is  in- 
creased in  wet  weather,  and  by  every  slight  cold.  This  comes  on  in 
paroxysms ;  is  generally  worse  in  the  morning ;  and  is  relieved  by 
raising  freely.  The  matter  raised  is  generally  yellowish,  but  some- 
times whitish  and  sticky ;  and  in  the  latter  stages,  is  thick,  and  some- 
times very  much  like  that  of  consumption.  Indeed,  the  disease  often 
ends  in  bronchial  consumption. 

Remarks.  —  The  breathing  is  bronchial  or  cavernous  when  the  di- 
lated portion  of  the  tube  is  empty;  —  if  it  contain  fluid,  the  mucous 
rattle  will  be  heard. 

Dulness  on  percussion  will  exist  if  a  dilated  tube  press  upon  the 
surrounding  portion  of  lung  so  as  to  condense  or  make  it  solid. 

Dilatation  of  the  tubes  occurs  only  in  chronic  bronchitis  of  long 
standing.  Its  physical  signs  are  much  like  those  of  a  cavity  in  ad- 
vanced consumption.  The  examiner  may  learn  to  aistingaish  them 
by  considering  that  in  consumption,  dulness  precedes  the  avitp,  while 
in  bronchial  dilatations,  the  cavity  precedes  dulness. 

The  dilatation  or  swelling  out  at  some  point  of  a  bronchial  tube,  is 
caused  by  obstructions  to  the  passage  of  air  through  it, — just  as  an 
India-rubber  tube,  partially  closed  up  at  a  given  point,  will  bulge  out 


H 


ij^ 


111 


:i*: 


■!> 


n<  »f 


]^ 


J    .  ■ 


234 


DISEASES  OF  THE  CHEST. 


Fi(*.  i»2. 
[Patentid  March  16,  1852.] 


f? 


\l 


just  in  front  of  the  obstructed  place,  when  air  is  forcibly  blown 
through  it,  and  just  as  the  left  ventricle  of  the  heart  enlarges  when 
the  blood  is  obstructed  in  its  passage  through  the  aortic  valve. 

Causes.  —  It  often  occurs  as  the  result  of  acute  bronchitis,  and  also 
of  measles,  hooping-cough,  etc.  But  tiking  cold,  and  damp  and  change- 
able weather,  are  more  frequently  its  causes.  It  most  often  follows 
chronic  inHamihations  of  the  throat,  which,  being  neglected,  gradually 
creep  down  the  windpipe  into  the  tubes,  and  become  very  obstinate 
in  their  character. 

Treatment. —  Medicinal  inhalation  is  one  of  the  best  remedies  for 
this  complaint.  The  inhaling  powder  has,  in  many  cases,  great  eili- 
ciency.  The  dose  is  iibt)ut  what  can  lie  on  a  ten  cent  [)iece.  It, 
should  be  used  once  a  day,  in  an  instrument  represented  in  the  cut. 

This  inst.  inent  I  had  constructed  in  I80O.  It  consists  mainly  of 
a  glass  tube  an  1  a  receiver,  —  the  latter  being  something  like  a  tube 
vial,  pierced  witl>  fmc  holes  around 
the  lower  end.  The  powch^r  is 
poured  into  the  receiver,  which  is 
placed  in  the  larger  tul)e,  and 
twirled  between  the  timmb  and 
finger  while  inhaling. 

When  the  powder  cannot  be 
easily  got  down  into  the  tubes  in  the  lungs,  —  as  often  happens, — 
the  inhalation  of  niedictated  vapor  will  do  better.  If  the  expectora- 
tion be  dillicult,  the  expectorant  inhalant,  described  under  " coiisiuii|)- 
tion,"  should  be  used  ;  if  the  expectoration  be  too  profuse  and  free, 
the  astringent  inhalant  must  be  taken. 

The  cough  preparations  recommended  for  consumption,  also  (113) 
(112),  will  be  the  proper  ones  in  this  complaint. 

The  daily  alkaline  bath,  and  brisk  friction,  are  particularly  service- 
able. 

Out-door  exercise  is  almost  as  necessary  in  this  disease  as  in  con- 
sumption. 

Enlargement  of  the  Air  Cells. — Emphysema. 

This  disease  consists  in  enlargement  of  the  air  cells,  the  obliteration 
of  their  vessels,  and  the  wasting  of  their  walls. 

Physical  KSi|t;ns.  —  Thumping  upon  the  chest  gives  a  clearer  and 
louder  sound  than  natural,  —  one  which  is  tympanitic,  or  drum-head 
like. 

The  murmur  of  the  ingoing  breath  is  diminished  both  in  duration 
and  intensity,  —  of  the  outgoing  breath,  it  is  increased. 

Dry,  crepitant  rattle  attends  the  ingoing  breath  only ;  occasionally, 
sibilous  rattle. 

General  Symptoms.  —  Habitual  shortness  of  breath,  and  very  great 
difficulty  of  breathing,  occurring  in  paroxysms,  which  cause  the  pa- 
tient to  rush  to  the  open  window  for  air. 


IS  111  con-  I 


DISEASES  OF  THE  CHEST. 


23-1 


There  is  generally  a  cough,  and  the  matter  raised  is  frothy,  liquid, 
and  mucous,  or  watery. 

The  face  has  a  peculiar  dusky  color,  and  the  countenance  an  anx- 
iouH,  melancholy  expression.  The  nostrils  are  thick,  and  the  lower 
lip  full.  The  muscles  of  the  nw^k  an;  large,  and  the  gait  of  the  pa- 
tient is  stooping.  The  strength  is  wasted  in  proportion  to  tlie  diffi- 
culty of  breathing. 

Emphysema  tends  to  produce  discat-.n  of  the  heart,  Bright's  disease, 
and  venous  coiigi^stions  in  the  head. 

OIlMTVations.  —  Tlie  tympanitic  sound  is  caused  by  the  increased 
amount  of  air  in  the  cells. 

The  air  cells  having  lost  their  elasticity,  the  air,  in  a  great  degree, 
remains  in  them, —  not  passing  in  and  out,  —  henec  the  absence  of  the 
vesicular  murmur. 

The  crepitant  ratlle  attends  the  ingoing  breath  only,  and  is  sup- 
posed to  arise  from  the  expansion  of  lungs  which  are  in  a  drier  stat(^ 
than  natural.  It  has  be(!n  compared  to  the  soun<l  produced  by  blow- 
ing into  a  dried  bladder. 

Treutmeilt. —  To  whatever  extent  the  air-cells  are  destroyed,  to  that 
extent,  of  course,  tlu;  disease  is  incurable.  It  may,  liowever,  be  pal- 
liated and  relieved  to  a  great  extent. 

(Generally,  bronchitis  exists  in  connection  with  emphysema;  and 
when  this  is  iVu. iid  to  be  case,  the  remedies  fi)r  that  disease  must  b<j 
employed. 

The  inhalation  of  tiiurture  of  stramonium,  in  one  or  two  teaspoon- 
tul  doses,  the  same  as  the  alterative  inhalant  is  used,  will  be  useful. 

To  be  taken  internally,  an  excellent  preparation  may  be  made  by 
uniting  oiu;  dram  of  ethereal  tincture  of  lobelia,  with  two  drams  of 
tiiicture  of  ipecac,  and  two  ounces  of  ammoniac  mixture.  The  dose 
is  one  to  two  tablespoonfuls.  Half  grain  to  grain  doses  of  extract  of 
cannabis  indica,  are  excellent  to  relii've  the  diliiculty  of  breathing. 

The  diet  must  be  very  (carefully  regulated,  as  overindulgence  at  the 
table  aggravates  the  symptoms. 

Change  of  air  is  often  highly  beneficial ;  but  it  is  impossible  to 
predict  its  effects  beforehand  in  each  individual  case. 

Swelling  of  the  Lungs.  —  ILfpertrophy  of  the  Lungs. 

This  can  hardly  be  regarded  as  a  disease.  It  generally  takes  place 
in  but  one  lung,  and  is  the  result  of  the  inaction  of  the  other.  Thus, 
when  one  lung  is  diseased,  the  other  has  to  do  the  work  of  both  ;  and 
being  overworked,  it  enlarges  as  the  heart,  or  an  arm  docs,  when  very 
tiinch  exercised. 

The  only  treatment  required  is  to  eat  sparingly,  and  exercise  with 
great  moderation,  so  as  not  to  inco^ase  the  rapidity  of  the  breathing. 

Pulmonarj  Apoplexy. 

This  is  generally  the  result  of  a  disease  of  the  heart,  particularly 
of  the  mitral  valve. 


i'ff«P 


lilM 


M  •' 


i;.» 


w*| 


m 


236 


DISEASES  OF  THE  CHEST. 


Physical  Si^ns.  —  Percussion  yields  a  clear  sound,  except  where 
the  engorgement  of  blood  is  large,  and  near  the  surface,  —  in  which 
case,  it  is  dull. 

The  sound  of  breathing  is  feeble  or  absent  over  a  limited  space. 

Bronchial  breathing  is  heard  in  some  places,  and  bronchophony  in 
pa?  t,  in  the  same  regions.  ,    •■ 

Mucous  rattle  is  also  heard. 

Observations.  —  In  this  disease  the  small  air-tubes  and  air-cells  are 
the  seat  of  bleeding ;  and  the  blood  becoming  coagulated  here,  cIosks 
these  vessels  against  the  entrance  of  air.  This  explains  the  feeble- 
ness or  absence  of  the  breathing  murmur. 

The  fluidity  of  blood  in  the  immediate  yicinity,  givjs  rise  to  the 
mucous  rattle. 

General  Symptoms.  —  These  are,  difficulty  of  breathing,  tightness, 
and  dull  pain  in  the  chest  The  mucus  raised  is  tinged  or  streaked 
with  blood.  The  blood  raised  is  darkish,  and  dirty-looking.  Tliiii 
last  symptom,  the  dirly  look  of  the  blood,  is  peculiar  in  tuis  Uisea.se. 

Treatment.  —  The  most  important  remedy  is  dry-cupping  upon  the 
chest  This  will  often  arrest  the  disease  at  once.  Counter-irritation 
by  crotctn  oil  is  also  useful.  A  free  movement  of  the  bowels  by  a 
preparation  containing  croton  oil,  or  elateriuui  (31)  (33),  has  an  ex- 
cellent efllect. 

Air  in  the  Chest.  —  Pneumothorax. 

This  disease  con.sists  in  the  presence  of  air  in  the  cavity  of  t!ie 
pleura.  Generally,  there  is  also  water  in  the  p]<!ural  sac  at  the  same 
lime  ;  the  water,  being  the  heavier  fluid,  occupying  the  lower  part  of 
the  cavity,  and  the  air  the  upper  part. 

Pliysical  Sipis.  —  Tympanitic  or  drum-like  sound  over  the  upper 
part  of  the  side.  .Dull  sound  over  the  lower  part.  Breathing  mur- 
mur diminished  or  suppressed.  Amphoric  breutliing.  Metallic  tink- 
ling. 

General  8>mpt«ms,  —  (ireat  oppression  of  the  chest,  and  diificuUy 
of  breathing ;  generally  attended  by  palpitation  of  the  heart,  an<i  fre- 
quently by  severe  pain  under  the  breast-bone,  on  the  afiected  side. 
The  patient  generally  has  to  remain  in  the  sitting  posture,  and  catuwt 
lie  an  instant  on  the  souiH  side. 

if,  on  perevission,  one  side  of  the  cheut  soojids  louder  than  the  othei; 
and  the  breathing  murmur  is  heard  d»sti:»ctly  on  the  side  which  give:* 
only  a  moderate  sound,  and  is  not  heard  at  all  on  the  loud-sounding 
fide,  we  may  be  sure  it  is  a  case  of  air  in  the  chest 

Observations.  —  The  metallic  tinkling  is  like  the  sound  produced  by 
dropping  a  pin's  head  into  a  metallic  dish,  or  like  the  distant  tinkling 
of  a  sheep-bell,  or  the  gentle  pulliv,^  of  the  string  of  a  violin. 

It  is  supposed  that  when  the  fluid  in  the  cavity  of  the  pleura  hap- 
j>en8  to  be  higher  than  the  orifice,  the  air,  when  it  enters  at  each 


. '■:7.r;p-iwtiwm 


ept  where 
-in  which 

I  space, 
lophony  in 


ir-cella  are 
lere,  closes 
the  feeble- 

risc  to  the 

,  tightness, 
or  streaked 
Jug.  This 
^  Jisea.-ie. 

y  upon  the 

:^r-irritatiou 

awels  by  a 

has  an  ex- 


vity  of  the 

t  the  same 

kver  part  of 


the  upper 

thing  niur- 

tallic  tiah- 

1  difficulty 
rt,  and  fro- 
"ected  side. 
and  cannot 

n  the  othet 
kvljich  gives 
d-soundiiij? 

)rodaced  by 
nt  tinklini; 
in. 

pleura  hap- 
ers  at  each 


DISEASES  OF  THE  CHEST. 


237 


in-drawn  breath,  forcesj  its  way  up  through  the  fluid,  in  the  shape  of 
bubbU's,  and,  bursting  at  the'surface,  gives  the  tinkling  i^ound.  This 
;si)und  is  sometimes  produced,  too,  by  the  falling  of  Irops  of  liquid 
fr*un  the  upper  part  of  the  cavity,  uj)on  the  surface  of  the  flu.'d. 

The  amphoric  breathing  is  like  the  sound  produced  by  blowing 
obliquely  into  an  empty  cask.  One  writer  says  he  heard  the  same 
.sound  when  out  shooting  in  a  rough  day,  produced  by  the  wind  blow- 
ing sideways  into  the  gun-barrel. 

Treutllieat.  —  T  would  recommend  the  use,  two  or  three  times  a 
(lay,  of  the  antiseptic  inhalant,  mentioned  under  the  head  of  con- 
>ii;tipti()n. 

To  tlii.s  should  be  added  dry -cupping  over  the  whole  chest,  which 
iiciierally  gives  great  relief.     Blisters  may  also  be  used. 

Sweating  must  be  encouraged  in  the  manner  recommend^  under 
acute  bronchitis. 

For  the  difficulty  of  breathing,  give  half  grain  doses  of  cannabis 
iiidica,  or  five  drop  doses  of  tincture  of  aconite,  or  one-si.\th  of  a 
grain  dose^.  of  morphia.  Extract  of  belladonna,  or  of  stramonium,  is 
also  worthy  of  trial. 

Water  in  the  Chest.  —  Ili/drothorax. 

Tnis  disease  consists  in  a  collection  of  water  in  the  cavity  of  the 

pleura. 

IMiyslCiil  Si«nis. —  There  is  a  dull  sound  over  the  eflfusion. 

The  breathing  nuirmur  is  diminished,  and  gradually  disappears 
altogether  over  tlie  space  occupied  by  the  effiision. 

Wrnnehial  breathing  is  heard  in  the  same  part. 

When  the  amount  of  fluid  ia  small,  egophony  ia  heard  in  the  mid- 
dl*.  icgiona  of  the  chest. 

Bronchophony  is  heard  when  the  effusion  is  larger. 

General  Symptoms. —  Eithef  upon  lying  down,  or  using  active  bodil^ 
exercise,  the  patient  finds  his  difficulty  of  breathing  increased,  Wheli 
in  bed,  he  lies  with  his  head  and  shoulders  raised,  which,  by  causing 
the  fluid  to  settle  at  the  bottom  of  the  cavity,  prevents,  in  a  measure, 
its  pressure  upon  the  lungs,  and  gives  him  a  little  rest.  His  sleep  ii«' 
intenupted  by  sudden  starts,  with  alarm  and  terror.  The  pulse  i* 
hard,  ihe  thirst  great,  ihe  urine  scanty  and  high-colored,  and  has  a 
Bedim. mt.  After  a  time,  the  feet  swell,  the  face  is  pallid  and  livid, 
and  Uie  countenance  expresses  anxiety  and  alarm.  There  is  a  short," 
dry  cough. 

When  the  quantity  of  fluid  in  the  chest  becomes  large,  the  patient 
cannot  lie  down  at  all,  and  only  gets  short  and  disturbed  naps  in  the 
sitting  posture. 

Of  all  the  .symptoms,  the  starting  in  sleep  is  the  most  certain  sign' 
of  the  disease. 

Causes. —  In  some  rare  cases,  this  may  occur  as  a  primary  diseaae, 
—  that  is,  as  a  disease  not  dependent  uuun  an-   other  as  it»  cause. 


* 


If    ,• 


s 


l..t. 


238 


DISEASES  OF  THE  CHEST. 


The  greater  number  of  cases,  however,  are  secondary.  They  arise 
from  organic  disease  of  the  heart,  or  liver,  or  stomach.  Inflammation 
of  the  pleura  is  a  very  frequent  cause. 

A  plethoric,  or  full  state  of  the  system,  predisposes  to  this  com- 
plaint,—  particularly  in  those  persons  who  indulge  freely  at  the 
table. 

It  may  arise,  too,  from  the  striking  in  of  skin  eruptions ;  from  the 
free  use  of  liquors ;  and  from  frequent  excessive  bleedings  or  purg- 
ings. 

Treatment. —  Dry-cupping  is  a  valuable  remedy,  and  should  always 
be  practised. 

The  chest  should  be  painted  with  the  tincture  of  iotline,  and  a  good 
degree  of  substantial  soreness  be  kept  up. 

The  internal  remedies  are  purges  (31)  (14)  (30),  and  diuretics 
(128)  (129)  (130)  (131). 

The  iodide  of  potassium,  in  doses  of  five  or  six  grains,  once  in 
three  or  four  hours,  is  an  excellent  remedy.  The  following  is  a  good 
form  of  taking  it,  —  iodide  of  potassium,  one  once ;  fluid  extract  of 
pipsissewa,  two  ounces ;  water,  half  a  pint     Dose,  one  teaspoonful. 

The  skin  should  be  bathed  and  rubbed  daily,  three  or  four  times, 
with  much  friction. 

Pleurisy. —  Pleuntis. 

Pleuiusy,  or  pleurisy  fever,  as  it  is  sometimes  called,  is  an  inflam- 
mation of  the  pleura,  or  the  membrane  which  lines  the  chest,  and,  at 
the  same  time,  is  folded  back  so  as  to  cover  the  outer  surface  of  the 
lungs. 

The  pleura,  as  is  elsowiiere  explained,  is  a  short  sac  or  bag,  whose 
inner  sides  are  kept  inoist,  so  that  they  may  slide  easily  upon  each 
other  as  tliey  are  moved  by  the  alternate  contractions  and  expan- 
sions of  the  lungs  in  the  act  of  breathing,  and  whose  outer  sides  are 
made  to  grow,  —  one  to  the  inside  of  the  chest,  and  the  other  to  the 
outside  of  the  Inngs. 

Pleurisy  and  lung  fever,  then,  must  be  kindred  diseases,  and  exist, 
more  or  less,  together.  In  truth  there  is  almost  always  some  aHectioii 
of  the  pleura  in  lung  fever,  and  some  afiiH^tion  of  the  lungs  in  pleu- 
risy. The  pain  in  lung  fever  is  owing  to  some  inflannnation  of  the 
pleura ;  and  the  appearance  of  the  rusty-colored  phlegm  in  pleurisy 
indicates  that  the  lungs  have  been  reached  by  the  inflammation  of  the 
membrane  v^hieh  covers  them. 

Physical  Hifm.  —  Dulness  on  percussion,  at  the  lower  part  of  the 
chest,  which  ciscends  as  the  eft'usion  of  water  increases. 

If  the  efl'used  fluid  is  not  great,  there  is  puerile  breathing  at  the  top 
of  the  lung.  , 

Friction  sound  is  heard  occasionally. 

Ego[)hony  is  heard  when  the  amount  of  fluid  in  the  pleura  is 
Bmall. 

As  the  amount  of  water  increases,  bronchophony  appears. 


¥ 


DISEASES  OF  THE  CHEST. 


239 


Cieneiul  Symptoms.  —  This  disease  is  most  frequently  introduced 
by  skiverings,  which  are  soon  succeeded  by  high  fever,  with  a  pecu- 
liarly hard,  resisting  pulse  ;  sharp,  stabbing  pain  in  the  side,  —  gener- 
ally just  below  the  nipple,  but  sometimes  extending  to  the  shoulder, 
arm-pit,  and  back ;  hurried  and  interrupted  breathing ;  and  a  short, 
dry  cough. 

The  pain  is  greatly  aggravated  by  motion,  coughing,  or  an  attempt 
to  take  a  long  breath.  It  holds  the  patient  under  constant  and  power- 
ful restraint.  We  find  him  lying  upon  his  back,  or  his  well  side  ;  his 
countenance  full  of  anxiety, — fearing  to  move,  cough,  or  even  breathe 
needlessly ;  and  often  crying  out  from  the  keen  torture  these  neces- 
sary acts  inflict  in  spite  of  all  his  caution. 

At  a  more  advanced  stage,  when  the  tenderness  has  somewhat 
abated,  he  will  prefer  to  lie  on  the  diseased  sid<;,  as  this  leaves  the 
healthy  lung  more  at  liberty. 

Observations.  —  The  first  effect  of  the  inflammation  of  the  pleura 
ib  to  dry  up  the  moisture  with  which  its  inner  surfaces  are  lubricated, 
or  made  smooth  and  slippery.  As  a  consetiuence,  these  surfaces  be- 
come rough,  and  rub  harshly  upon  each  other,  and  produce  a  sound, 
in  the  early  stages  of  pleurisy,  like  that  of  rubbing  two  pi<H!cs  of  wet 
leather  together.  It  may  be  imitated  by  rubbing  the  finger  back  and 
forth  upon  a  table.  It  is  sometimes  a  crcriking  noise,  like  that  of 
new  shoes. 

As  the  disease  advances  an  important  change  takes  place  in  the 
state  of  things.  Instead  of  an  unnatural  dryness,  a  watery  fluid  is 
poured  out  copiously  from  the  iritlamed  surfaces  of  the  pleural  sac. 
This  is  calleti  l/ie  period  of  effusion.  This  generally,  though  not  al- 
ways, relieves  tho  pain.  But,  by  compressing  the  lung,  causes  dan- 
gerous ditficulty  of  breathing. 

The  air-cells  are  compressed  by  the  eflused  fluid,  and  are  not  pene- 
trated by  air.     Hence  the  absence  of  the  breathing  murmur. 

The  pouring  out  of  water  between  the  layers  of  the  pleura,  com- 
presses the  lung,  and  removes  it  froui  the  walls  of  the  chest.  Hence 
the  dulness  or  deadness  of  sound  upon  percussion. 

When  listening  with  the  stethoscope,  the  voice  of  the  patient  sounds 
feeble  and  interrupted,  like  the  bleating  of  a  goat,  and  is  hence  termed, 
tgophoni/,  or  goal-voice. 

This  peculiar  voice  is  heard  only  when  the  cfl'usion  of  water  has 
been  moderate  in  tpiantity,  and  only  a  thin  layer  of  licjuid  lies  be- 
tween the  ribs  and  lung.  It  is  caused  by  the  voice  passing  over  this 
thin  layer,  which  is  thereby  thrown  into  vibrations^  or  wavy,  quiver- 
ing motions.  When  thus  agitated,  the  fluid  reacts  upon  the  voice, 
making  it  sharp  and  tremulous. 

When  the  effusion  has  become  large,  these  effects  cease  ;  but  an- 
other sign  then  shows  itself,  and  distinguishes  pleurisy  from  the 
healthy  state,  and  likewise  from  the  solid,  hepatized  state  of  the  lung 

discovered  thus : 


mg 


may 


:hile 


If  the  hand  be  laid  flat  upon  the  chest  of  a  healthy  person, 
he  is  speaking,  a  vibration  or  thrill  will  be  felt     If,  in  like  manner, 


'm 


240 


DISEASES  OF  THE  CHEST. 


the  hand  be  laid  upon  the  cheat  of  a  person  having  lung  fever,  with 
hepatized  lung,  this  thrill  will  be  found  still  more  perceptible.  But 
when  the  hand  is  placed  over  the  place  of  watery  effusion  on  the  chest 
of  a  person  having  pleurisy,  there  will  be  discovered,  when  the  person 
speaks,  no  thrill  lohalever.  The  absence  of  this  thrill,  then,  is  one  of 
the  very  best  signs  of  pleurisy  with  effusion. 

Persons  recover  from  pleurisy  sometimes  very  rapidly,  before  effu- 
sion has  taken  place.  It  is  then  said  they  have  had  an  attack  of  dn/ 
pleurisy.  When  liquid  has  been  poun^d  out,  even  in  considerable 
(juantity,  it  is  sometimes  reabsorbed,  and  the  patient  recovers  pi^r- 
fectly.  In  other  iiistaiiees,  it  compresses  the  lungs,  interferes  seriously 
with  breatliing,  reduces  his  strength,  and  he  sinks  rapidly. 

Treatment.  —  Pleurisy  has  been  divichul  for  description  and  treat- 
ment into  three  stages,  following  the  natural  events  of  the  inffamma- 
tion.  The  first  stage  comprises  the  period  from  the  first  onset  to  the 
time  when  effusion  commences.  The  second  stage  or  stage  of  effu- 
sion extends  to  the  time  when  the  liquid  begins  to  diminish  ;  and  the 
third  stage  consists  of  the  period  occupied  by  the  absorption  of  the 
liquid. 

Should  the  quantity  remain  stationary  or  diminish  very  slowly 
after  the  lapse  of  two  or  three  weeks,  the  disease  become  j  chronio 

The  indication  for  treatment  during  the  first  stage  is  to  arrest  the 
progress  of  the  disease,  to  diminish  its  intensity,  to  limit  the  amount 
of  morbid  products,  and  to  relieve  suffering. 

If  the  patient  is  robust,  has  a  hard,  frequent  pulse,  accompanied 
with  extreme  pain  and  fever,  blo^'^-letting  is  indicated.  The  abstrac- 
tion of  ten  to  fifteen  ounces  of  blood  will  give  great  relief  and  diminish 
the  intensity  of  the  attack ;  but  if  the  patient  is  not  seen  early,  and  is  of 
a  feeble  constitution,  some  other  measures  should  be  substituted  for  it. 
The  mass  of  blood  may  be  lessened  by  saline  cathartics,  such  as  che 
sulphate  of  magnesia,  or  the  bitartrate  of  potash  in  combination  with 
jalap. 

The  effect  of  a  full  dose  of  Epsom  salts  is  equal  to  the  abstraction 
of  a  pint  of  blood  from  the  system.  Depletion  is  obtained  this  way 
without  the  impoverishment  of  the  blood. 

The  frequency  and  force  of  the  heart's  action  may  also  be  affected 
by  the  nauseant  sedatives,  such  as  tartarized  antimony  and  ipecacuanha, 
and  by  the  direct  sedatives,  such  as  the  tincture  of  aconite  and  of 
veratrum  viride ;  therefore,  if  blood-letting  is  contra-indicated,  the 
first  thing  to  be  done  is  to  give  the  sulphate  of  magnesia,  and  follow 
it  with  a  full  opiate  in  the  shape  of  Dover's  powder,  to  alleviate  the 
painful  stitch  in  the  side  and  to  tranquilize  ^e  system.  (See  addi- 
tional treatment  p.  876.) 

■  ■ 

Lung  Teyer.  —  Pneumonia, 

Tms  disease,  by  common  usage,  has  been  called  a  fever ;  but  by 
physicians  it  is  reckoned  one  of  the  inflammatioM,  It  is  inflamnw- 
tion  of  the  lung8  or  UglUa;  and  whatever  fever  there  may  be  results 
entirely  from  this  local  inflammation. 


\nw 


DISEASES  OF  THE  CHEST. 


241 


Sijfns  and  Symptoms. —  A  patient  suffering  with  lung  fever,  is  gen- 
erally found  lying  upon  his  back,  with  some  pain  in  the  side ;  more 
or  less  difficulty  of  breathing ;  a  cough,  at  first  dry,  but  soon  accom- 
])anied  by  raising  a  thick,  sticky,  rusty-colored  matter,  composed  of  a 
mixture  of  phlegm  and  blood.  As  the  disease  increases  in  severity, 
this  matter  will  become  more  sticky  and  tenacious,  so  that  it  will  ad- 
here to  a  spit-cup  turned  upside  down.  There  will  be  more  difficulty 
of  breathing,  greater  prostration,  and  perhaps  some  delirium. 

For  the  purpose  of  more  clearly  describing  this  complaint,  it  is 
foun.l  convenie.it  to  divide  it  into  three  stages,  or  degrees  of  progress. 

First  Stii^ie.  —  This  is  called  the  stng-e  of  engorgement.  The  lungs 
during  this  stage  are  en{;^orged  or  crov)ded  witli  blood.  If  we  could 
inspect  them,  we  should  find  the  inflamed  portion  redder,  thicker,  and 
heavier  than  usual.  We  should  find  them  weaker,  that  is,  more 
easily  torn  than  in  the  natural  state  ;  with  less  air  in  them,  and  con- 
sequently crackling  less  upon  pressure,  —  yet-not  entirely  destitute  of 
air  and  crackling,  and  not  so  heavy  as  to  sink  in  water.  Rapping 
upon  the  chest  at  this  period  gives  out  a  flatter,  duller,  or  less  hollow 
sound  than  usual.  On  applying  the  stethoscope,  we  hear  less  of  the 
jiatural  rustling  sound  of  health  ;  and,  either  mingling  with,  or  over- 
coming it,  we  hear  a  minute  crackling  sound,  as  the  air  passes  in  and 
out  in  breathing. 

This  crackling  has  been  compared  to  that  produced  by  fine  salt 
thrown  upon  red-hot  coals  ;  or  by  that  of  rubbing  a  lock  of  fine  hair 
between  tlje  thumb  and  finger  near  the  ear.  It  is  caused  by  small 
bubbles  of  air  being  forced  along  the  moist  and  sticky  sides  of  the , 
sma]l  tubes  and  air-cells.  It  is  heard  only  while  the  breath  is  being 
drawn  in. 

Second  Stag;e. —  If  the  inflammation  advances  to  the  second  stage, 
the  swelling  of  the  diseased  lung  increases  so  as  to  force  out  the  air 
entirely,  and  it  becomes  solid,  and  wholly  useless  for  the  purpose  of 
breathing.  In  solidity  and  general  appearance,  it  resembles  a  piece 
of  liver.  Hence  it  is  said  to  be  hepatized,  or  liverized;  and  this  is 
called  the  stage  of  hepatization. 

As  the  lung  grows  more  solid,  its  vitality  and  strength  diminish ; 
it  is  not  near  as  strong  as  a  piece  of  heaiLhy  liver,  though  it  looks  like 
it ;  it  is  soft  and  easily  broken ,  indeed  it  seems  to  be  in  a  state  of 
commencing  decay  or  rottenness.  Hence  some  writers,  in  order  to 
oe  more  precisely  correct,  call  this  the  stage  of  red  softening. 

With  increased  solidity,  there  is  of  course  increased  dulness  on 
percussion.  When  the  stethoscope  is  ap[)lied  to  the  chest,  we  hear 
no  bound  of  air  passing  into  and  out  of  the  diseased  lung ;  no  natu- 
ral rustling,  or  minute  crackling;  but  in  1  heir  stead,  we  have  a  kind 
of  whistliKg,  produced  by  the  air  passing  back  and  forth  in  the  wind- 
pipe and  its  branches,  but  finding  no  entrance  into  the  solidified  air- 
cells.  The  breathing  oometimes  sounds  like  a  sort  of  pufT,  —  owing 
to  the  columi.  of  air  rebounding  when  refused  admission  to  the 
olosed-up  cells. 

The  general  symptoms  now  increase  in  severity.     There  is  greater 


m 


( 'ii;! 


I  i 


1 1 


•ii 


difficulty  of  breathing  ;  tiie  plilegm  is  more  gluey 
shows  itself  ;  and  the  patient  grows  weaker. 


perhaps  some  delirium 


Third  Stage.  —  At  this  period,  the  lung  changes  from  red  hepatization  or  red 
aoftening  to  gray  hepatization  or  gray  softening,  and  matter  is  now  found  dif- 
fused through  its  whole  substance.  The  percus^iion  sounds  are  much  the  same 
as  in  the  second  stage.  On  listening,  we  hear  more  of  the  rattling  sound  pro- 
duced by  disturbed  phlegm.  The  matter  raised  is  thinner,  —  more  like  liquid  ; 
and  looks  like  prune-juice.  The  symptoms  generally  indicate  that  the  patient 
is  sinking.  Patients  may  recover  from  the  first  and  second  stages,  but  rarely 
from  the  third. 

Treatment*  —  Pneumonitis  has  been  divided  into  three  stages,  corresponding 
to  the  inflammatory  events  of  the  disease:  the  first  stage  is  that  of  active  con- 
gestion, the  second  that  of  solidification,  and  the  third  that  of  resolution. 
The  duration  of  the  first  stage  is  from  twenty-four  to  forty-eight  hours,  of  the 
secovd  from  two  to  four  days,  and  the  stage  of  resolution  lasts  from  eight  to 
ten  days.  Different  cases  vary,  ho'"  ever,  in  these  times.  These  different 
stages  furnish  different  remedial  indications. 

The  objects  of  treatment  in  the  first  stage  are  to  arrest  the  disease,  to  lessen 
its  intensity,  to  relieve  pain,  and  to  promote  toleration  of  the  disease. 

When  high  fever,  a  hard  pulse,  and  extreme  pain  are  present  in  a  robust 
constitution,  the  abstraction  of  blood  from  the  arm  is  indicated.  These  cases 
are  not  frequent,  for  lung  fever  mostly  occurs  in  patients  with  feeble  constitu- 
tions, but  when  practised  in  the  proper  cases,  the  relief  to  pain  and  embarrass- 
ment of  breathing  is  often  immediate  and  marked.  In  thosi  cases  where 
blood-letting  is  contra-indicated,  the  same  end  can  be  secured,  bul  more  slowly, 
by  saline  cathartics  and  sedative  remedies.  After  saline  purgation,  if  the 
skin  is  hot  and  the  pulse  is  frequent;  tartar  emetic  may  be  given  in  small 
dpses  as  a  nauseant  sedative;  but  it  must  not  be  carried  to  the  extent  of  dis- 
tressing nausea.  After  this  follows  the  use  of  vascular  sedatives,  such  as  the 
tincture  of  aconite  and  the  tincture  of  vei*atrum  vinde,if  not  contra-indicated 
by  the  feebleness  of  the  patient  with  a  tendency  to  depression. 

Sometimes  the  sulphate  of  quinine,  in  a  full  dose  of  from  twenty  to  forty 
grains,  at  the  onset  or  within  eight  or  ten  hours,  will  arrest  the  disease.  It 
may  be  well  to  try  it,  as  it  can  be  administered  witli  perfect  safety.  Opium  is 
of  great  importance  also,  to  relieve  pain  and  tninquillize  the  system. 

Cold  or  warm  application  to  the  chest  may  be  used  according  to  the  prefer- 
ences of  the  patient.  Warm  applications  act  as  revulsents;  the  cold  diminishes 
the  determination  of  blood  to  the  part,  and  relieves  the  pain  by  obtunding 
sensibility.    Counter-irritants  are  not  advisable  in  this  stage. 

The  treatment  of  the  second  stage  aims  at  the  promotion  of  resolution  of  the 
Inflammation,  the  palliation  of  the  symptoms,  and  the  maintenance  of  the  powers  - 
of  life. 

The  tinctures  of  veratrum  viride  and  aconite  may  be  continued  in  this  stage, 
if  there  is  considerable  fever  and  there  is  no  tendency  to  asthenia;  but  the 
leading  measure  is  to  support  the  system. 

This  course  embraces  the  use  of  tonics,  stimulants,  and  nutritious  diet 
The  use  of  alcohols  is  necessaiy  in  most  cases,  and  sometimes  very  freely. 


::ili 


DISEASES  OF  THE    CHEST. 


243 


The  diet  should  consist  of  milk,  farinaceous  substances,  and  animal  broths. 
Quinine  in  tonic  doses  is  the  best  remedy  in  this  stage. 

The  preparations  of  opium  are  very  useful,  antl  only  contra-indicated  by  the 
accumulation  of  mucus  in  the  bronchial  tubes. 

Digitalis  is  useful  in  five  to  ten  grain  doses  three  or  four  times  a  day,  when 
it  is  necessary  to  increase  the  heart's  action. 

The  carbonate  of  ammonia  is  necessary  in  cases  of  extreme  prostration. 

The  external  application  of  the  tincture  of  iodine  is  the  best  counter-irritant 
in  this  stage. 

During  the  third  stage,  all  those  hygienic  measures  which  improve  the  gen- 
eral health  are  to  be  puisued. 


Typhoid  Lung  Fever.  —  Typhoid  Pneumonia. 

This  is  an  intlamraation  of  the  lungs,  differing  from  the  preceding  only  in 
the  character  of  the  fever  attending  it,  which  is  of  a  low,  typhoid  character. 
The  disease,  like  typhoid  fever,  is  characterized  by  great  debility  and  prostra- 
tion. 

Symptoms.  —  These  are  a  combination  of  the  symptoms  of  pneumonia  and  of 
typhoid  fever.  The  disease  begins  with  great  weariness,  lassitude,  dizziness, 
pain  in  the  head,  back,  and  limbs.  Soon  there  is  much  difficulty  of  breathing, 
tightness  across  the  chest,  with  a  dry,  short,  hacking  cough. 

As  the  disease  advances,  the  active  symptoms  pass  away;  there  is  a  dull  pain 
across  the  chest;  drowsiness  is  very  apt  to  come  on,  with  the  various  symptoms 
of  sinking  peculiar  to  typhoid  fever.  The  skin  is  harsh  and  dry,  the  tempeni- 
ture  uneven,  the  tip  and  edge  of  the  tongue  red,  and  the  middle  covered  with  a 
yellow  or  brown  fur.  The  bowels  are  tender,  swollen,  and  drum-head  like; 
while  there  is  often  a  diarrhoea,  —  the  discharges  having  a  dirty-yellow  color. 

Treatment.  —  This  should  be  like  the  treatment  of  pneumonia  and  typhoid 
fever  united. 

Great  care  must  be  taken  not  to  use  reducing  remedies.  While  active  pur- 
ging must  not  be  used,  yet,  if  there  are  symptous  of  an  inactive  stale  of  the 
bowels,  podophyllin  and  leptandrin,  (34),  (39),  may  be  employed  with  advan- 
tage. 

When  there  are  symptoms  of  great  depression,  use  tonics  (40),  (*Jy  (50), 
(53),  (00),  (64),  (67),  (73),  taking  care  to  keep  the  cough  loose  by  flaxstcd, 
slippery  elm,  and  marshmallow  tea,  and  by  some  external  irritant. 


Ir': 


of  the 
powers  • 

s  stage, 
but  the 


Asthma. 

Asthma  may  be  defined  to  be  great  difficulty  of  drawing  in  the  breath,— 
coming  on  suddenly,  sometimes  gradually,  —  accompanied  with  a  sense  of 
extreme  suffocation,  and  a  desire  for  fresh  air;  continuing  for  a  longer  or 
shorter  period,  and  then  passing  away,  and  leaving  the  patient  a  period  of  com- 
paratively easy  respiration. 

gymptOHi.  —  There  are  sometimes  no  premonitory  symptoms,  the  attack 
coming  on  suddenly,  and  without  warring;  ••at  more  frequently  there  are,  for 
some  days  before  the  onset,  loss  of  af  petite,  flatulence,  belching  of  winJ,  irri- 
tability, languor,  chilliness,  oppression,  and  drowsiness.  Tlie  hard  breathing 
generally  makes  its  appearance  in  the  night,  —  quite  often  at  three  or  four  o'clock 


JHJ 


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244 


DISEASES   OF   TirlE   CHEST. 


in  the  morning,  when  the  nervous  HyHt^ra  •»  at  its  lowest  ebb.  There  in  first  a 
sense  of  tiglitness,  or  stricture,  acios?  tlw  chest,  which  seems  to  expand  with 
difHciiIty.  The  patient  can  no  longer  •  ein.iin  lying  down;  lie  rises  up,  draws  up 
his  Ivnees,  and,  leaning  forward  pits  *iis  elbows  upon  them,  and  his  liead  upon 
liis  h:inds,  and  tlii'ii  struggles  liar i  ttd.aw  in  his  breath;  wliicli,  passing  in 
slowly  and  laboriously,  produces  a  lot  I  v/heczing  sound.  Sl)^l>.'tiIn(^s  lie  feels 
that  he  must  liave  fresh  air,  and,  nif  ling  to  a  window,  puts  his  head  far  out, 
to  catch  a  stirring  breeze.  The  li;  nd  ai.d  feet  aro  cnll,  the  f.ice  haggard  and 
distressed,  —  sometimes  a  little  rdl  a  itl  swollen,  l)ut  more  gt  ncnilly  pale  and 
shrunk,  —  the  body  wet  with  persp  ira  ion,  the  pulse  irregular,  ftH:i)le,  aiul  small, 
though  sometimes  not  disturbed.  Tl  eso  symptoms  continue  for  some  liours, 
more  or  less,  when  tlie  breath,  ug  bi  co.ncs  more  easy,  and  there  is  a  little 
phlegm  mised,  sometimes  consi  Icr  ihl  •.  This  ccssnli!)ii  of  ditlicult  breathing 
may  be  complete,  or  only  ^larlia) ;  a  ul  asts  for  a  longer  or  shorter  period,  wheu 
the  attaclv  again  recurs. 

Causes.  —  It  Is  well  known  that  Ast.'imn  has  its  cause  mainly  in  the  nervous 
system.  Tlie  air  tubes  are  encircled  willi  a  series  of  little  bundles  of  fibres, 
wliidi  are,  in  fact,  muscles,  and  lik-j  all  otlier  muscles,  liave  the  power  of 
contracting  or  sliortening  tliemselvts.  These  muscles,  too,  like  all  others, 
have  nerves  distributed  to  them;  and  wlien  these  nerves  become  diseased  or 
irritable,  they  will  become  disturbed  on  certain  occasions,  and  cause  these 
small,  circular  puckering  strings  to  contract  and  close  up  the  air  tubes  near 
^heir  termimations,  very  mucli  as  tlie  puckering  string  closes  the  mouth  of  the 
work-bag,  so  that  very  little  air  can  pass  into  the  air  cells,  and  that  little  with 
^reat  difficulty  and  slowness.  When  tlieso  contractions  take  place,  and  the  air 
is  thus  shut  off,  the  result  is  a  fit  of  asthma.  This  disease  may  be  brought  od 
oy  any  of  those  states  of  the  atmosphere  which  disturb  or  irritate  the  broii- 
chial  surfaces,  or  by  any  of  the  numerous  causes  which  mysteriously  unbalance 
the  nervous  system.    A  fit  may  be  brought  on  by  whatever  disturbs  the  midd. 

Treatneat.  —  The  disease  has  been  regarded  as  >-  .:tremely  difficult  of  cure. 
There  are  certain  remedies,  however,  which  have  f  emarkable  control  over  it, 
and  if  skilfully  used,  will  frequently  bring  it  to  »  complete  termination,  and 
even  in  the  worst  cases,  to  a  state  of  very  great  mitigation  and  improvement. 

Inhaltttion. — The  most  important  and  certain  remedy  is  the  us6  of  tke 
Alterative  Inhalant,  described  on  page  221.  I  have  with  this  article  alode 
effected  some  surprising  cures;  yet  it  is  well  to  combine  other  treatment  With 
it  I  have  had  several  cases  of  a  most  distressing  character,  —  the  attacks  con- 
tinuing night  and  day,  —  in  which  the  inhalation,  judiciously  administered, 
has  caused  the  disappearance  of  the  complaint  within  twenty-four  hours,  and 
in  which  no  return  of  suffering  has  occurred  for  several  weeks,  and  then  only 
in  a  modified  form.    This  remedy  should  be  used  four  or  five  times  a  day. 

Iodide  of  potassium  is  a  most  valuable  internal  remedy  in  this  complaint, 
indeed,  in  a  certain  sense,  it  is  almost  a  specific.  It  should  be  used  (prescrip- 
tions 101, 138, 140, 151)  at  the  same  time  with  the  inhalation.  The  following 
preparation  is  a  very  good  remedy  for  this  disease:  Ethereal  tincture  of  lobe; 
lia,  two  ounces;  tincture  of  asafoetida,  one  ounce;  laudanum,  one  ounce; 
iodide  of  potassium,  two  ounces;  simple  syrup,  four  ounces.  Mix.  Dose, 
from  a  teaspoonful  to  a  tablespoonful,  every  hour  or  two. 

Several  other  remedies  are  used  for  asthma,  with  more  or  less  success,  — 


'  'mm 


euch  as  electro-magnetism,  smoking  stramonium  leaves,  burning  paper  dipped 
in  a  strong  solution  of  nitrate  of  potash,  and  inhaling  the  f)n\oke,  etc.,  —  but 
none  of  these  have  us  much  value  as  the  two  remedies  first  named. 

In  as  grave  a  complaint  as  a  severe  case  of  asthma,  it  is  always  well  to  seek 
the  aid  of  a  physician.  I  intended  to  have  given  some  interesting  cases,  but 
want  of  space  forbids. 

Hay-Asthma. — Hay-Feyer. 

This  is  a  very  troublesome  complaint,  which  seems  to  combine  the  peculiar- 
ities both  of  asthma  and  of  influenza.  Fortunately,  it  attacks  but  few  persons, 
and  those  only  at  particular  seasons  of  the  year,  —  namely,  while  hay  is  inblos* 
. jKKD ,  and  during  |>ay-n»pkipg. 

8yMpC*Bt.  —  These  are  a  combination  of  the  symptoms  of  the  two  diseases 
above  named.  There  is  great  irritation  of  the  eyes,  with  sneezing,  and  a  free 
discharge  from  the  nose.  There  is  tightness  across  the  chest,  difficulty  ttt 
'bseathing,  and  a  pricking  sensation  in  the  throat  These  symptonui  pften 
^pear  in  great  severity,  making  the  complaint  a  really  distressing  one. 

Caue.  —  This  disorder  spears  to  have  but  one  cause,  —  namely,  some  sort  ()f 
emanations  from  the  grasses,  flowers,  etc.,  while  in  blossom;  which  emanations 
come  in  contact  with  the  mucous  lining  of  the  eyes,  nose,  and  throat,  producing 
very  great  and  teasing  irritation. 

IraatBCBt.  —  One  of  the  best  remedies  for  this  troublesome  complaint  is  to 
avoid  the  cause,  by  removing,  during  the  flowering  and  haying  season,  to  some 
large  city,  or,  still  better,  close  down  to  the  seashore,  where  flowers  and  hay  do 
not  grow. 

Qf  mediciues,  the  tincture  of  lobelia,  taken  in  moderate  doses,  is  a  very  good 
remedy.  Quinine  and  iron,  given  in  combination  (75),  are  valuable  preparar 
tions.  Strychnine  and  nux  vomica,  in  connection  with  iron,  or  otherwise 
(316),  (83),  (84),  (85),  (86),  (95),  are  very  useful.  Iodide  of  potassium  (101), 
(138),  (140),  is.also  worth  a  trial.  Another  very  good  remedy  is  the  chloride  of 
))ine,  or  the  chloride  of  soda,  placed  in  saucers  about  the  sleeping-room. 
Pieces  of  cotton  cloth  may  also  be  dipped  in  one  of  these  solutions,  and  hung 
about  the  apartments  of  the  house.  The  hands  and  face  may  likewrise  be 
W^hed,  once  or  twice  a  day,  in  a  weak  solution. 

The  oxide  of  zinc  and  the  extract  of  nux  vomica,  made  into  pills,  two  grains 
of  the  zinc  to  half  a  grain  of  the  extract  to  each  pill,  and  one  pill  taken  moa»> 
ing  fmd  ttveiiing,  should  not  be  forgotten. 


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HEART    DISEASES. 


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Life  rests  upon  a  tripod,  —  the  brain,  the  lungs,  and  the  heart 
These  are  equally  important  to  its  well-being  and  continuance. 

In  substance,  the  human  heart  is  a  bundle  of  muscles,  so  put  to- 
gether as  to  bear  the  greatest  possible  amount  ol"  work.  In  size, 
shape,  and  look,  it  is  much  like  the  heart  of  the  hog.  I  wish  it  never 
had  a  likeness  to  it  in  its  moral  nature.  ♦ 

The  heart  is  cncloscfl  in  a  case  or  sac,  called  the  pericardium.  It 
lies  between  the  two  lungs,  a  little  to  the  left  side  of  the  chest.  Its 
point  is  under  the  sixth  rib  on  the  left  side,  and  its  low-  r  surface  rests 
on  the  diaphragm^ — a  horizontal  partition  between  the      est  and  belly. 

The  heart  is  double.  It  has  four  cavities,  —  two  foi  receiving  the 
blood,  which  are  called  auricles,  and  two  for  driving  it  out,  called 
ventricles. 

The  venous,  or  dark  blood,  is  brought  from  all  parts  below,  and 
emptied  into  the  right  auricle  through  the  ascemling^  vena  cava^  and 
from  all  parts  from  above,  and  poured  into  the  same  cavity  through 
the  descending  vena  cava.  From  this  it  passes  into  the  right  ventri- 
cle, which  contracts,  and  forces  it  through  the  pulmonary  artery  into 
the  lungs,  where  it  becomes  red,  and  passes  into  the  left  auricle 
through  the  pulmonary  vein,  thence  into  the  left  ventricle,  which  con- 
tracts, and  throws  it  out  through  the  great  aorta  to  all  parts  of  the 
body.  Fig.  93  gives  a  good  idea  of  the  circulation  through  the  heart 
and  lungs. 

The  heart  is  divided  into  two  sides,  which  are  separated  from  each 
other  by  a  muscular  partition,  —  each  side 'having  an  auricle  a.nd  a 
ventricle. 

The  auricles  have  comparatively  thin  walls,  as  they  are  only  used 
for  reservoirs.  The  walls  of  the  ventricles  are  much  thicker,  being 
used, —  particularly  that  of  the  left  side,  —  for  forcing  the  blood  over 
a  large  surface. 

BetwtHMi  the  auricle  and  ventricle  on  the  right  side,  are  three  folds 
of  triangular  membrane,  called  the  tricuspid  valves.  Between  the 
auricle  and  ventricle  on  the  left  side,  are  three  valves,  called  mitral. 

At  the  beginning  of  the  pulmonary  artery,  and  the  a^rta,  are  three 
half-moon  shaped  folds  of  membrane,  called  semilunar  valves. 

The  office  of  all  these  valves  is,  to  close  after  the  blood  has  gone 
through,  and  prevent  its  flowing  back  while  the  cavity  is  being  agaia 
filled.     They  do  the  same  duty,  in  fact,  au  the  valves  of  a  pump. 


heart 


HEART  DISKA8ES. 


247 


Through  this  heart,  thus  constructed,  nil  the  blood  in  the  body, — 
about  twenty-eight  pounds,  —  passes  once  in  about  one  minute  and  a 
half.  This  is  r.  pid  work ;  and  when  we  consider  that  the  heart 
works  in  this  way  through  the  whole  life,  resting  not,  day  or  night, 
we  cannot  wonder  that  it  gets  out  of  order. 

Fio  96. 


The  whole  heart  is  seldom  affected. 
to  disease  than  the  right 


The  left  ^ide  is  more  liable 


Impulse  of  the  Heart. 

The  ear  when  placed  over  the  heart,  feels,  at  each  beat,  a  slight 
shock.  This  is  felt  at  the  same  time  the  first  sound  is  heard.  This 
impulse  is  caused  by  the  apex  or  point  of  the  heart  being  thrown  up 
against  the  ribs  by  the  contraction  of  tiie  ventricles.  It  is  felt  best 
between  the  cartilages  of  the  fifth  and  sixth  ribs  on  the  left  side. 

The  Sounds  of  the  Heart. 

On  applying  the  ear  to  the  chest  just  over  the  heart,  two  sounds 
are  heard.  The  first  one  is  dull  and  slightly  prolonged  ;  the  second 
is  a  shorter  and  smarter  sound,  having  u  sort  of  clack.  These  occur 
in  pretty  rapid  succession,  and  then  comes  a  lirief  interval.  And  this 
round  of  action,  first  a  long  and  dull  sound,  then  a  short  and  smart 
one,  and  then  an  interval,  —  called  the  heart's  rA/////m,  —  is  repeated 
continually.  If  the  space  of  time  occupied  by  the  rhythm  be  divided 
into  five  parts,  the  first  sound  will  take  about  two  parts,  the  second 
one,  and  the  interval  of  repose,  the  remaining  two.  The  first  sound 
is  heard  about  the  time  of  the  contraction  of  the  ventricles,  and  is 
therefore  called  the  systolic  sound    the  second  is  synchronous  with 


■  I' 


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i 

ii. 

1 


m, 


.in 


248 


HEART  DISEASES. 


the  opening  of  the  ventricles,  and  is  called  the  diastolic  sound. 
The  syllables  too'to  —  too-to,  very  fairly  represent  the  two  sounds  of 
the  heart  These  sounds  are  heard  over  the  largest  space  in  lean 
persons. 

Pereuiiion  Soandi. 

If  the  ends  of  the  fingers  be  struck  upon  the  chest  over  the  heart, 
a  dull  sound  will  be  heard  over  a  space  from  one  and  a  half  to  two 
inches  square, —  beginning  at  the  fourth  rib  on  the  left  side,  and  ex- 
tending  down  neany  to  the  sixth.  The  dulness  is  diminished  by 
lying  upon  the  back,  and  increased  by  leaning  forward,  and  by  taking 
a  fuU  breath.  The  deadness  of  sound  is  caused  by  the  heart  being 
a  parliaily  solid  body.  The  lungs  which  surround  it,  yield  a  clear 
sound. 

If  a  solid  substance,  as  large  as  the  heart,  were  placed  on  the  inside 
of  a  drum,  against  the  head,  only  a  dead  sound  would  be  obtained  by 
striking  on  that  spot ;  everywhere  else,  the  sound  would  be  louder. 

Altered  Soan48  of  the  Heart. 

These  sounds  are  changed  by  disease  in  a  variety  of  ways,  both  as 
to  their  character  and  duration.  One  or  both  sounds  may  be  turned 
I  into  a  noise  like  the  blowing  of  a  pair  of  bellows.  This  is  called  the 
bellows  sound.  When  this  sound  is  very  harsh,  it  may  become  like 
the  noise  of  a  rasp,  or  file,  or  saw.  These  altered  sounds  are  all  pro- 
duced by  an  altered  condition  of  the  valvular  passages  through  whjch 
the  blood  passes.  If  you  build  an  aqueduct  of  equal  dimensions 
throughout,  and  smooth  on  the  inside,  you  may  send  a  certain  vol- 
ume of  water  through,  at  a  given  speed,  without  noise.  But  if  you 
make  sudden  contractions  in  the  aqueduct,  or  allow  large  stones  to 
project  into  it,  and  then  attempt  to  send  through  the  same  body  of 
water,  at  the  same  rate  of  speed,  you  will  hear  all  sorts  of  noises. 

Enlargement  or  Hypertrophy  of  the  Ventricles. 

This  is  simply  a  thickening,  or  an  increase  of  bulk,  in  the  walls  of 
the  ventricles.  The  muscles  composing  the  walls  of  one  or  both  of 
these  cavities,  grow  thick  and  large. 

Physical  Si^S.  —  Impulse  stronger  than  natural.  When  consider- 
able, it  is  accompanied  with  a  lifting  and  heaving  of  the  parts.  Dull 
sound  on  percussion  over  a  larger  space.  First  sound  of  heart  pro- 
longed ;  second  sound  feeble.  The  interval  of  silence,  shorter  than 
natural.     In  bad  cases,  the  second  sound  is  nearly  extinguished. 

General  Symptoms.  —  Hypertrophy  of  left  ventricle  gives  a  strong, 
prolonged,  and  tense  pulse.  Palpitation  more  constant  than  in  any 
other  disease  of  the  heart.  In  advanced  stages,  the  patient  is  easily 
out  of  breath.     There  is  a  rush  of  blood  to  the  head  on  making  exer- 


BEART  DISEASES. 


34U 


)S. 


tion,  or  stooping,  with  more  or  less  throbbing  and  lancinating  head* 
aches,  which  are  aggravated  by  suddenly  lying  down  or  rising  up. 
There  are  vertigo,  ringing  in  the  ears,  sparks  of  light  and  other  illusions 
before  the  eyes;  aJHO  a  purplish,  violet  or  livid  color  upon  the  chpeks, 
nose,  and  lipn.  In  many  cases  there  is  a  dull,  severe,  aching  pain  in 
the  region  of  the  heart,  and  extending  towards  the  shoulder  and  the 
inside  of  the  arm. 

When  the  rig^ht  ventricle  is  enlarged,  there  is  a  swelling  of  the  ex- 
ternal jugular  veins. 

Causes.  —  The  walls  of  the  heart  are  thickened  by  overwork,  |p  the 
same  way  that  the  blacksmith's  arm  is  made  muscular  and  large.  All 
mi^Bcles  grow  in  the  same  way.  More  action  sends  more  blood  to 
them,  and  this  causes  an  increase  of  nutrition. 

Whatever  interposes  an  obstacle  to  the  passage  of  the  blood  through 
the  valvular  openings,  will  cause  fibe  ventricles  which  force  it  through 
tp  work  harder.  Hence,  obstructions  in  the  semilunar  valves  cau/|C 
hypertrophy  of  the  ventricles. 

Any  excitement  of  the  mind,  or  any  great  exertion,  which  causes 
th^  heart  to  beat  harder  and  faster,  if  it  be  often  repeated,  will  induce 
a  thickening  of  the  ventricles. 

Treatmeilt.  —  First,  remove,  as  far  as  possible,  all  causes  of  excite- 
ment which  produce  palpitation.  If  the  head  is  much  aflected,  apply 
wet  cups  to  the  back  of  the  neck.  The  same  may  be  applied  over  the 
heart  This  will  generally  improve  the  symptoiiia  at  once.  A  blister 
placed  over  the  heart  will  likewise  make  a  favorable  impression. 

The  meals  should  be  taken  at  regular  intervals,  and  should  be  very 
light.  The  food  should  be  plain  and  simple,  and  composed  much 
more  of  vegetable  than  of  animal  food.  In  fact,  the  diet  should  be 
80  spare  as  slightly  to  reduce  the  strength. 

The  patient  should  be  careful  never  to  take  violent  exercise,  or,  in- 
deed to  be  in  a  hurry  about  anything.  In  bad  cases,  walking  up  hill, 
or  against  a  strong  wind,  is  often  out  of  the  question,  and  must  in 
any  case  be  attempted  with  great  caution.  Stair-cases  are  to  be 
shunned  as  enemies.  An  attempt  to  run,  even  to  avoid  being  left  by 
the  cars,  might,  in  some  cases,  prove  immediately  fatal.  Carriage 
riding  is  not  objectionable. 

The  passions  must  be  held  in  the  most  thorough  subjection.  Ex' 
citements  of  all  sorts  are  dangerous,  and  must  be  avoided. 

For  the  first  week  or  two  of  treatment,  active  purgatives  will  be 
useful.  For  this  purpose,  epsom  salts  and  senna  will  answer  a  good 
purpose,  and  should  be  used  so  as  to  procure  two  or  three  watery 
stools  a  day. 

In  addition  to  this,  some  sedative  to  lessen  the  force  of  the  heart's 
action,  is  generally  needed,  —  especially  when  there  is  considerable 
palpitation.  For  this  purpose,  tincture  of  black  cohosh,  and  tincture 
of  scullcap,  or  the  former  with  tincture  of  digitalis  (285)  (94),  are 
quite  useful.  Three  to  ten  drops  of  tincture  of  the  American  helle- 
bore (veratrum  viride)  will  reduce  the  action  of  the  heart  perhaps 
more  effectually  than  any  other  medicine. 


,1  . 


:s-«C 


i 


Dilatation  of  the  Ventricles. 

The  several  cavities  of  tlifi  heart  hold  about  one  and  a  half  ounces 
ea<!h.  Dii  .tution  is  simply  an  enlarge tnent  of  these  cavities,  so  that 
they  will  hold  moro.  And-  this  increase  in  the  size  of  the  cavity  in 
simple  dilatation  is  generally  at  the  cost  of  the  ■'.valls,  which  are  made 
thinner  and  w*  uktT,  —  just  as  the  walls  of  a  bladder  are  made  thinner 
by  blowing  into  it  and  increasing  its  internal  dimensions. 

I*liysit*fil  tSij^iiS. —  Impulse  more  abrupt,  and  less  marked  than  nat- 
ural. Dull  sound  on  percussion  conmiensurate  in  extent  with  tlir 
dilatation.  The  iirst  beat  of  the  heart,  clearer,  louder,  and  shorter 
than  natural,  and  more  nearly  resembling  the  second. 

fieneral  Hvinptoilis. —  nillieulry  of  breathing;  terrific  dreams;  start- 
ing from  sleep;  .■*w(>lling  of  the.  feet  and  h'gs  ;  purple,  violet,  or  blue 
color  of  cheeks,  nose,  lips,  and  especially  around  the  eyes;  feeble  and 
oppressed  palpitation;  various  disturbances  in  the  head ;  bleeding 
from  the  nose,  stomach,  bowels,  and  womb ;  and  fre(iuently  enlarge- 
ment of  the  liver. 

Explanations.  —  The  first  sound  of  the  heart  is  short  and  not  well 
marked,  in  consequence  of  the  Tuuscular  walis  of  the  ventricles  \\\ 
this  disease  being  thin  and  in  a  weakened  condition,  so  that  every 
stroke  they  make  is  short,  (juick,  and  spasmodic,  instead  of  strong 
and  lifting,  as  in  hypertrophy.  For  the  same  reason,  the  impulse  is 
a  brief  blow  dealt  the  walls  of  the  chest,  which  gives  a  slight  shc-ck, 
but  has  not  power  enough  to  lift  the  chest  up.  The  blow  is  quick, 
be(!auae  the  nmscle  is  thin  and  can  contract  quicker  than  a  thick  one. 

Dilatation,  by  thinning  the  walls  of  the  cavities,  enleebles  the  heart, 
and  shows  us  an  obstructed  circulation.  Accordingly  the  blood  is 
not  transmitted  by  the  left  ventricle,  and  being  rc^tained  in  the  lungs, 
it  causes  a  crowded  state  of  the  vessels,  and  difficulty  of  breathing; 
also  congestion  of  the  brain,  with  terrific  dreams,  etc.  And  this  en- 
gorgement of  the  Inngs,  being  propagated  backwards  to  the  riji^hl 
heart,  great  veins,  and  all  their  ramifications,  produces  dropsy  of  tht* 
feet  and  legs,  discoloration  kA  the  face,  passive  hemon'hag«\H,  and  con- 
gestion of  the  brail!,  liver,  and  imMiibranes.  Fig.  93  gives  an  ulen 
of  how  ail  this  happens. 

Treatineiit. —  As  in  many  other  diseases,  search  on:,  the  causes,  and 
remove  them.  If  it  be  obstruction  of  the  circulation  in  the  lungs  l)y 
bronchitis,  or  other  complaint,  that  n-'cds  the  Iirst  attention.  If  it  Ix' 
caused  by  violent  exercise,  by  strong  emotions  of  the  mind  habittially 
indulged,  or  by  drunkemu'ss,  or  any  other  irregularity  of  life,  thiise 
habits  nmst  l)e  corrcetcfl  without  delay. 

If  it  be  caused  l)y  organic  disease  of  the  valves  of  the  heart,  relief 
cannot  be  so  n'tulily  obtiiined  ;  but  even  in  thes  cases,  it  is  to  be 
nought  and  expected. 

The  circulation  is  to  be  kept  as  tranquil  as  possible  by  a  strictly 
quiet  and  orderly  life,  and  a  plain,  moderate,  unstlmulating  diet«     Jn 


,-Ji 


HEART  DISEASES. 


251 


this  disease,  however,  it  should  be  more  nutritious,  and  composed  to 
a  larger  extent  of  meats,  than  in  hypertrophy. 

In  some  cases  the  general  health  and  tone  of  the  system  will  need 
to  be  improved  by  bitters  (50)  (67)  (64)  (69)  (79),  mineral  acids  (60), 
iron  (269)  (61),  and  aromatics  (115).  The  compound  mixture  of  iron 
is  a  good  preparation  when  this  miiu'ral  is  called  for  by  a  low  state  of 
the  blood. 

The  stomach  should  be  kept  in  the  best  possibh;  condition,  as  a 
very  small  disturbance  of  it,  even  from  acidity,  will  set  the  heart  to 
bt'iiting  very  violently. 

If  hystericfvl  symptoms  are  present,  the  compound  galbanum  pill, 
and  valerian  (97),  and  other  nervines  will  be  called  for. 

In  attai'ks  of  great  dlHiculty  in  breathing,  immerse  all  the  extremi- 
ties in  warm  water,  and  throw  a  blanr'i  around  the  patitnt  to  |)ro- 
inote  sweating,  —  at  the  same  time  admitting  fresh  air  to  satisfy  the 
desire  for  breath.  (»iv(?  a  draught,  composed  of  ether,  laudamuji, 
ammonia,  etc.  (I'ii)).  This  may  be  repeated  two  or  three  times,  at 
intervals  of  half  an  hour,  or  an  hour,  according  to  the  urgency  of  the 
case. 

Hypertrophy  with  Slight  Dilatation. 

This  is  one  of  the  most  connnon  complications  of  heart  disease. 
It  consists  both  in  a  thickening  of  the  walls  of  tin;  heart,  and  an  en- 
largement of  the  cavities,  —  the  former  being  more  marked  than  the 
latter. 

Physical  Hif^»»  —  Both  sounds  are  louder  than  in  any  other  disease 
of  the  heart,  and  are  heard  sometimes  over  the  whole  chest.  The 
impulse  is  strong  and  heaving,  with  an  abrupt  back-stroke.  In  bad 
cases,  the  whole  person,  antl  even  the  bed,  is  shaken  by  it.  The  dull 
sound  on  percussion  covers  a  large  space. 

(•euenil  Myiiiptonis.  —  The  same  as  those  of  the  two  diseases  of 
which  it  IS  compos''d,  slightly  modii  cd  by  the  action  of  each  upon 
the  other. 

Dilatation  with  Slight  Hypertrophy. 

This  is  an  enlargement  of  the  cavities  of  the  heart,  with  a  slight 
thickening  of  its  walls;  the  dilatation  being  the  predominant  disease, 
<»r  greater  than  hypertrophy. 

PliyHicul  Ni)(li8. —  Percussion  gives  a  dull  soimd  in  the  region  of  the 
heart,  in  proportion  to  its  size.  The  first  beat  resembles  the  scvond. 
Th«;  second  beat  is  louder  than  natural. 

The  impulse  is  a  short,  quick  stroke,  which  contrasts  strongly  with 
the  slower  and  heaving  one  of  hypertrophy  with  dilatatit)n. 

The  general  symptoms  and  the  treatment  are  a  modification  of 
thovse  of  the  two  diseases  united  in  it.  It  is,  however,  to  be  kept  in 
mind  that  the  dilatation  takes  the  lead;  and,  furnishing  tlu-  predomi- 
nant symptoms,  is  specially  to  be  regarded  in  the  treatment. 


ii 


i: 


f1 


Aneurismal  Tumors  of  the  Heart. 

When,  from  some  obstruction  in  the  valves,  the  blood  cannot  easily 
pfkBS  out  of  an  auricle  or  a  ventricle,  its  inner  walls  may  beconie 
unable  to  bear  the  distending  force,  and  giving  way,  let  the  blood 
through  against  the  outer  coats,  which  stretch,  and  swell  out  into  the 
^Ijape  of  a  tumor,  —  the  inside  of  the  tumor  becoming  a  regular  sac. 
^uch  a  state  of  things  constitutes  an  aneurism  of  the  heart  Of 
course  it  is  a  grave  disease. 

Softening  of  the  Hei^rt. 

In  this  disease  the  substance  of  the  heart  becomes  soft,  and  easiW 
;|^roken.     It  is  generally  the  result  of  some  form  of  inftamrnation. 

Physical  Slfus. —  The  contractions  of  the  heart  being  weakened  bv 
softening,  the  impulse  is  reduced  in  force,  and  both  beats  are  weaker, 
and  often  they  are  intermittent  The  first  beat  becomes  short  and 
flapping,  like  the  second. 

CSeneral  Symptoms*— A  quick,  feeble,  small,  and  faltering  pulne, 
great  anxiety,  and  a  disposition  to  faint.  (General  languor  ;  a  sallow, 
bloodless,  withered  complexion,  with  a  purple,  livid  tint  of  the  lips 
and  cheeks,  and  frequently,  general  dropsy,  from  the  inability  of  the 
heart  to  propel  its  contents. 

Treatment.  —  When  accompanied  by  acute  inflammation,  softening 
is  to  be  treated  un  the  same  principles  as  iiitlHinination  of  the  heart- 
case. 

If  it  be  a  re^sult  of  chronic  inflanunation,  it  calls  for  iron,  bitters, 
nutritious  animal  food,  and  good  air. 

Induration  of  the  Heart. 

The  muscular  substance  of  the  heart  sometimes  undergoes  a  hard- 
ening process.  It  is  occasionally  so  much  hartlciH'd  as  to  sound. 
when  struck,  like  a  hollow  horn  vessel.     The  disease  is  rare. 

It  increases  the  heart's  impulse,  like  hypertrophy ;  and  it  requires 
fifiout  the  same  treatment  with  that  disease. 

Fatty  Degenerations  of  the  Heart. 

The  heart  sometimes  becomes  overloaded  with  fat,  which  is  depos- 
ited between  the  heart-case  and  the  muscular  substance,  —  covering 
the  organ  all  over  externally,  and  in  some  cases  penetrating  to  some 
depth  into  its  substance.  The  muscular  walls  themselves  become 
thin  and  Habby. 

SymptomH. —  The  soun^jK  of  the  heart  are  diminished,  —  especially 
the  firs*  The  pulse  is  irregdlar  Fain,  and  a  feeling  of  oppression 
in  the  region  of  the  heart,  v*ith  gfti^rdl  tigns  of  retarded  circulation, 


'^•m^ 


HEART  DISEASES. 


25H 


such  as  congestion  of  the  brain  and  liver.     There  is  occasionally  gid- 
diness, loss  of  memory,  and  palpitation. 

Treatment. —  Exercise,  mentnl  excitement,  and  stimulating  drinka 
must  be  avoided ;  and  the  pationt  must  live  for  one  or  tw^o  years  on 
a  very  light  diet,  taking  but  v.ry  little  animal  food. 

Bony  and  Cartilaginous  Productions  in  the  Heart. 

TiiKSK  productions  in  tlie  heart  are  fortunately  rare.  Yet  they 
occur;  aud  the  point  of  the  heart,  in  its  wliole  thickn«'ss,  is  some- 
times cliani^ed  to  cartilage.  'I'lie  ventricles  are  sometimes  so  ossified 
as  to  n'semble  the  bt)nes  of  the  head. 

The  symptoms  of  these  degenerations  are  obscure;  and  as  such 
cases  are  not  curable,  it  is  of  lest  consecpuMu^e  that  we  sliouid  be  able 
to  know  their  pn>eise  nature  during  the  life  of  (he  patient.  The  treat- 
incut  can  only  all'ord  temporary  relief,  and  should  be  such  as  is  pre- 
scribed in  other  heart  diseases  with  similar  .symptoms. 

Shrinking  of  the  Heart.  —  Atrophy. 

Thk  heart,  like  any  other  n)uscl(',  is  liable  to  defective  nutrition, 
and  in  consequence  of  it  may  become  small.  It  shrinks,  in  some 
eases,  to  the  size  of  an  infant's  heart. 

The  conjplaint  is  generally  craused  by  whatever  reduces  the  general 
llcsli,  as  (^ousum|)tion,  diabeU-s,  chrotiic  dysentery,  cancer,  and  exces- 
sive loss  (if  bl(.M>d. 

It  can  hardly  be  called  a  disease.  Persons  who  have  it  are  less 
subject,  to  indamrnatory  diseases  than  others,  though  they  faint  from 
slight  causes,  and  have  nervous  att'ections. 

Treatment.  —  If  its  causes  can  be  discovered,  treat  tiiem ;  if  not 
the  treatment  should  be  the  same  as  for  dilatation. 

Aeate  Inflammatio  i  of  the  Heart-Case.  —  Pericarditis. 

Thk  pericardium,  or  h'.ar*-case,  is  a  membranous  sac,  in  which 
the  heart  i«  contained,  it  x*  compos««d  of  two  layers.  The  outside 
one  mfibraus,  dense,  and  white ;  the  inside  one  is  serous.  The  serons 
layer  forms  the  lining  of  the  tibrous  one,  and  then  is  reflected  over 
the  heart,  and  the  roots  of  the  large  blood-vessels. 

When  t\v'  pericardium  \n-cnnu'H  acutely  inllamed,  it  throws  out, 
both  lymph,  and  w  lum  or  water.  Th<  lymph  often  causes  the  two 
layers  of  »he  sac  to  y/o//  together. 

PiiysH'rii  Sigftg.  —  The  iinpidf>«'  ix  ulrong  when  the  elTusion  of  water 
is  small,  feeble  and  uneqiiiil  when  it  is  larg«\  Hercussion  yields  a 
dull  sound  in  proportion  t<;  the  amount  of  (Initl  in  the  sac. 

When  listening  with  the  stethow  »pe,  a  rough  noise  is  heard,  resem- 
bling either  the  rasping  of  wmd,  the  gratmg  of  a  nutmeg,  the  rustling 
'ji  silk,  or  the  cnulding  of  parchment.     SometimeH  it  is  softer,  likfl 


:  r 


ii!i 


il 


the  blowing  of  a  pair  of  boUowrt.  Occasionally,  it  resembles  the 
creaking  of  a  new  shoe-sole,  or  has  a  low  creaking,  like  the  tearing 
of  linen  cloth. 

When  there  is  effusion,  the  ordinary  beats  of  the  heart  sound  dull 
and  distant.  • 

General  SyiiiptmilH. —  Acute  inflammatory  fever  generally  preceded 
by  chills,  with  pungent  pain  in  the  region  of  the  heart,  shooting  to  the 
left  shoulder-blade,  shoulder,  and  upper  arm. 

Pain  increased  by  taking  a  full  breath,  by  stretching  the  left  side, 
by  percussion,  and  by  pressure  between  th(!  ribs  over  the  heart.  Soine- 
times  the  pain  is  in  the  epigastrium,  or  left  hypocondrium.  Inability 
to  lie  on  the  left  side. 

Explanation.  —  The  noises  mentioned  above,  are  produced  by  the 
rubbing  together  of  opposite  surfaces  of  the  heart-case,  made  rough 
by  the  exudation  of  iyiiiph.  The  rasping  is  supposed  to  be  caused 
hy  firm  and  rvffg'ed  lymph ;  the  rustling  and  creaking,  by  soft  and  wet 
lymph ;  the  bellows  nuirmur,  by  soft  and  dri/  lymph ;  the  creaking, 
croaking,  and  crackling,  l)y  drt/,  Unis^h  lymph,  'fhese  sounds  may  ail 
be  imitated  by  rubbing  a  damp  finger  upon  the  back  of  the  hand, 
while  listening  with  the  stethoscope  applied  to  the  palm. 

Chronic  Inflammation  of  the  Heart-Case. 

"When  acute  pericarditis  runs  for  more  than  ten  days  or  a  fortnight, 
it  becomes  chronic.  It  is  chronic  from  the  begiiming,  when  it  runs  a 
slow,  insidious  course,  without  marked  or  violent  symptoms. 

The  symptoms  are  much  the  same  in  kind  with  those  of  the  acute 
form,  only  less  in  degree.  This. low  grade  of  the  symptoms  of  the 
disease  renders  it  inore  obscure  than  the  acute. 

Treatment.  —  In  the  acute  form  of  the  disease,  apply  wet  cups  over 
the  region  of  the  heart,  or  apply  from  a  do/en  to  forty  leeches  to  the 
same  parts. 

At  the  same  time,  move  the  bowels  freely  by  an  injection  (247),  or 
by  a  purgative  pill  (31). 

The  strength  and  amount  of  the  remedies  einpU)yi'd  in  each  cas*', 
must  be  in  proportion  to  the  vigor  of  the  patient's  constitution. 

It  is  of  great  importance  that  the  treatment  slioui* I  be  active  and 
prompt,  and  that  the  disease  should  be  broken  down  tarhj. 

Diluent,  cooling  drinkn  (132)  (129)  (298)  (299)  should  be  allowed 
as  freely  as  the  patient  desires,  in  order  to  dilute  the  blood,  and  ren^ 
der  it  less  stimulating  to  the  heart. 

At  the  same  time,  live  to  fifteen-drop  doses  i>f  tiiX'^Mre  of  veratruin 
viride  should  be  given  every  hour,  to  bring  dowH  tl»  action  of  the 
heart 

Let  the  diet  be  wholly  oi  bariey-waKT,  thit  fwe^  weak  tea,  or 
aiTow  root 

During  recovery,  the  diet  must  bt  spam.  «nd  the  greatest  tranqniV 
lity  of  mind  and  body  be  preserved. 


'.;TTi5II^lj 


IIEAKT  DISEASES. 


25o 


In  the  treatment  .of  ehronic  cases,  when  the  cavity  appears  to  con- 
tain fluid,  counter-irritation  is  suitable.  Blisters,  croion  oil,  the  com- 
pound tar  plaster,  and  especially  the  tincture  of  iodine.  The  diet 
may  be  a  little  more  nutritious  than  in  the  acute  form  of  the  disease, 
—  embracing  light  animal  food  and  broths. 

Inflammation  of  the  Heart. — Carditis. 

This  is  an  inflammation  of  the  muscular  substance  of  the  heart 
When  existing  alone,  it  is  a  very  rare  disease.  Being  mixed  up  with 
other  forms  of  heart  disease,  it  does  not  require  any  separate  account 
of  its  symptoms  or  treatment. 

Acute  Inflammation  of  the  Lining  of  the  Heart. 

Endocarditis. 

The  heart  is  one  of  the  citadels  of  life.  Disease  attacks  it  on  all 
sides.  In  this  complaint,  it  has  entered  the  fort,  and  taken  possession. 
The  inflammation  is  on  the  lining-  membrane. 

Physicnl  8i^ns.  —  The  impulse  is  violent,  abrupt,  and  regular,  as 
long  as  the  circulation  through  the  heart  is  free,  but  when  this  is  im- 
peded, it  is  at  first  a  confused  tumult  (which  generally  happens  when 
a  fort  is  first  taken),  and  gradually  sinks  to  a  feeble  fluttf-r. 

The  dull  sound  upon  percussion  covers  a  space  of  from  three  to 
seven  square  inches. 

The  beats  of  the  heart  are  generally  accompanied  or  marked  by  a 
bellows  murmur,  —  the  loudness  of  which  depiMids  on  the  strength  of 
the  heart's  action. 

General  Symptoms. —  Inflammatctry  fever.  The  action  of  the  heart 
being  generally  violent  and  ;ibrupt,  the  pube  I'orresptJnds  with  it,  and 
is  strong,  full,  and  nan}; 

Eiplanation. —  The  bellows  sound  is  supposed  o  depend  on  the 
inflamed  and  swollen  condition  of  the  valves. 

The  duhit'ss  on  percussion  will  b«'  slight  when  the  circulation 
through  the  heart  is  free;  —  more  distinct  and  marketi  when  it  is 
obstructed. 

Dr.  Hope  says  the  disease  may  be  anticipated,  if  a  person  be  sud- 
denly attacked  with  these  three  signs  :  namely.  f«'ver.  violent  action 
of  the  heart,  and  a  murmur  which  did  not  exist  before. 

This  disease,  like  inflammation  of  the  heart-case,  »s  often  produced 
by,  and  is  intimately  connected  with,  acute  rheumatism. 

Ghronio  Inflammation  of  the  Heart's  Liaing-. 

Physical  Signs.  —  The  impulse  more  perceptible  and  iifFused  than 
natural. 

The  dull  sound  upon  percuasion  covers  a  space  of  from  four  to 
•ight  square  inches. 


1 


»'.".. 


i 


256 


HEAUT  DISEASES. 


There  is  a  sawing,  rasping,  or  filing  sound.  This  sound  may  cover 
one  or  botli  beats  of  the  heart.  Sometimes  these  unnatural  sounds 
arc  double ;  in  whieh  case,  the  first  is  caused  by  an  obstruction  to  the 
natural  flow  of  the  blood  forward ;  the  second,  by  the  regurgitation 
or  retrograde  flow  of  the  blood  from  some  defect  in  the  valve, — just 
as  a  pump  valve  may  get  out  of  order,  and  allow  the  water  which 
has  gone  through  to  flow  back. 

Ei'plniiutioii. —  A  variety  of  organic  changes  occur  in  the  valves, 
which  give  rise  to  the  umrmurs.  Inflammation  of  the  lining  mem- 
brane of  the  heart,  reaches  the  valves,  causes  puckering,  thickening, 
vegetations, cartilaginous,  bony, and  fat-like  degenations,  which  obstruct 
the  blood  in  its  onward  flow,  or  prevent  a  closure  of  the  valves,  and 
allow  it  to  flow"  back  ;  tiie  ft)rmer  causing  the  first  sound,  the  latter 
the  seciond.  If  the  unnatural  noise  be  synchronous  with  the  first  beat 
of  the  heart,  it  implies  disease  in  either  set  of  the  semilunar  valves, 
or  an  impossibility  of  closing  the  auriculo-ventricular  openings;  if  it 
accompany  the  second  beat,  it  signifies  that  cither  set  of  the  semilu- 
nar valves  may  be  open. 

A  murmur  attending  the  first  beat  of  the  heart,  must  be  caused  by 
a  current  of  blood  from  a  ventricle ;  one  attending  a  si'cond  sound, 
by  a  like  necessity,  is  produced  by  a  current  into  a  ventricle. 

Treatment. — The  same  as  that  for  pericarditis.  It  should  be  equally 
prompt  and  vigorous.  It  must  not  be  forgotten  that  this  disease  leads 
to  various  organic  diseases  of  the  valves  of  a  very  grave  character, 
and  that  such  mischiefs  can  only  be  escaped  by  cutting  the  disease 
short  in  the  very  beginning. 

Disease  of  the  Semilunar  Valves. 

The  inflammation  of  the  lining  of  the  heart  makes  sad  work  #ith 
the  valves.  The  semilunars  are  subject  to  various  changes  in  their 
■tructure. 

Physical  Sig^s.  —  Obstruetlve  ttturmiir.  —  In  disease  of  the  semilu- 
nar?, the  first  beat  of  the  heart  is  accompanied  or  obscured  either  by 
the  bellows  murmur,  or  a  sawing,  rasping,  or  filing  sound.  The  un- 
natural murmur,  whatever  it  is,  appears  superficial  or  near.  The 
second  beat  is  natural. 

When  the  opening  into  the  aorta  is  ciontracted,  or  in  any  way  ob- 
structed by  unhealthy  growths,  so  that  the  blood  is  subjected  to  more 
than  a  natural  degree  of  friction  in  passing,  this  sound  will  be  heard. 
It  is  caliJ'd  obstructive,  because  it  arises  from  the  obstruction  of  the 
blood  in  its-  forward  course. 

Reg^Ul^itfliit  murmurs.  —  First  beat  of  heart  natural.  Second  beat 
accompanied  or  replaced  by  bellows  murmur.  There  is  sometimes  a 
musical  murmur. 

Explanation.  —  The  regurgitant  murmurs  arise  from  the  valves  be- 
ing too  small,  or  defective  in  some  way,  and  allowing  the  blood  to 
flow  back  through  the  orifice. 


>le^ 


T^yrra 


l 


HEART  DISEASES. 


257 


7 


This  murmur  is  loudest  opposite  the  semilunar  valves,  and  is  more 
audible  ab'jt'e  thuse  valves  than  below  them. 

When  the  aortic  valves  are  contracted  or  shortened,  and  the  open- 
ings are  not  guarded  by  them,  so  as  to  prevent  the  backward  passage 
of  the  blood,  there  is  a  double  bellows  murmur,  —  one  when  it  ia 
drive Hthrotiffh  the  orifice,  and  another  when  it /lows  back. 

Disease  of  the  Mitral  Valves. 

Physioal  Sijfiis.  —  Ohstnu'tlve  Ifliiniiiir. —  First  beat  of  heart  natu- 
ral.    Second  beat  accompanied  or  replaced  by  bellows  murmur 

R<'2iii'it;it)iiit  raiiriiiiirs. — The  first  beat  of  the  heart  accompanied  by 
a  loud  and  rough  bellows  murmur.  This  sound  is  like  sawing  or 
iiliiig.  It  ii  loudest  above  or  below  the  nipple,  between  the  fourth 
and  .•««'v«'iitli  ribs.  There  is  occasionally  a  musical  murnnir.  Th") 
vcond  beat  of  the  heart  is  natural,  yometimes  there  is  a  purring 
tremor. 

General  Syiiiptoins  of  Valvulnr  Disease.  —  Cough,  in  many  cases 
with  watery  expectoration;  dilliculty  of  breathing;  frightful  dreams, 
and  starting  from  sleep;  congestion  of  the  lungs;  expectoration 
Btained  with  dark  and  grumons  blood  ;  swelling  of  the  jugular  veins; 
a  livid  look  of  the  face  ;  a  feeling  as  if  a  cord  were  tied  tight  around 
the  lower  part  of  the  chest,  general  dropsy,  of  the  legs  and  feet  in 
particular ;  j)assive  hemorrhages  from  the  mucous  membranes ;  en- 
gorgement of  the  liver  and  spleen  ;  congestion  of  the  brain,  with  feel- 
ings of  oppression.  When  the  mitral  valve  is  contracted,  admitting 
regurgitation,  the  pUlse  is  small,  weak,  irregular,  and  intermittent. 

These  are  the  worst  symptoms  of  an  advanced  stage. 

Explanntiuiis.  —  The  examiner  will  distinguish  the  various  sounds 
thus: 

The  murmurs  generated  at  the  origin  of  the  arteries,  spread  their 
sonorous  currents  upwards  along-  these  arteries. 

Those  produced  in  the  auricular  orifices,  will  be  conducted  into  the 
auricles,  and  propagated  downwards  towards  the  apex  of  the  heart. 

Which  Set  of  Valves,  —  To  learn  in  which  set  of  valves  it  origft> 
nates,  therefore,  find  its  seat,  and  trace  its  direction. 

Finding  the  murmur  to  be  in  the  aortic  orifice,  it  is  then  known  to 
be  obstructive,  if  the  first  sound  is  morbid,  and  the  second  sound  natu- 
ral; and  regurgitant,  if  the  first  sound  is  natural,  ami  the  secotul  sourui 
morbid. 

But  if  the  murmur  be  in  the  mitral  orifice,  it  is  obstructive  when  the 
first  beat  of  the  heart  is  natural,  and  the  second  beat  morbid;  and  re- 
gurgitant,  when  the  first  beat  is  morbid,  and  the  second  beat  natural. 

The  Pitch  or  Key  of  a  murmur  depends  on  the  distance  of  its  seat 
from  the  ear  of  the  listener ;  —  nearness  giving  a  high,  and  distance  a 
low  key.  Thus,  a  murmur  seated  in  the  orifice  of  the  pulmonary 
artery,  being  riearer  the  surface,  has  a  '  igher  pitch  than  any  othec 


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258 


HEART  DISEASES. 


It  is  on  about  the  samo  key  with  a  whispered  s,  —  soirn'iimes  a  little 
lower,  and  depending  sotnewiuit  on  the  strength  of  the  current  of 
blood,  —  a  strong  current  elemiting-y  and  a  weak  current  depressing  the 
tone. 

The  mitral  orifiee  is  situated  opposite  the  junction  of  the  c^artilajEja 
of  the  third  rib  with  the  left  side  of  the  breast  bone.  The  aortic 
orifice  is  about  half  an  inch  to  the  right  of  tiiis,  and  the  same  dis- 
tance lower.  It  is  known  by  the  key  being  lower,  —  about  like  a 
whispered  /•,  which  is  the  ordinary  type  of  tlie  sawing  sound. 

Murmurs  from  pulmonic  and  aortic  reg-urf>Uafions,  are  about  two 
tones  lower,  in  consecpunice  of  the  currents  of  the  l)lood  bying  weaker. 
They  are  like  whispering  awe  by  inspiration  ;  and  if  the  click  of  the 
valve  be  heard,  the  sound  will  be  changed  to  pair. 

Murmurn  in  the  mitral  valve,  being  more  deeply  seated,  are  about 
four  tones  lower,  and  are  like  a  whispered  v:ho. 

The  tricuspid  murmurs  are  higher  than  the  mitral,  because  nearer 
the  surface. 

The  musical  murmur  has  been  compared  to  whistling,  the  cooing 
of  a  Jove,  and  the  mewing  of  a  kitten.  It  generally  results  frt)m  re- 
gurgitation. 

The  purring  tremor  is  caused,  generally,  by  regurgitation  through 
Ihe  fm'tral  valve. 

Otlicr  SyiiiptoiiiH  Explained.  —  The  diflleulty  of  bn'athing,  frightful 
dreams^  congestion  of  the  lungs,  hemorrhages,  engorgements,  etc., 
mentioned  above,  all  proceed  from  such  valvular  stitlenings,  pucker- 
ings,  ossifications,  enlargements,  and  contractions,  as  occasion  a  decid- 
edly obstructed  circulation. 

The  small,  weak,  irregular,  and  interrupted  pulse,  is  caused  by  con- 
traction of  th(;  mitral  valve,  which'  occasions  an  insuflieient  or  irregu- 
iar  supply  of  blood  to  the  ventricle,  and  causes  the  ventricle,  by  losing 
the  retiistancc  of  the  valve,  to  expend  its  force  in  a  backward  as  well 
a  forward  direction,  —  th".3  sending  but  little  blood  into  the  arteries. 

Treatmeilf. —  The  tendency  of  valvular  disease  is  to  produce  hyper- 
trophy and  dilatation.  The  strong  and  ceaseless  efibrts  of  the  ven- 
tricle to  drive  the  blood  through,  an  orifice  obstructed  by  valvular 
disease,  will  of  course  make  the  walls  grow  thick,  which  is  hypertre- 
phy ;  and  at  the  same  time,  the  accumulation  of  blood  which  cannot 
be  driven  lorward  fast  enough,  must  Umd  to  swell  and  enlarge  the 
cavity,  —  which  is  dilatation. 

The  great  object  of  treatment,  therefore,  is  to  diminish  the  force 
and  activity  of  the  circulation,  —  to  induce  the  heart  to  cease  striving 
to  do  what  cannot  be  done. 

To  accomplish  this,  give  sedatives  (285)  (94)  (124).  The  hellebore 
and  cohosh  will  be  found  particularly  serviceable. 

The  tincture  of  the  American  hellebore  is  about  the  best  of  all 
Purgatives  may  be  given  according  to  the  strength  of  the  patient. 

When  there  is  dropsy,  and  a  scanty  secretion  of  high-colored  urinej 
diuretics,  or  medicines  to  increase  the  action  of  the  kidneys,  are  very 
important.     For  this  purpose,  digitalis  and  acetate  of  potash  (130) 


frightful    II 
its,  etc., 
pucker- 
a  decid- 


•e  hyper- 

ilhe'vfii- 

v'dlvular 

Ih  cannot 
jarge  tlio 

the  force 
striving 

I  hellebore 

Lst  of  all 
Itient. 
ted  urinej 
r  are  very 
wh  (130) 


are  excellent.  Should  this  not  succeed  in  redut^ing  the  dropsy,  an 
active  purgative  (31)  may  accompany  it. 

Diaphoretics,  or  medicines  which  promote  perspiration,  are  also 
useful.  This  opening  of  the  skin,  however,  is  generally  brought 
about  by  the  hellclKni',  etc.  (124). 

The  diet  should  Ih'  unstinailating,  and  yet  should  be  sufliciently 
ncMirishing  to  prevent  th<'  patient  from  running  too  low.  Animal 
f(Kxl  of  the  most  digestil)le  kind  may  bi;  taken  once  a  day ;  though 
there  are  many  cases  reijuiring  its  entire  rejection. 

The  passions  should  be  kept  in  the  most  perfect  su!)jec  tioii,  and 
t/ie  life  should  be  as  tranquil  as  jiossiltlv.  Nothing-  must  be  done  in  a 
hurry. 

Water  in  the  Heart-Case. — Ilydropericardmm. 

This  disease  is  common  as  an  attendant  of  g(!neral  dropsy. 

Pllj'sic'iil  Si|ni!i> — The  impul.'^e  is  undulatory,  as  if  transmitted 
through  a  lluid,  and  it  is  not  always  of  the  same  strength. 

The  dulness  extends  upward  in  a  conical  form,  in  proportion  to  the 
amount  of  fluid  ;  —  sometimes  rising  ns  high  as  the  .second  rib.  The 
impulse  does  not  coincide  with  the  first  beat  of  tin-  heart. 

flieiieriii  Syiiiptoiiis. —  The  jiatient  has  a  sensation  of  the  heart  being 
in  a  floating  state.     The  pulse  is  small,  frequent,  and  intermittent. 

Explniltitioil. —  The  reason  that  the  impul.se  does  not  occur  at  the 
same  time  with  the  first  beat  of  the  heart  is,  that  the  apex  does  not 
immediately  strike  the  walls  of  the  chest,  —  some  time  being  required 
to  push  it  up  through  the  fluid. 

The  beats  of  the  heart  sound  more  distant  than  natural  in  conse' 
quence  of  the  organ  being  pushed  away  from  the  walls  of  the  chest 
by  the  fluid. 

Palpitation.— Nervous  Palpitation.— Anaemic  Palpitation. 

There  is  a  great  deal  of  palpitation  of  the  heart  dependent  on 
dyspepsia,  hypochondria,  hysterics,  mental  agitation,  excessive  study 
with  deficient  sleep,  venereal  excesses,  and  masturbation. 

Palpitations  likewise  occur  from  what  is  called  antemia,  or  a  low 
Bnd  deficient  state  of  the  blood. 

Physical  Sij^ns.  —  The  impulse  is  weak,  fluttering,  or  tumultuous, 
—  generally  increased  by  trifles. 

The  beats  of  the  heart  are  increased  in  frequency,  and  sometimes 
marked  by  intermission.  Now  and  then  they  are  accompanied  by  a 
bellows  murmur.  There  are  musical  murmurs  in  the  jugular  veins, 
—loudest  a  little  above  the  collar  bones. 

General  Symptoms. —  The  complexion  is  generally  pallid  and  blood- 
less ;  the  lips  and  the  inside  of  the  mouth  partaking  of  the  same  pale- 


i  1 


r  I 


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If 

r.«!,' 


I 


ness ;  the  pulse  quick,  small,  weak,  and  jerking ;  and  during  palpita- 
tion, it  Hoiiirtiincs  has  a  thrill.  Slight  causM'si  produce  breath lessneHs 
and  faintncss.  A  disliki^  of  animal  food,  and  a  fondness  for  acids. 
The  monthly  dischurm'  in  females  ia  delioicnt,  and  the  whites  take  its 
pliU'e.  Hometimes  the  menses  are  too  profuse,  lasting  for  several  days, 
and  consistiuii;  only  of  hloml.  In  this  state  of  things  there  is  great 
feebleness  both  of  mind  and  liody,  with  rushing  noises  in  the  ears. 

Expltllitltioiis. —  The  murmurs  de|x*nd  on  a  lack  of  blood.  The  con 
ditions  of  their  existence  are,  thinness  of  blood,  n  swift  and  spasmodic 
'urculation,  and  j)articularly  an  unfilled  comUtioii  of  the  bloixJ-vessels. 
A  brook  is  the  more  babbling  in  projjortion  as  its  water  is  more 
shallow.  It  is  a  law  in  j)liysics,  that  ln!aviness  of  freight  gives  st^^ad- 
iness  of  motion  ;  and  lightness  of  freight  gives  misteady  motion. 
The  fireman's  hose  trembles  and  vibrates  when  only  half  full  of  water. 
In  like  manner  the  blood-vessels  are  agitated  when  imperfectly  filled. 

Treutllieilt.  —  This  is  to  be  governed  altogether  by  the  cause  of  the 
trouble.  If  it  be  dyspe|)sia,  hypochondria,  hyst«!rics,  etc.,  these  sev- 
eral diseases  reipiire  their  usual  treatment;  wlu'U  they  are  cured,  the 
palpitation  will  stop. 

But  when  it  is  caused  by  a  low  state  of  the  blood,  then  give  for 
several  weeks,  iron,  the  compound  mixture,  and  (31())  (5U0). 

The  food  must  likewise  be  nourishing,  —  tender  meat,  beef  and 
mutton,  with  broths,  etc. 

Gentle  exercise  will  be  required,  and  much  exjjosure  to  a  bracing, 
out-door  air. 

Neuralgia  of  the  Heart. — Angina  Pectoris. 

This  is  a  strictly  nervous  disease.  It  begins  with  a  sensation  of 
pain  and  constriction  in  the  region  of  the  heart.  This  pain  is  accom- 
panied with  more  or  less  pain  and  numbness  in  the  left  arm.  In 
females  it  is  not  uncommon  for  it  to  be  attended  by  great  sensitive- 
ness and  pain  of  the  breasts.  When  the  attack  is  violent,  the  pain 
in  the  heart  is  excruciating,  and  even  terrific.  There  is  attending  this 
a  feeling  of  great  oppression  in  the  chest,  amounting,  in  the  worst 
cases,' to  a  sense  of  suffocation.  The  heart  palpitates  violently,  the 
brain  is  oppressed,  and  fainting  sometimes  occui-s. 

The  disease  is  brought  on,  in  nervous  subjects,  by  over  excitement 
of  the  heart.  Walking  up  hill,  against  a  strong  wind,  may  bring  it 
on.  If  walking  at  the  time  of  the  attack,  the  patient  is  compelled  to 
stop,  {^nd  stand  still  till  the  pain  subsides. 

The  disease  is  often  connected  with  organic  changes  in  the  heart's 
structure,  such  as  ossifications,  and  other  alterations. 

Treatment. —  When  the  complaint  depends  on  organic  disease  of 
the  heart,  the  treatment  must  be  directed  to  the  cure  of  these  dis- 
eases. 

To  relieve  a  severe  attack,  the  patient  should  be  instantly  placed 
in  a  quiet  position;  wind  in  the  stomach,  if  present,  should  be  ex- 


[  nalpita* 

ll(u88lie8S      i 

'or  acids. 
i  take  its 
•ral  days, 
in  great 
!  ears. 

The  con 

pasiitodic 

d-vcsaels. 

is  more 
res  stead- 

motioti. 
of  water. 
;tly  filled. 

ISO  of  the 
hewe  sev- 
:;ured,  the 

I  give  for 

beef  and 

a  bracing, 


nsation  of 

is  accom- 

arm.    In 

sensitive- 

t,  the  pain 

tiding  this 

the  worst 

(lently,  the 

jxcitement 
ly  bring  it 
mpelled  to 

the  heart's 


disease  of 
these  dia- 

itly  placed 
uld  be  ex- 


pelled by  poppormint  or  anise  water,  or  ether,  or  (ll**)),  or  some  other 
arotiiutii*.  if  there  is  acidity  or  soijriicss  of  the  stomach,  it  must  be 
corrected  by  a  tcaKpooiiful  of  soda  in  half  a  tumbler  of  water;  and 
if  the  stomach  bv.  full  of  undigested  food,  let  tin;  patient  take  a  table- 
spoonful  of  ground  naistard,  stirred  up  with  a  teacupful  of  warm 
water.     This  will  cause  almost  instant  vomiting. 

These  things  being  done,  give  some  (juicling,  or  antispasmodic 
medicines,  as  on<!  sixth  of  a  grain  of  morphine,  or  one  of  the  following 
prescriptions:  ('^80)  (97)  (Kl'j)  (124). 

Great  relief  is  often  obtained  by  sending  a  current  of  magnetism 
through  till'  region  of  the  heart,  by  applying  one  pole  of  the  machine 
in  front,  and  the  other  upon  the  back. 

During  tin*  intervals,  the  general  health  is  to  be  improved  by  a 
wholesome,  nourishing  diet,  gentle,  out-door  exercise,  and  a  careful 
control  of  all  the  passions. 

Polypus  of  the  Heart. 

A  poHTioN  of  the  fibrine  sometimes  separates  from  the  blood  in  the 
heart  and  large  vessels,  and  becoming  more  or  less  organiztnl,  forms 
polypuses,  which  till  the  cavities  to  which  they  are  attached,  and  seri- 
ously obstruct  the  circulation. 

PliysiCill  Siccus. —  When  the  pulsations  of  the  heart,  previously 
regular,  become  suddenly  anoinalous,  confused,  and  obscure,  so  that 
they  cannot  be  analyzed,  we  may  suspect  a  polypus. 

Gnieral  Symptoms. —  A  sudden  and  great  aggravation  of  the  bad 
breathing,  without  Any  visil)le  caus«'.  —  the  patient  being  in  agony 
from  a  sense  of  iiripending  suflbcation,  and  tossing  about  from  side 
to  side,  struggliiiif  lor  breath.  Tin;  pulse  small,  weak,  irregular,  in- 
termittent, and  uiieciual ;  the  surfaeir  and  extremities  cold  ;  the  face, 
livid,  —  to  which  there  is  generally  aihled  nausea  and  vomiting. 

Treatllieilt. —  When  the  polypus  is  once  fonned,  the  case  is  hope- 
less.    The  treatment,  therefore,  can  only  be  |)reventive. 

The  chief  things  to  be  done  are,  to  keep  th<;  |)atient  in  a  state  of 
entire  tran(|uilliiy,  and  to  bring  the  circulation  to  the  surface,  by  keej)- 
ing  the  skin  warm,  and  excited  by  frii^tion.     This  will  call  the  blood 

sels,  and  lessen  the  chances  of  the 


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Displacements  of  the  Heart. 

The  hea-t  ?jr.;y  be  misplaced  from  birth.  I  have  seen  a  ease  in 
which  it  la;  vq.o  i  the  right  side,  and  had  always  been  in  that  posi- 
tion.    Its  ac'ion  v/as  natural. 

A  variety  ji"  caases  may  tend  to  push  it  out  of  its  place,  as  water 
in  the  cavity  of  the  pleura.  In  such  cases,  it  will  return  to  its  place 
when  the  water  is  drawn  off  or  absorbed. 


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Hiotograpjiic 

Sciences 
Corporation 


23  WEST  MAIN  STREET 

WEBSTER,  N.Y.  14580 

(716)  872-4503 


DISEASES   OF   THE   ABDOMINAL   CAVITY. 


Under  the  above  head  I  shall  consider  most  of  the  diseases  which 
occur  in  the  great  cavity  below  the  diaphragm,  called  the  abdomen 
or  belly.  These  affections  are  quite  iinportant,  and  make  up  a  con- 
siderable part  of  the  ills  we  suffer  from  disease. 

Before  speaking  of  these  diseases,  however,  I  will  call  the  reader's 
attention  to  a  profile  view  of  the 
relative  position  of  the  several  or-  fio.m. 

gans  lodged  in  this  cavity. 

In  Fig.  94,  L  is  the  liver,  S  the 
stomach,  C  the  colon,  R  the  rectum, 
B  the  bladder,  P  D  the  pancreas, 
and  I  the  intestines.  The  double 
lines,  folded  back  upon  each  other, 
and  surrounding  most  of  the  or- 
gans, represent  the  peritoneum,  a 
membrane  which  lines  the  great 
cavity  of  which  I  am  speaking. 

It  will  be  well,  too,  before  pro- 
ceeding further,  to  make  the  reader 
acquainted  with  the  names  of  cer- 
tain regions  of  the  abdomen  which 
he  will  find  constantly  spoken  of 
in  medical  books.  I  have  not 
used  these  terms  much  in  my 
book ;  but  it  will  be  convenient 
to  be  acquainted  with  them.  Phy- 
sicians who  are  careless  in  their 
readings,  are  not  always  familiar 
with  their  exact  locality. 

In  Fig.  95,  the  abdomen  is  di- 
vided into  nine  different  regions 
by  the  drawing  of  two  parallel 
lines  up  and  down,  2,  2,  and  3,  3, 
and  two  lines  across,  4,  4,  and  1,  1. 
three  in  the  middle,  and  three  below. 

In  the  upper  row,  6  is  the  epigastrinni,  or  e/ngasfric  region,  in  which 
are  the  left  lobe  of  the  liver,  and  a  portion  of  the  stomach  ;  6,  on  the 


This  gives  three  regions  above, 


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DISEASES  OF  THE  ABDOMINAL  CAVITY. 


2()U 


Fia.K. 


Fia  96. 


right  side,  is  the  rig-ht  hypochondrium.  in  whic^h  is  the  right  lobe  of  the 

liver;  and  5,  on  the  left  side,  is  the  left 
hypochomlrinm.  which  contains  the  spleen, 
and  a  portion  of  the  stomach  and  liver. 

In  the  middle  row,  7  is  the  mnbilical 
reg70W,  which  contains  the  small  intestines. 
On  the  right  side,  8  is  the  rifi^ht  lumbar  re- 
gion, which  holds  the  right  kidney  and  the 
ascending  colon  ;  and  8,  on  the  left,  is  the 
left  lumbar  region,  which  contains  the  left 
kidney  and  the  dcscciidiiig  colon. 

In  the  lower  row,  9  is  the  hypogastrwrn^ 
or  hypogastric  region,  which  contiiins  a  por- 
tion of  the  small  intestines  and  bladder. 
On  the  right,  lU  is  llie  right  iliac  fassa, 
containing  the  rarum  or  caput  coli;  and  10, 
on  the  left,  is  the  /eft  iliac  fassa,  contain- 
ing the  sigmoid  llexure. 

And    now    I   may  as  well   present,  in 

Fig.  96,  a  front  view  of 
many  of  the  organs  both 
in  the  chest  and  abdo- 
men :  1,  1,  1,  1,  are  the 
muscles  of  the  chest ;  2, 
2,  2,  2,  the  ribs ;  3,  3,  3, 
the  upper,  middle,  and 
lower  lobes  of  the  right 
lung;  4,  4,  the  lobes  of 
the  left  lung;  5,  the  right 
ventricle  of  the  heart ;  6, 
the  left  ventricle ;  7,  the 
right  auricle  of  the  heart; 
8,  the  left  auricle ;  9,  the 
pulmonary  artery  ;  10, 
the  aorta;  11,  the  vena 
cava  descenden*;  12,  the 
windpipe ;  13,  cESopha- 
gus ;  14,  14,  14,  14,  the 
pleura  ;  W,  15,  15,  the 
diaphragm ;  16,  IG,  the 
right  and  left  lobes  of 
the  liver;  17,  the  gall 
bladder  ;  18,  stomach  •, 
23,  the  spleen ;  19,  19, 
the  duodenum ;  20,  the 
ascending  colon;  21,  the 
transverse  colon ;  25,  the 
descending  colon ;  22, 22, 
22,  22,  the  small  intes- 
tines ;  23,  23,  the  walls  of  the  belly  turned  down ;  24,  the  thoracio 


U 


J'—  —  7 7       ^ 

duct,  opening  into  the  left  subclavian  vein  (27). 


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264 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


Acute  Inflammation  of  the  Liver.     ^ 

The  liver  is  the  largest  gland  in  the  body.  (See  Fig.  31.)  It  lies 
in  the  right  side,  and  at  the  top  of  the  great  abdominal  cavity,  di- 
rectly under  the  midriff,  and  lapping  upon  the  stomach.  Fig.  94 
shows  its  relative  position.  Its  office  is  to  take  the  superabundant 
carbon  out  of  the  blood.  This  carbon  it  unites  with  other  elements 
and  forms  bile,  the  peculiar  b'tter  substance,  which  is  poured  into  the 
upper  bowel,  and  greatly  aids  digestion. 

The  liver  is  liable  to  become  inHamed  from  several  causes,  such 
as  gravel  stones,  external  violence,  suppressed  secretions,  hot  climates, 
inflammation  of  the  duodenum,  etc. 

Symptoms.  —  These  are  sympathetic  fever,  with  pain,  and  a  sense 
of  tension  in  the  right  side,  inability  to  lie  oi  the  left  side,  difficulty 
of  breathing,  a  dry  cough,  vomiting,  and  hiccup. 

The  pain  is  acute  and  lancinatiiig  generally,  though  sometimes 
dull  and  tensive.  When  sharp,  it  is  like  the  stitch  of  pleurisy,  and  it 
indicates  that  the  peritoneum  which  covers  the  liver  is  inflamed. 
When  dull,  it  is  the  body  of  the  organ  which  is  suffering.  When  the 
convex  surface  of  the  liver  is  the  seat  of  the  disease,  the  pain  is  apt  to 
run  up  to  the  right  collar-bone,  and  to  the  top  of  the  right  shoulder. 
Breathing,  coughing,  and  lying  on  the  left  side,  increase  the  pain. 
A  soreness  is  felt  by  pressing  over  the  liver.  The  pulse  is  full,  hard, 
and  strong,  the  bowels  are  costive,  and  the  stools  are  clay  colored, 
owing  to  not  being  tinged  with  bile,  —  this  having  stopped  flowing. 
The  tongue  is  covered  with  a  yellow,  dark  brown,  or  even  black  coat, 
and  there  is  a  bitter  taste  in  the  mouth.     .  , 

Explanation.  —  The  bile,  secreted  by  the  liver,  is  poured  into  the 
upper  bowel,  and  gives  the  brown  or  the  yellow  color  to  the  contents 
of  the  bowels.  When  the  liver  is  inflamed,  it  cuiuiot  work,  —  it  se- 
cretes little  or  no  bile,  and  the  discharge  from  the  bowels  lose  their 
color.  The  bile  is  slightly  physical,  and  when  it  ceases  to  How  into 
the  bowels,  they  become  bound  or  costive.  When  the  liver  does  not 
work,  the  bile  has  to  be  taken  out  of  the  blood  by  the  kidneys,  and 
the  urine  becomes  of  a  deep  yellow  color.  Much  of  it  goes  out 
through  the  skin,  too,  which  is  likewise  yellow,  and  the  sweat  be- 
comes so  yellow  as  to  stain  the  linen. 

Treatment. —  Apply  wet  cups  or  leeches  over  the  liver  pretty  freely. 

Purgatives  will  also  need  to  be  used  pretty  freely  at  first.  Those 
which  produce  watery  stools  (31)  (247)  (34)  will  be  of  the  greatest 
service. 

After  the  cups  and  purgatives  have  been  thoroughly  used,  blisters 
will  be  useful,  and  it  will  be  better  to  apply  several  in  succession, 
rather  than  to  Keep  the  first  one  open.  Or,  in  the  milder  cases,  a 
mustard  poulticj  may  be  applied  over  the  whole  side,  and  even  along 
the  $pine. 

Frictions  over  the  stomach  and  liver  with  the  nitro-muriatic  acid, 


Ml  ;i 


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DIPIJASES  OF  THE  ABDOMINAL  CAVITT. 


26o 


and  a  foot  bath  of  the  same,  will  sometimes  do  well.  The  acid 
should  be  reduced  with  water  to  about  the  strength  of  sharp  vinegar. 
Water  a  little  soured  with  this  same  acid  makes  an  excellent  dank 
for  the  patient. 

Perspiration  should  be  induced  by  the  spirit  vapor  bath,  and  kept 
up  gently  by  the  tincture  of  the  American  hellebore,  from  three  to 
ten  drops  every  hour.  Or,  the  same  thing  may  be  done  by  prescrip- 
tion (126). 

When  the  urine  is  small  in  quantity  and  red,  give  some  diu- 
retic, as  infusion  of  marshmallow  root,  pumpkin  seeds,  or  trailing 
arbutus. 

The  diet  should  be  rice-water,  gruel,  and  toast-water.  While  get- 
ting up,  it  may  gradually  be  improved,  and  some  light  tonics  (49) 
(58)  (64)  be  added  to  it 

Chronic  Inflammation  of  the  Liver. 

There  are  few  chronic  diseases  for  which  the  physician  is  more 
often  consulted  than  this.  In  the  war^n  climate  of  the  South,  in  the 
bilious  districts  of  the  West,  and  indeed  even  in  the  Middle  and 
Eastern  States,  it  meets  us  continually,  and  demands  our  attention. 
That  it  is  difficult  to  cure  must  be  admitted ;  but  a  constant  famil- 
iarity with  chronic  diseases,  for  several  years,  has  convinced  me  that 
it  is  generally  curable. 

Symptoms. —  A  sense  of  fulness  and  weight  in  the  right  side,  with 
some  enlargement,  and  shooting  pains  felt  in  the  same  region,  partic- 
ularly when  it  is  pressed,  with  pains  in  one  or  both  shoulders,  and 
under  the  shoulder  blades ;  uncomfortable  sensations  when  lying  on 
the  left  side  ;  yellowness  of  the  skin,  eyes,  and  urine  ;  bowels  irregu- 
lar, loose,  or  costive ;  appetite  disturbed ;  sometimes  a  dry,  hacking 
cough ;  shortness  of  breath ;  tongue  whitish,  and  brown  or  yellow 
towards  the  root ;  a  bitter  and  bad  taste  in  the  morning.  The  urine 
deposits  a  sediment  on  standing.  There  is  generally  a  low  and  des- 
ponding state  of  mind,  with  irritability  and  peevishness  of  temper. 

The  skin  is  qften  covered  with  yellow  spots,  and  with  a  branny 
substance.  The  various  symptoms  of  dyspepsia  are  often  present. 
The  nervous  system  is  generally  much  disturbed,  and  there  is  a  dis- 
inclination to  apply  the  mind.  There  is  frequently  a  great  dread  of 
imagined  evil,  supposed  to  be  impending. 

Treatment —  This  does  not  require  to  be  as  active  as  that  for  the 
acute  form  of  the  disease. 

If  there  be  much  tenderness  of  the  liver,  begin  with  mustard  poul- 
tices, and  the  compound  pills  of  podophyllin,  or  the  compound  pill.* 
of  leptandrin,  or  (36). 

I  have  abandoned  the  use  of  mercury  in  this  disease,  as  in  most 
others  ;  but  if  any  prefer  to  use  it,  tjje  blue  pill  (52)  will  be  found  tfte 
most  useful  form. 

The  compound  tar  plaster  placed  over  the  liver,  in  bad  cases,  is 
often  very  serviceable. 


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266 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


An  alterative  (138)  (146)  will  be  found  useful. 

The  daily  alkaline  sponge  bath  must  on  no  account  be  omitted. 
Vigorous  friction  must  follow  it  Vigorous  constitutions  will  bear 
the  shower  bath ;  in  such  cases  it  may,  occasionally,  take  the  place  of 
the  sponge  bath. 

The  diet  must  be  simple,  yet  nourishing  and  wholesome,  —  and 
embracing  but  a  small  amount  of  fat,  —  as  this  is  composed  largely 
of  carbon,  and  the  liver  is  unable  to  remove  what  is  already  in  the 
blood. 

Especially  and  above  all,  out-door  exercise  must  be  taken  to  the 
full  amount  of  the  strength,  and  the  thoughts  be  occupied  with  cheer- 
ful subjects.  Let  the  hot  sun  be  avoided,  and  the  summer  exercise 
be  taken  in  the  cool  hours  of  the  day. 

The  recovery  from  this,  as  from  all  other  chronic  diseases,  must 
necessarily  be  slow. 

Acute  Inflammation  of  the  Spleen. — Splenitis. 

The  spleen  is  in  the  upper  part  of  the  belly,  on  the  left  side,  oppo- 
site the  liver.  It  is  subject  to  acute  inflammation,  which  is  known  by 
a  pain  just  under  the  short  ribs  on  the  left  side,  also  by  swelling,  sore- 
ness to  the  touch,  and  by  more  or  less  fever.  The  pain  often  shoots 
up  through  the  midriff"  and  to  the  left  shoulder.  There  is  a  short,  dry 
cough  ;  a  feeling  of  tightness  about  the  heart ;  a  sickness  at  the  stom- 
ach, and  vomiting ;  and  a  discharge  frequently  of  black  blood  from 
the  bowels.  The  urine  is  scanty,  is  passed  with  some  difficulty,  and 
is  high  colored. 

This  disease  appears  most  frequently  in  hot  climates,  and  is  often 
connected  with  intermittent  fevers.. 

Chronic  Inflammation  of  the  Spleen. 

This  prevails  most  in  fever  and  ague  districts,  and  is  a  frequent 
result  of  chills  and  fever.  It  is  generally  very  stubborn,  often  lasting 
many  years. 

Symptoms.  —  A  feeling  of  weight,  tightness,  and  sometimes  pain  in 
the  left  side,  —  the  pain  being  increased  by  pressure,  or  an  attempt  to 
lie  on  the  left  side.  The  organ  sometimes  enlarges  very  much,  so 
that  it  can  be  felt  by  the  hand.  This  enlarged  mass  passes  under  the 
common  name  of  "  ague  cake."  There  are  sometimes  numbness, 
weakness  of  the  legs,  difficulty  of  breathing,  palpitation  of  the  heart, 
inability  to  exercise  mucii  obstinate  constipation,  vomiting  of  food, 
piles,  dry  skin,  tongue  coated  white  or  red,  low  spirits,  and  occasion- 
aUy  dropsical  affections. 

During  the  chill  in  fever  and  ague,  the  spleen  becomes  enormously 
loaded  with  blood.  Surfeited  and  stretched  in  this  way  again  and 
again,  it  is  not  strange  that  the  organ  should  become  diseased. 

Treatment.  —  This  should  be  about  the  same  with  the  treatment  for 
acute  and  chronic  inflammation  of  the  liver. 


After  the  active  symptoms  of  inflammation  are  subdued,  the  warm 
bath  may  be  used  once  or  twice  a  week. 

In  the  chronic  lorm  of  the  disease,  counter-irritation  with  the  com- 
pound tar  plaster,  with  mustard  poultices,  croton  oil,  or  tincture  of 
iodine,  will  be  particularly  needed. 

Among  medicines,  muriate  of  ammonia  (53)  has  a  high  reputation. 
To  keep  the  bowels  open,  podophyllin,  quinine,  and  nux  vomica  (46), 
have  a  fine  effect.  Iron  may  be  given  (73)  when  the  patient  is  blood- 
less and  pale. 

Jaundice. — Icterus. 

The  jaundice  is  a  very  common  disease,  and  to  be  known,  needs  only 
to  be  seen. 

Symptoms.  —  The  most  prominent  symptoms  are,  yellowness  of  the 
skin  and  whites  of  the  eyes,  saffron-colored  urine,  and  whitish  or  clay- 
colored  stools.  So  full  ia  the  urine  of  bile,  that  a  piece  of  white  linen, 
dipped  in  it,  receives  a  brigiit  yellow  tinge. 

Beside  these  leading  symptoms,  there  aro  impaired  appetite,  a  loath- 
ing of  food,  the  sense  of  a  load  at  the  pit  of  the  stomach,  sourness  of 
stomach,  sometimes  sickness  and  vomiting,  a  bitter  taste  in  the  mouth, 
disinclination  to  move  about,  sleepiness,  a  dull  pain  in  che  right  side, 
which  is  increased  by  pressure. 

The  entire  body  of  a  person  who  has  died  of  jaundice,  including 
bones,  muscles,  and  membranes,  are  found  to  be  full  of  bile,  and  colored 
yellow. 

Explanation.  —  The  bile  flows  into  the  upper  bowel,  a  little  below 
the  stomach,  through  a  duct  or  tube  about  as  large  as  a  goose-quill. 
This  little  tube  or  vessel  receives  the  bile  from  a  smaller  tube,  called 
the  hepatic  duct,  and  from  another  which  goes  to  the  gall-bladder, 
called  the  cystic  duct 

Those  little  tubes  sometimes  get  obstructed  or  plugged  up  by 
sticky,  thickened,  or  hardened  bile,  or  by  gall-stones,  formed  in  the  liver, 
and  the  bile  finding  no  outlet  through  its  natural  channels,  is  taken 
up  by  the  absorbent^,  distributed  over  the  system,  and  produces  the  yel- 
lowness we  witness.  Wlien  these  ducts  and  the  gall-bladder  are  filled  and 
stretched  by  this  thickened  and  hardeued  bile  they  become  tender 
and  sore.  Hence  the  sore  feeling  in  the  side  when  pressure  is 
made. 

There  is  another  explanation  of  the  way  in  which  the  yellowness  of 
jaundice  is  produced,  and  it  matters  not  whether  it,  or  the  one  just 
given,  be  adopted.  It  is  this :  The  bile  is  formed  by  the  blood,  and 
not  by  the  liver.  The  oflSce  of  the  liver  is  to  draw  or  strain  off  the  bile 
from  the  blood.  And  when  this  organ  is  inflamed,  or  gets  sluggish  and 
will  nut  work,  the  blood  is  not  relieved  of  its  yellow  freight.  The 
bile  accumulates  and  in  attempting  to  escape  through  other  channeb,  it 
lodges  in  the  various  tissues,  particularly  in  the  skin. 

Treatment If  there  be  much  inactivity  of  the  liver,  the  treatment 

may  begia  with  an  emetic  (1)   (2)  (4). 


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268 


DISEASES  OF  THE  AMDOMINAL  CAVITY. 


An  infusion  of  thoroughvvort,  drank  freely  every  day,  is  a  valuable 
remedy.  The  inner  bark  of  the  barberry  steeped  in  cider,  or  this  arti- 
cle compounded  with  others  (286)  (287)  will  be  found  excellent. 

The  diet  should  be  plain,  wholesome,  and  nourishing,  but  com- 
posed mostly  of  vegetable  articles,  particularly  green  vegetables  and 
berries  when  they  are  to  be  had. 

Cold  water  should  be  the  principal  drink  ;  or  drink  and  mediciiu' 
may  be  combined  in  the  shape  of  five  drops  of  muriatic  acid,  ami 
three  drops  of  nitric  acid,  dissolved  in  a  tumbler  of  water  slightly 
sweetened.  This  is  generally  a  pleasant  drink,  and  will  assist  very 
much  in  the  cure. 

The  warm  bath  once  or  twice  a  week,  and  the  alkaline  sponge  bath 
every  day,  with  smart  friction,  must  not  be  omitted. 

When  jaundice  is  caused  by  the  passage  of  gall-stones  through  the 
bile  duct,  there  is  sometimes  terrible  pain  and  suftering,  —  the  stone. 
occasionally,  being  as  large  as  a  nutmeg,  and  forcing  its  way  through 
a  quill-sized  tube.  So  great  is  the  distress  that  the  patient  sometimes 
rolls  upon  the  floor  in  agony.  To  alleviate  this  pain,  large  doses  of 
opium,  laudanum,  or  morphine,  are  required.  A  large  teaspoonful  of 
bicarbonate  of  soda  dissolved  in  a  tumblerful  of  hot  water  is  an  ex- 
cellent remedy  if  drank  at  a  single  draught.  It  relieves  the  acidity 
of  the  stomach,  and  acts  as  a  fomentation  to  the  internal  seat  of  the 
pain.  Mustard  poultices,  or  warm  fomentations,  over  the  seat  of  the 
pain,  are  required.     The  warm  bath  is  excellent. 

The  acid  bath,  made  by  mixing  three  parts  of  muriatic  acid  with 
two  parts  of  nitric  acid,  and  adding  as  much  of  this  mixture  to  water 
as  will  make  it  about  as  sour  as  weak  vinegar,  is  valuable  in  jaundice. 
Only  a  quart  of  water  need  be  taken  ;  and  the  solution  should  be 
applied  with  a  sponge.  It  is  of  the  right  strength,  if  it  produce  a 
sUght  tingling  of  the  skin. 

Gall  Stones. — Biliary  Calculi. 

These  are  concretions,  or  hardening  of  bile  into  masses  of  all  sizes 
from  that  of  mere  grains,  to  that  of  a  nutmeg.  Fig.  97  is  a  specimen 
of  them.  They  are  found  in  the  gall  bladder,  the  cystic 
duct,  the  hepatic  duct,  and  are  sometimes  precipitated 
from  the  bile  after  it  has  passed  into  the  bowels.  In  pass- 
ing through  the  ducts,  if  of  considerable  size,  they  produce 

intense  pain,  particularly  if  they  are  jagged  upon  their  ^ .^  x^ 

surface.  Mflb 

These  stones,  so  called,  are  composed,  chemically,  of^^^ 
cholesterine,  bile  pigment,  choleic  acid,  choleate  of  soda,  mucus,  earthy 
salts,  and  margarin  and  its  compounds.  A  nucleus  seems  to  be 
first  formed,  and  then  a  gradual  accumulation  takes  place  upon  its 
surface. 


Fig.  97. 


Symptoms. —  An  almost  constant  uneasiness  in  the  right  hypochon- 
driac region,  with  spasms  of  pain,  coming  on  suddenly,  and  lasting 
for  a  time  with  great  severity,  and  then  subsiding.    The  pain  is  caused 


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DISEASES  OF  THE  ABDOMINAL  CAVITY. 


26J» 


by  a  stone  being  suddenly  forced  into  the  duct  and  moving  forward  in 
it,  and  it  subsides  when  the  stone  either  stops,  or  gets  through  the  duct. 
When  the  stone  reaches  tiie  bowels,  it  passes  oft  with  the  stools. 

The  patient  generally  hiis  a  pale,  sallow  complexion,  a  small,  feeble 
pulse,  and  often  suffers  fn.in  nausea  and  vomiting,  and  from  restless- 
ness and  hurried  breathing. 

Treatment. —  To  reduce  the  spasm,  give  Dover's  powder  in  full 
doses,  or  chlorodine.  Also,  apply  mustard  over  the  right  hypochon- 
driiun  and  stomach,  and  follow  it  with  hot  fomentations  with  hops, 
or  use  wet  cu|)s. 

If  the  stoni..ch  is  irritable,  give  the  neutralizinnf  mixture  until  it 
moves  the  bowels.  A  v/arin  infusion  of  thoroughv^ort,  given  to  the 
extent  of  producing  vomiting,  will  sometimes  do  well,  and  lobelia 
enough  with  it  to  relax  the  duet  may  be  useful. 

To  relieve  the  acidity  on  which  the  formation  of  these  stones  so 
often  depends,  a  neutralizing  preparation  {'.i-iS)  may  be  given  for  a 
long  time,  the  diet,  in  the  mean  time,  being  well  regulated.  The 
sponge  bath,  with  saleratus  and  water,  should  be  taken  daily,  followed 
by  brisk  rubbing;  and  free  exercise  in  the  open  air  should  on  no 
account  be  omitted. 

Acute  Inflammation  of  the  Stomach. — Gastritis. 

This  is  a  rare  disease.  It  is  generally  induced  by  irritating  and 
corrosive  substances  taken  into  the  stomach.  Poisons,  as  arsenic, 
aquafortis,  corrosive  sublimate,  and  the  like,  are  the  most  common 
causes  oi  it.  Blows,  sudden  stoppage  of  sweat,  and  excessive  use 
of  ardent  spirits,  may  also  excite  it. 

Symptoms.  —  It  is  marked  by  burning  pain  in  the  stomach,  thirst, 
restlessness,  anxiety,  constant  vomiting,  prostration  of  strength,  a 
quick,  hard,  and  small  pulse,  incessant  retching,  a  sunken  counte- 
nance, hiccough,  cold  hands  and  feet,  and  a  damp  skin. 

Treatment.  —  If  the  inflammation  be  excited  by  poison,  the  reme- 
dies named  under  antidotes  for  poisons  must  be  hrst  employed. 

The  poison  bemg  neutralized  or  thrown  off,  the  inflammatory  con- 
dition must  be  combatted  with  the  remedies  usual  for  such  states. 
Mustard  poultices  to  the  feet,  along  the  spine,  and  particularly  over 
the  pit  of  the  stomacb)  will  be  among  the  first  things  to  be  employed, 
and  should  be  followed  by  hot  fomentations  of  stramonium  leo.ve.*  or 
hops,  —  both  the  fomentations  and  the  poultices  to  be  repeated  as  oc- 
casion may  require.  Dry  cupping  over  the  region  of  the  stomach  is 
useful. 

Drinks.  —  Cold  water,  bread-water,  rice-water,  arrow-root  gruel,  in- 
fusion of  slippery  elm  bark,  and  of  marshmallow.  These  should  be 
taken  in  very  small  quantities, —  say  a  teaspoonful  at  a  time,  —  about 
twenty  drops  of  tincture  of  aconite  root  being  added  to  half  a  tum- 
blerful. Lumps  of  ice  may  be  held  in  the  mouth,  and  occasionally 
swallowed. 


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270 


DISKASKS  OF  TIIK  AUDOMINAL  CAVITY. 


Injections.  —  Emetics  and  physic  are  not  proper,  but  injections 
(248)  (2o3),  or  simply  soap  suds,  will  be  re(iiiired. 

The  remedies  must  be  pursued  until  "U  tenderness  has  disappeared 
from  the  pit  of  the  stomach. 

While  the  patient  is  recovering,  great  care  mi^.;-«t  be  taken  not  to 
overload  the  stomach  with  food.  Arrow-root,  sago,  and  milk  are 
among  the  first  articles  to  be  allowed.  After  these,  will  come  grad- 
ually beef-tea,  chicken  broth,  soft-boiled  eggs,  and  'jeef-steak,  until  the 
whole  diet  can  be  restored. 

Chronic  Inflammation  of  the  Stomach. 

This  is  a  much  more  common  disease  than  the  preceding;  indeed 
it  is  very  common.  Though  it  does  not  put  life  in  immediate  danger, 
it  perverts  the  feelings  of  the  stomach,  and  causes  many  of  the  symp- 
toms of  indigestion.  Dyspepsia,  however,  is  a  different  complaint, 
and  not  necessarily  connected  with  inflammation. 

Symptoms. —  There  is  generally  pain  in  the  stomach,  which  is  in- 
creased by  the  presence  of  food,  and  by  external  pressure.  The  pain 
is  sometimes  felt  only  during  digestion.  The  fermentation  of  the 
food  in  the  stomach  generates  a  gas,  which  is  frequently  belched  up. 
This  is  what  is  meant  in  common  language  by  having  "wind  in  the 
stomach,"  and  "belching  wind."  The  meals  are  frequently  vomited 
up ;  the  appetite  is  fickle,  sometimes  voracious,  and  again  nearly  ab- 
sent ;  the  thirst  is  likewise  variant ;  the  tongue  is  white  in  the  centre, 
and  red  at  the  sides  and  tip,  —  sometimes  smooth  and  red  all  over, 
like  a  slice  of  raw  beef.     The  urina  is  scanty  and  high-colored. 

The  disease  is  very  liable,  if  badly  managed,  to  lead  to  ulceration 
of  the  coats  of  the  stomach,  and  thence  to  a  fatal  end ;  for  an  ulcer 
may  penetrate  the  walls  of  the  stomach,  and  let  its  contents  into  the 
abdominal  cavity,  which  would  excite  an  immediately  fatal  inflamma- 
tion. 

Treatment.  —  If  there  be  much  tenderness,  we  may  apply  leeches 
over  the  stomach.  With  less  tenderness,  counter-irritation  will  an- 
swer,—  as  blisters,  croton  oil,  mustard  poultices,  the  compound  tar 
plaster,  or  dry  cups. 

The  skin  of  the  whole  surface  should  receive  special  attention. 
'The  warm  or  the  cold  bath  should  be  used  often,  according  to  the 
strength  of  the  patient.  When  the  reaction  is  good,  a  cold  compress 
bound  upon  the  stomach  every  night,  will  do  much  to  bring  relief. 

The  diet  cannot  be  too  carefully  managed.  While  there  is  consid- 
erable tenderness,  the  nourishment  must  be  of  the  most  simple  and 
unirritating  kind,  —  consisting  of  little  more  than  the  most  bland 
nutritive  drinks ;  and  even  these  should  be  taken  in  small  quantities 
at  a  time.  Gum  arable  water,  rice-water,  barley-water,  arrow-root 
gruel,  tea,  and  toast  without  butter,  will  be  amply  sufficient  to  keep 
soul  and  body  together,  and  will,  in  two  or  three  weeks,  generally 
starve  the  enemy  out  of  his  quarters.  After  this,  a  more  nourishing 
diet  may  gradually  be  resumed. 


imm 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


271 


Indigestion.— Dyspepsia. 

Dyspepsia  ia  a  disease  of  civili/atioti.  Savages  know  nothing  of 
it.  It  is  the  costly  price  we  pay  for  hixnries.  All  civilized  nations 
Bufler  from  it,  more  or  less,  but  none  so  much  as  the  jx-ople  of  the 
United  States.  It  is  here,  in  the  new  world,  that  the  disease  has  b.'- 
eoine  domesticated,  and  we,  as  a  people,  who  have  threatened  to 
monopolize  its  miseries. 

F'ew  disorders  indict  upon  their  victims  greater  sullering;  yet  it  is 
not  particularly  dangerous,  and  it  is  even  doubtful  whether  it  tends 
very  much  to  shorten  life,  unless  the  length  of  life  be  judged  to  con- 
sist in  the  sum  of  happiness  enjoyed,  —  in  which  case,  few  complaints 
shorten  it  more. 

Symptoms.  —  These  vary  very  much  in  different  stages  of  the  dis- 
ease, and  in  different  persons.  In  general  the  complaint  begins  with 
a  sense  of  fulness,  tightness,  and  weight  in  the  stomach,  sooner  or 
later,  after  meals,  and  a  c^-angeable,  diminished,  or  lost  appetite. 
Occasionally,  the  appetite  is  craving,  and  when,  in  obedience  to  its 
promptings,  a  large  meal  is  taken,  there  is  pain  in  the  stomach,  with 
general  distress  and  nervousness,  and  sometimes  vomiting.  Flatu- 
lency and  acidity  are  common,  with  sour  and  oflensive  belching  of 
wind;  and  very  often  there  is  a  water-brash,  or  vomiting  of  a  clear, 
glairy  fluid  when  the  stomach  is  empty.  Diziness  is  a  prominent 
symptom.  There  is  a  great  deal  of  what  patients  call  an  "  all-gone  '* 
feeling  at  the  pit  of  the  stomach,  —  a  vvH'akness  so  great  at  that  par- 
ticular spot,  that  it  is  very  hard  to  sit  up  straight.  There  is  a  bad 
taste  in  the  mouth ;  the  tongue  is  covered  with  a  whitish  fur ;  there 
is  headache,  heartburn,  palpitation  at  times,  high-colored  urine,  and 
tenderness,  now  and  then,  at  the  pit  of  the  stomach.  The  bowels  are 
generally  irregular,  sometimes  very  costive,  at  other  times  loose,  when 
portions  of  food  are  passed  off  undigested. 

]Vervous  Complication.  —  Such  are  the  symptoms  in  a  case  of  sim- 
ple disorder  of  the  stomach,  when  no  other  part  of  the  system  is 
materially  involve^.  This  is  indigestion,  well-marked,  and  distressing 
enough ;  but  it  is  only  a  part  of  what  is  understood  by  a  case  of 
modern  dyspepsia.  In  //its,  either  the  indigestion,  in  its  course,  dis- 
turbs and  involves  the  nervous  system,  or  the  nerves  become  them- 
selves disordered,  and  produce  the  indigestion.  Sometimes  one  hap- 
pens, sometimes  the  other,  it  matters  not  which ;  both  are  present,  — 
the  affection  of  the  stomach  and- of  the  nerves,  in  a  case  of  thorough 
dyspepsia.  To  make  out  a  full  case,  in  its  tormenting  completeness,  we 
must  add  to  the  above  symptoms,  great  depression  of  spirits,  amount- 
ing at  times  to  complete  hopelessness  and  despondency  ;  a  dread  and 
fear  of  some  impending  evil ;  a  lack  of  interest  in  passing  events ;  un- 
willingness to  see  company  or  to  move  about ;  an  irritable  and  fretful 
temper ;  a  desire  to  talk  of  one's  troubles,  and  nothing  else ;  a  sallow, 
haggard,  sunken,  and  sometimes  wild  expression  of  countenance ;  a 
'Iry,  wrinkled,  and  harsh  skin,  ^ith  unrefreshing  sleep,  disturbed  by 


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272 


DISEASES  OF  THK  ABDOMINAL  CAVITY. 


all  sorts  of  annoyancoH  and  ditficultieH,  such  as  shipwrcck.s,  falls  down 
precipices,  and  niglittnare. 

The  man  who  has  all  these  symptoms,  or  ai.y  considerable  portion 
of  them,  has  di/spepsia,  and  is  about  as  miserable  as  if  all  the  sorrows 
of  life  were  electrical  currents,  and  were  running  through  him  contin- 
ually. 

CauseH  of  Dysprpsin.  —  To  healthy  digestion,  three  conditions  are 
especially  necessary,  —  that  the  food  should  be  well  chewed  and 
mixed  with  saliva  before  it  is  swallowed  ;  that  the  stomach  should 
pour  out  and  mix  with  it  the  right  amount  of  healthy  gastric  juice  ; 
and  that  it  should  be  well  churned  while  in  the  stomach. 

It  is  well  known  that  the  first  of  these  conditions,  a  thorough  chew- 
ing of  food  is  rare  in  this  country.  We  eat  too  fast ;  we  do  not  mas- 
ticate our  food  ;  we  bo/t  it  whole. 

This  is  the  first  cause  of  dyspepsia,  and  it  is  the  fruitful  mother  of 
causes.  It  furnishes  the  occasion  for  eating  too  much  ;  for  when  the 
food  is  swallow(!d  with  such  rapidity,  the  stomach  is  taken  by  sur- 
jirise,  as  it  were  ;  it  cannot  secriite  gastric  juice  fast  enough  to  be 
diirused  through  th(!  fast-growing  mass;  and  the  appetite  does  not 
decline  until  a  great  deal  too  much  is  taken.  The  coats  of  the  stom- 
ach, being  stretched  unnaturally,  do  not  pour  out  the  gastric  juice  at 
the  right  time,  or  as  much  of  it  as  is  wanted,  and  what  there  is,  is 
altered  in  quality. 

li/loreover,  the  stomach  being  overburdened,  cannot  turn  over  and 
churn  its  contents  properly. 

To  fas*^  eating,  we  may  add,  high-seasoned  dishes,  too  stimulating 
for  the  stomach;  eating  between  meals,  and  at  unseasonable  hours, — 
particularly  at  bed-time  ;  excessive  use  of  strong  drinks  and  tobacco ; 
habitually  sitting  up  late  at  night  ;■  inactive  habits  of  body  ;  and  ex- 
cessive use  of  the  mind. 

No  causes  of  dyspepsia  are  more  active  than  those  which  disturb 
and  fret  the  mind.  It  is  surprising  how  suddenly  any  mental  agita- 
tion will  put  an  end  to  the  appetite,  and  suspend  digestion.  And 
when  these  mental  disturbances  are  protracted,  when  care  becomes  a 
daily  and  hourly  companion,  dyspepsia  is  almost  sure  to  show  itself. 
Considering  the  numerous  causes  of  unpleasant  mental  excitement 
which  we  have  in  the  politics,  the  business,  the  ambition,  the  family 
jars,  etc.,  of  this  country,  it  is  a  wonder  that  dyspepsia  is  not  even  more 
prevalent.     It  is  hard  for  the  sensitive  to  escape. 

Urinary  Deposits.  —  Before  speaking  of  the  treatment  of  dyspepsia, 
it  will  be  proper  to  take  notice  of  certain  deposits  in  the  urine,  to 
which  persons  suffering  from  this  complaint  are  liable,  and  the  dis- 
covery of  which,  will,  in  many  cases,  indicate  the  treatment. 

Many  dyspeptics  have  acid  urine,  which  is  loaded  with  crystals  of 
oxalcUe  of  lime.  These  persons  are  much  depressed  in  spirit.,  and 
look  upon  the  dark  side  of  everything.  They  are  painfully  disturbed 
by  small  annoyances,  are  irritable  in  temper,  incapable  of  exerting 
themselves,  look  with  dread  upon  the  future,  and  generally  have  the 
dark  and  dingy  look  of  the  face,  which  indicates  functionsu  derange- 
ment of  the  liver. 


I 


i 


DISEASES  OF  TUB  ABDOMINAL  CAVITY. 


27;« 


The  most  of  these  crystals  are  octahedral  in  form,  and  in  the  field 
of  a  pood  inicroacope,  are  beautiful  objects  for  inspection.  (Fig».  98 
and  99.)  To  obtain  them,  take  a  portion  of  urine  passed  in  the 
morning  (uritui  sarigminis),  and  let  it  stand  till  a  deposit  takes  place. 
Pour  on'  the  upper  portion  of  the  urine ;  put  a  part  of  the  remainder 
in  a  watch  glass,  and  gently  heat  it  over  a  lamp.  The  heat  will  cause 
ft  deposit  of  the  crystals. 


Flo.  98 


Flo.  99. 


Fio.  100. 


The  oxalate  of  lime  is  freciuciitly  '"ound  in  urine,  having  the  form 
of  dumb-bells.  When  examined  b>  ^^olarized  light,  they  appear  beau- 
tifully colored  and  striated.     (Fig.  100.) 

The  urate  of  ammonia,  and  uric  aci<^I  gravel,  are  likewise  found  in 
large  quantities,  in  the  urine  of  many  dyspeptics.  Some  are  exhausted 
by  them,  and  reduced  almost  to  skeletons,  and  to  a  wretched  state  of 
health,  —  having  boils,  eruptions,  etc. 

To  find  the  urates,  put  a  little  of  the  urine  containing  the  deposit 
in  a  test  tube,  and  warm  it  gently  over  a  lamp.  1/  the  deposit  readily 
dissolve,  it  is  probably  urate  of  ammonia  (Figs.  101  and  102),  and  may- 
then  be  examined  under  the  microscope,  to  make  the  matter  sure. 


Fio.  101. 


Fia.  loa. 


To  find  uric  or  lithic  acid,  let  morning  urine  stand  until  a  solid 
deposit  has  sunk  to  the  bottom ;  then  pour  off  the  liquid,  and  place 
some  of  the  solid  portion  upon  a  glass,  and  examine  it  with  a  micro- 
scope, and  if  this  acid  be  present,  its  peculiar  crystaline  forms 
(I^ig.  103)  win  be  discovered,  either  alone,  or  mixed  with  urate  of 
amrildriia. 

In  tho^6  cases  in  which  there  is  a  great  prostration  of  the  nervim* 


=) 


274 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


FlO.  103. 


system,  with  a  loss  of  sexual  power,  bad  feelings  in  the  head,  perhaps 
pain  and  weakness  across  the  loins,  and  a  tendency  to  consumption, 

we  may  suspect  the  presence  of  the  triple 
phosphates  in  the  urine.  Phosphorus  is 
one  of  the  elements  of  the  brain  and 
nerves,  and  when  there  is  a  constant  drain 
of  this  element  through  the  kidneys,  the 
nervous  system  is  gradually  exhausted. 
To  find  the  triple  phosphates,  put  some 
morning  urine  in  a  glass  vessel,  and  let  it 
stand  till  a  sediment  has  gone  to  the  bot- 
tom. Put  some  of  the  sediment  in  a  test 
tube,  and  warm  it  gently  over  a  lamp. 
If  the  warmth  do  not  dissolve  the  deposit, 
add  to  it  a  little  acetic  acid ;  if  the  de- 
posit dissolve  in  the  acetic  acid,  it  proba- 
bly consists  of  earthy  phosphates.  This  is 
then  to  be  examined  under  the  micro- 
scope to  ascertain  whether  it  is  the  phos- 
phate of  lime,  the  triple  phosphate,  or  a  mixture  of  both. 


Fio.  104. 


Fio.  106. 


Fio.  106. 


Fro.  107. 


Fig.  104  shows  us  the  prismatic  crystals  of  the  triple  phosphate. 
In  a  few  rare  cases,  these  are  penniform  (Fig.  105).  Fig.  106  gives 
us  another  specimen  of  the  crystals  of  the 
triple  phosphates,  as  they  appear  under  the 
,  microscope,  mixed  with  amorphous  particles 
of  phosphate  of  lime.  If  an  excess  of  am- 
monia be  added  to  the  urine,  the  crystals 
become  star-like,  and  foliaceous,  as  in  Fig. 
107. 


Treatment  of  Dyspepsia.  —  As  there  are 
few  complaints  which  distress  the  patient 
more  than  dyspepsia,  so  there  are  few  which 
give  the  physician  more  trouble.  Generally 
our  art  has  failed  upon  it  because  too  much 
has  been  required  of  us.  We  have  not  merely  been  asked  to  cure 
the  disease,  but  to  do  it  while  the  patient  continues  the  indulgence  of 
his  appetite,  or  his  excessive  application  to  business  or  study.     It  has 


jerhaps 
nnption, 
le  triple 
lorus  is 
lin   and 
tit  drain 
eys,  the 
hausted. 
lit  some 
nd  let  it 
tlie  bot- 
in  a  test 
a  lamp. 
I  deposit, 
f  the  de- 
it  prohor 
This  is 
le  micro- 
the  phos- 


jhopphato. 
106  gives 


ed  to  cure 


ilgence 


of 


been  expected  of  us,  that  with  medicine  we  should  contravene  the 
la'vs  of  nature,  and  restore  health  while  the  causes  of  disease  are  in 
full  activity. 

This  complaint  is  often  brought  on  by  not  keeping  the  bowels 
open.  To  cure  it,  therefore,  one  of  the  first  things  to  be  done  is  to 
remove  costiveness  and  regulate  the  bowels. 

One  of  the  very  best  articles  I  know  of  to  remove  constipation  is 
Mettauer's  Aperient.  I  have  placed  it  in  the  department  of  Phar- 
macy ;  it  ought  to  be  in  the  United  States  Dispensatory.  Taken 
immediately  after  meals,  in  doses  of  a  teaspoonful,  it  corrects  acidity 
of  the  stomach,  it  gently  opens  the  bowels,  and  when  its  action  is 
over,  will  be  found  to  liave  diminished  the  costiveness,  rather  than  in- 
creased it,  as  most  kinds  of  physic  do.  It  is  excellent  in  the  bilious 
forms  of  dyspepsia,  —  acting  finely  upon  the  liver,  —  particularly  if 
a  few  drops  of  aqua  regia  in  water  be  taken  before  meals,  —  the  ape- 
rient being  taken  after. 

If  piles  exist,  this  mixture  will  be  objectionable  on  accoimt  of  the 
aloes,  and  the  fluid  neutralizing  extract  may  take  its  place.  Sweet 
tincture  of  rhubarb  and  soda  (37)  is  sometimes  preferable  to  the  ape- 
rient. 

Several  other  preparations  (38)  (289)  (39)  (290)  will  be  found  use- 
ful to  remove  costiveness  and  debility  of  the  stomach. 

For  acidity,  beside  the  remedies  already  mentioned,  prepared  char- 
coal may  be  used,  in  teaspoonful  doses,  or  carbonate  of  magnesia,  or 
fluid  magnesia,  or  trisnitrate  of  bismuth.  A  good  remedy  is  pulver- 
ized guaiacum,  rhubarb,  prepared  charcoal,  and  carbonate  of  mag- 
nesia, equal  parts ;  also  (2b)  (37)  (38)  (42).  If  crystals  of  oxalate  of 
lime  be  found  in  the  urine,  give  a  few  drops  of  aqua  regia,  in  water, 
three  times  a  day. 

Hyj^ienic  Treatment. —  The  diet  must  be  managed  with  great  pru- 
dence. Food  must  be  taken  in  such  quantities  only  as  the  stomach 
can  digest,  however  small  that  quantity  may  be ;  and  it  must  be  taken 
slowly,  and  well  chewed.  No  article  should  be  touched,  or  thought 
of,  which  disagrees  with  the  stomach.  Costiveness  may  frequently 
be  entirely  removed  by  eating  no  bread  except  that  made  from  un- 
bolted wheat  flour,  commonly  called  Graham  bread,  or  by  making 
one  of  the  three  daily  meals  of  boiled  cracked  wheat,  with  milk  or 
molasses.  If  the  triple  phosphates  be  found  in  the  urine,  there  is  a 
spticial  reason  why  the  unbolted  flour,  or  the  cracked  wheat  should 
be  ujjed.  The  wheat  grain  abounds  in  phosphorus,  the  largest  por- 
tion of  which  is  in  the  bran,  and  this  is  much  needed  when  the  kid- 
neys are  robbing  the  brain  of  its  phosphoric  element 

Not  too  r^isch  Brain-work.  —  It  is  important  that  the  brain  and 
nervous  sysvcm  should  be  relieved  of  the  burden  of  too  much  work, 
and  that  Lhe  thoughts  should  be  turned  into  the  most  agreeable  chan- 
nels. If  the  patient  would  get  well,  the  disinclination  to  move  about, 
and  see  company  must  be  resisted.  In  many  cases,  dyspeptics  are 
like  sea-sick  persons,  —  feeling  as  though  they  would  rather  go  over- 
board than  move.     In  such  instances,  friends  must  not  be  harsh  with 


1' 

;  11 

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1 

MlHn 

1.'      ■  .' 

11 

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'r^wi 


them,  and  frown  upon  their  listlessness  aa  if  it  were  a  fault ;  bul 
rather  treat  them  affectionately,  and  beguile  them  out  by  all  sorts  of 
pleasing  enticements.  Exercise  must  be  had,  every  day,  and  be  coh* 
nected,  if  possible,  with  an  object,  so  that  it  may  be  performed  ch^fer- 
fuUy.  It  is  important  to  engage  the  mind  in  the  exercise;  and  for  this 
purpose,  some  contested  game  is  very  useful,  as  playing  at  billiards, 
rolling  nine-pins,  pitching  quoits,  or,  where  the  strength  will  permiti 
playing  ball. 

Cheerfulness.  —  Nothing  does  more  to  drive  away  dyspepsia  than  a 
cheerful,  lively,  and  even  mirthful  state  of  mind.  AH  the  nervous  in- 
fluences sent  from  the  brain  to  the  stomach  should  be  of  the  most 
agreeable  kind.  Some  people  think  it  vulgar  to  laugh.  Let  such 
stand  with  long  faces  in  life's  shadows,  if  they  choose.  As  a  general 
rule,  the  best  men  and  women  laugh  the  most.  Good,  round,  hearty, 
side-shaking  laughter,  is  health  for  everybody ;  for  the  dyspeptic,  U  is 
life. 

Dyspeptics  who  h&ve  a  taste  for  it,  and  can  endure  the  expense, 
should  travel.  A  voyage  to  Europe,  and  a  year  spent  in  seeing  the 
wonders  of  the  old  world,  will  generally  cure  the  most  stubborn  case 
of  indigestion.  This,  however,  depends  upon  circumstances.  For 
those  having  the  finer  organizations  and  the  higher  natures,  extensive 
travelling  is  sometimes  indispensable.  The  narrow  circle  of  thoughts, 
associations,  and  things,  in  their  own  neighborhood,  do  not  fill  the 
compass  of  their  wants ;  their  many-sided  faculties  need  to  be  drawn 
on  by  the  large  variety  to  be  found  only  in  travel.  Their  large  and 
impressible  natures  want  to  be  filled  full  in  order  to  drive  out  disease, 
and  it  takes  -^  world,  or  a  considerable  part  of  it,  to  fill  them.  The 
dyspepsia  of  such  natures  is  not  comprehended  by  the  multitude,  and 
even  physicians  are  often  amazed  that  their  narrow  prescriptions  do 
not  reach  it 

Heartburn. — Cardialgiai 

This  is  a  gnawing  and  burning  pain  in  the  stomach,  attended  by 
disturbed  appetite.  It  is  generally  caused  by  great  acidity  of  the 
stomach,  and  is  a  symptom  of  dyspepsia,  and  often  afflicts  pregnant 
women.  Whenever  too  much  food  is  taken,  it  is  liable  to  ferment, 
and  become  extremely  sour,  —  causing  heartburn.  In  such  cases, 
vomiting  often  occurs;  and  what  is  thrown  up,  is  sour,  and  some- 
times bitter. 

Treatment. — Immediate  temporary  relief  may  be  obtained  by  swal- 
lowing a  teaspoonful  of  soda,  magnesia,  or  chalk,  in  a  tumbler  of  cold 
or  watm  water.  Fluid  magnesia,  or  lime  water,  will  answer  the 
same  purpose.  If  there  is  wind  in  the  stomach,  as  well  as  acidity,  a 
teaspoonful  of  the  aromatic  spirit  of  ammonia,  or  (135),  will  often 
still  the  utieiisiness  in  a  moment 

To  cure  the  complaint,  the  stomtieh  must  be  streflgthetied  by  the 
refliledies  'directed  for  dyspepsia. 


Spasm  or  Cramp  in  the  Stomach. —  Gastrodynia. 

Though  generally  of  shorter  duration,  this  is  more  violent  than 
heartburn.  It  is  attended  by  a  sense  of  fulness,  by  anxiety,  and  by 
great  restlessness.  In  females,  hysterical  symptoms  are  often  coupled 
with  it  Great  quantitiefe  of  air  or  gas  are  generally  expelled,  and  the 
pain  shoots  through  to  the  back  and  shoulders. 

Treatment.  —  A  strong  purgative  injection  (248)  will  often  bring 
immediate  relief.  The  sweet  tincture  of  rhubarb  and  soda  (37),  with 
a  few  drops  of  tincture  of  cayenne  mixed  A^ith  it,  will  often  bring 
speedy  relief.  So  will  a  mustard  poultice  laid  upon  the  stomach. 
The  mustard  poultice  is  a  remedy  of  great  excellence,  in  many  cases. 
It  deserves  to  be  called  the  poor  man's  friend. 

Water  Brash. — Pyrosis. 

This  consists  in  a  discharge  from  the*  stomach,  generally  in  the 
morning,  of  a  thin,  .glairy,  watery  fluid,  sometimes  insipid,  at  other 
times,  sweetish,  and  at  still  others,  sour.  A  burning  heat  or  pain  in 
the  stomach  attends,  and  seems  to  be  the  immediate  cause  of  the 
discharge.  The  discharge  appears  to  be  the  natural  mucus  of  the 
stomach,  wliich  is  poured  out  in  large  quantities  in  consequence  of  a 
kind  of  catarrh  of  its  mucous  lining.  The  amount  thrown  up  varies 
from  a  spoonful  to  a  pint  or  more. 

The  complaint  is  caused  by  a  poor  innutritious  diet,  or  oy  whatever 
causes  the  blood  to  become  thin  and  watery. 

Trentment.  —  Ten  or  fifteen  drops  of  water  of  ammonia,  in  half  a 
tumbler  of  water,  will  quiet  the  distress,  and  check  the  discharge. 
The  most  eil'ectual  remedy  I  am  acquainted  with  for  breaking  up  the 
discharge,  is  the  trisnitrate  of  bismuth,  taken  at  meal  times,  in  from 
twenty  to  thirty-grain  dosets,  three  times  a  day.  The  eoinpound  pow- 
der of  kino  is  a  valuable  remedy.  The  compound  tincture  of  senna 
and  the  tincture  of  balsam  of  tolu,  in  equal  parts,  and  administered 
in  tablespoonful  doses,  are  sometimes  useful.  The  tincture  of  nux 
vomica  is  a  good  remedy. 

To  restore  the  blood,  sojne  of  the  various  preparations  of  iron  (74) 
(80)  (73)  (316)  will  be  reciuired. 

The  diet  should  consist  of  easily-digested,  nutritious  food,  —  a» 
soups,  broths,  fresh  meat,  potatoes,  and  unboltc^d  wheat  bread. 

Vomiting. 

This  occurs  under  a  great  variety  of  circumstances.  It  may  be 
induced  by  acidity  of  the  stomach,  by  irritability  of  the  stomach,  by 
distress  of  mind,  by  injury  of  the  brain,  by  otlensive  odors,  and  by  all 
organic  diseases  of  the  stomach. 

Treatment — Generally,  it  is  cured  by  treating  the  disease  which 
induces  it  But  in  many  eases,  it  persists  very  obstinately,  and  may 
become  the  chief  thing  to  be  attended  to.  In  such  cases,  it  may  re- 
quire a  sixth  or  quarter  of  a  grain  of  morphia  to  check  it     But  gen- 


■  '"'W 

■|!' 

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t' 

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LI'Wt 


I    :     ii 


278 


DISKASKS  OF  THE  ABDOMINAL  CAVITY. 


erally  some  aromatic,  as  ginger,  spearmint,  peppermint,  or  spice  tea, 
will  put  an  end  to  it.  Some  cordial  or  stimulant,  as  brandy,  cham* 
pagne,  tincture  of  ginger,  paregoric,  elixir  solutis,  or  cherry  brandy, 
will  answer  well.  Strong  coffee,  without  sugar  or  milk,  will,  in  some 
cases,  act  like  a  charm.  If  it  is  dependent  Oii  acidity,  the  remedies 
are  given  under  "dyspepsia."  If  caused  by  irritability  of  stomach, 
a  pill  of  extract  of  belladonna  and  ipecac  (339)  will  do  well. 

While  vomiting,  the  patient  should  lie  still  in  bed,  and  in  bad  cases^ 
a  mustard  poultice  should  be  placed  upon  the  stomach. 

The  vomiting  of  children  may  sometimes  be  stopped  by  wetting  a 
piece  of  cloth  with  laudanum,  and  laying  it  upon  the  pit  of  the  stomach. 

Seasickness. 

This  is  the  great  terror  of  persons,  who,  for  the  first  time,  cross  the 
ocean.  It  is  said  that  dark  complexioned  persons  suffer  more  from  it 
than  others. 

If  it  cannot  be  entirely  prevented,  it  may  be  mitigated  by  lying  flat 
upon  the  back.  To  lie  on  deck,  in  the  open  air,  is  much  better  than 
lying  in  the  close  air  of  the  cabin,  or  state  room.  A  wineglass  of 
brandy,  or  from  ten  to  forty  drops  of  laudanum  will  relieve  the  sick- 
ness very  much.  For  a  child,  it  is  sometimes  sufficient  to  wet  a  cloth 
with  laudanum,  and  lay  it  upon  the  pit  of  the  stomach.  Morphine 
is  sometimes  even  better  than  laudaimm.  Creosote,  one  drop  at  a 
dose,  made  into  a  pill,  is  excellent  Ten  drops  of  hartshorn,  in  half  a 
tumbler  of  water,  is  good  for  some.  But  the  best  known  remedy  is 
chloroform,  taken  in  doses  of  from  forty  to  eighty  drops,  suspended 
in  water  by  means  of  a  little  gum  arable. 

Milk  Sickness. 

This  disease  prevails  in  the  West,  chiefly  in  the  neighborhood  of 
level,  heavily-timbered,  rather  wet  oak  land. 

The  cattle,  horses,  and  shvjep,  which  range  in  these  lands,  are  fre- 
quently attacked  by  a  disease  which  the  people  call  the  trembles.  It 
is  supposed  to  be  produced  by  eating  some  plant  growing  upon  those 
lands,  as  cattle  which  feed  in  the  neighboring  regions  are  free  from 
it  until  they  find  their  way  into  these  low  grounds.  It  has  been  sug- 
gested that  the  offl'uding  plant  may  be  the  poison  ivy  {rhus  toxicoden- 
dron). Be  this  as  it  may,  the  calves,  soon  after  sucking  cows  which 
have  run  in  these  grounds,  are  seized  with  trembling,  and  frequer  .^ 
die  of  the  disease.  Dogs  which  lap  the  milk,  are  affected  in  a  similar 
manner.  Children  drinking  it,  leave  the  table  and  vomit.  Upon 
grown  persons  the  effects  are  more  severe,  but  not  so  sudden.  The 
eating  of  the  beef,  mutton,  or  veal,  of  atfected  animals,  bii'igs  on  the 
same  disease. 

Symptoms.  —  The  disease  sets  in  with  sickness  at  the  stomach, 
which  is  preceded  by  general  debility,  more  particularly  of  the  legs. 
There  is  nausea,  vomiting,  and  the  breath  is  so  offensive  and  peculiar 
that  those  acquainted  with  the  complaint  immediately  recognize  it 
from  this  smell. 


if 


spice  tea, 
idy,  cham- 
■y  brandy, 
11,  in  some 
!  Temediea 
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1. 
bad  cases^ 

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)etter  than 
iaeglass  of 
e  the  sick- 
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Morphine 
J  drop  at  a 
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1  remedy  is 
,  suspended 


iborhood  of 

ids,  are  fre- 
<-embles.  It 
upon  those 
e  free  from 
LS  been  sug- 
s  loxicoden- 
cows  which 
I  frequer  .^ 
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mit.  Upon 
dden.  The 
i'lgs  on  the    " 

le  stomach, 
of  the  legs. 
md  peculiar 
recognize  it 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


979 


These  existing  for  weeks,  constitute,  in  some  cases,  the  whole  of 
the  symptoms.  In  other  cases  they  are  more  severe,  being  attended 
by  chills  and  flushes,  great  oppression  about  the  heart,  anxiety,  deep 
breathing,  heat  in  the  stouiacli  compared  to  fire  and  boiling  water, 
violent  retching  and  vomiting,  alarming  beatings  of  the  heart,  and 
throbbings  of  the  large  vessels,  and  cold  extremities,  —  producing,  all 
together,  extreme  distress. 

In  most  cases,  the  vomiting  returns  every  hour  or  two,  attended  by 
great  burning  at  the  pit  of  the  stomach,  the  substance  thrown  up 
liaving  a  peruliar  bluish-green  color,  and  a  sour  smell.  As  soon  as 
Ihis  discharge  takes  place,  the  patient  falls  back  upon  the  pillow,  and 
lies  easy  until  another  turn  comes  round.  The  tongue  is  covered 
with  a  whitish  coat,  the  bowels  are  obstinately  costive,  and  the  pulse 
is  small  and  quick. 

Treatiiieiit. —  It  is  believed  that  the  neutralizing  mixture,  given  in 
tablespoonful  doses  every  time  the  nausea  and  burning  sensavion  are 
felt,  is  the  most  effectual  remedy  yet  used.  It  reli<'ves  the  acidity, 
and  seems  well  adapted  to  allay  the  irritation.  Some  antibiiious 
physic  (40)  to  move  the  bowels  should  also  be  given. 

Beside  these  remedies,'  a  mustard  poultice  should  be  put  upon  the 
stomach,  and  hot  bricks  to  the  feet,  and  the  patient  be  kept  still  for 
some  hours.  The  diet  should  be  very  mild,  only  toast  water,  rice 
water,  or  thin  gruel. 

Acute  Inflammation  of  the  Peritoneum. — Peritonitis. 

This  disease  affects  the  extensive  membrane  which  lines  the  whole 
inside  of  the  belly,  an  extension  of  which  forms  the  omentum  or 
apron.  It  is  an  inflammation  to  which  women  are  much  exposed 
after  confinement,  and  is  known,  in  such  cases,  as  child-bed  fever.  It 
18  common  among  men,  also,  and  is  a  grave  disease. 

Symptoms. —  Like  other  forms  of  fever  and  inflammation,  it  is  pre- 
ceded by  chills,  with  increased  heat  of  surface,  thirst,  full,  strong,  and 
frequent  pulse,  flushed  face,  and  red  eyes,  dry  tongue  with  red  edges, 
dry  skin,  restlessness,  short  quick  breathing,  nausea  and  vomiting. 

The  pain  is  increased  by  the  patient  sitting  or  standing  up, — the 
bowels  being  thus  pressed  against  the  inflamed  membrane.  Lying 
upon  either  side  is  painful  for  the  same  reason.  To  lie  flat  upon  the 
back,  with  the  feet  drawn  up,  is  the  only  endurable  position.  The 
pati(3nt  lies  stiU^  for  all  movements  give  pain. 

The  pam  in  this  disease  is  generally  sharp,  cutting,  and  prickings 
but  is  not  always  equally  intense.  It  is  aggravated  by  the  passage  of 
wind  along  the  bowel,  by  which  the  inflamed  membrane  is  slightly 
stretched. 

When  the  disease  is  advancing  towards  a  fatal  termination,  the  belly 
becomes  greatly  swollen  and  tense,  —  having  to  the  hand  a  peculiarly 
tight,  drum-head  feeling ;  the  pulse  is  rapid  and  feeble ;  the  counte- 
nance is  full  of  anxiety,  apd  \»  piiictied  and  ghastly ;  and  a  cold  sweat 
breaks  out. 


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280 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


Treatment. —  Small  doses  of  antimony,  lobelia,  or  ipecac,  to  jro- 
duce  nausea,  and  a  moisture  upon  the  skin,  is  generally  among  the 
first  things  given.  The  tincture  of  veratrum  viride,  in  five  to  ten- 
drop  doses,  repeated  every  hour,  will  accomplish  the  same  thing  more 
effectually  than  any  other  known  article.  For  such  purposes,  I  give 
it  the  first  place  among  medicines.  A  large  poultice  of  white  bread,, 
rye  meal,  or  flax-seed,  may  be  spread  over  the  belly ;  or  cloths  wet 
with  cold  water,  will  be  still  better,  if  the  patient  be  full-blooded,  and 
naturally  strong.  The  bowels  should  be  moved  at  once  by  some 
active  physic,  as  butternut,  salts,  m&gnesia,  castor  oil,  or  cream  of 
tartar  (20)  (17)  (18)  (27),  or  by  podophyllin,  etc.  (40)  (41)  (31). 

The  drinks  should  be  lemonade,  soda  water,  tamarind  water,  current 
jelly  dissolved  in  water,  and  preparations  (298)  and  (299).  Indian 
meal  gruel,  toast-water,  barley  gruel,  and  the  like,  are  the  only  allow- 
able diet 

Chronic  Inflammation  of  the  Peritoneum. 

When  the  acute  inflammation  of  the  peritoneal  membrane  is  not 
successfully  treated,  it  may  run  on  for  a  time,  and  then  subside  into  a 
lower  grade  of  inflammation,  called  chronic,  and  in  this  state  remain 
for  an  indefinite  time.  But  it  often  arises  independently  of  the  acute 
disease,  and  attacks  persons  of  botli  sexes,  and  of  all  classes  and  ages. 
Scrofulous  children  have  it,  and,  wasting  away  under  it  to  mere  skel- 
etons, are  said  to  have  consumption  of  the  boivels. 

Symptoms. —  These  are  sometimes  very  obscure,  and  the  advances 
of  the  disease  stealthy.  At  first,  there  may  be  only  a  little  soreness 
of  the  belly,  so  slight  as  not  to  be  noticed  except  after  hard  work,  or 
upon  some  wrenching  motion.  Generally,  there  is  a  sense  of  fulness 
and  tension  of  the  belly,  although  it  may  not  be  incrciised  in  size. 
After  a  time,  it  enlarges  a  little,  and  its  tension  or  tiii;litiiess  increases, 
especially  towards  evening.  By  pressing  carernlly  with  tlie  hand,  a 
deep-feeling  tension  may  be  detected,  giving  to  the  hand  a  sensa- 
tion as  of  a  tight  bandage  underneath,  with  the  skin  and  integu- 
ments sliding  loosely  over  it.  If  water  has  bren  poured  out  into  the 
abdominal  cavity,  its  fluctuation  may  frequently  be  detected  by  press- 
ing upon  one  side  of  the  belly  with  the  palm  of  one  hand,  and  strik- 
ing the  other  side  with  the  ends  of  the  fingers. 

As  the  disease  goes  on,  the  features  become  sharp  and  contracted, 
and  the  countenance  grows  pale  and  sallow.  Costiveness  comes  on, 
sometimes  chills  and  fever,  with  debility,  loss  of  flesh,  cough,  diflicult 
breathing,  hectic,  and  swelling  of  the  legs. 

Treatment.  —  Costveness,  if  present,  may  be  relieved  by  Mettauer's 
aperient,  or  the  neutralizing  mixture,  assisted  by  coarse  bread,  and 
boiled  cracked  wheat. 

Daily  bathing  is  specially  necessary,  particularly  the  alkaline  sponge 
bath,  with  vigorous  friction  over  the  bowels.  The  warm  bath  once 
or  twice  a  week  will  be  useful.     In  some  cases,  the  wet  towel  laid 


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DISEASES  OF  THE  ABDOMINAL  CAVITY. 


281 


upon  the  bowels  over  night,  and  well  covered  by  flannels,  will  afford 
relief;  or  the  compound  tar  plaster  may  occasionally  be  used. 

If  there  be  dropsy  of  the  belly,  iodide  of  potassium  (138)  should 
be  taken  freely,  and  the  skin  made  sore  over  the  inflamed  part,  by 
tincture  of  iodine,  well  rubbed  in,  once  a  day. 

If  the  patient  be  pale  and  bloodless,  give  iron,  quinine,  etc.  (74) 
(75),  and  let  the  diet  be  nourishing;  and  if  nervous  symptoms  be 
connected  with  the  debility  and  paleness,  add  some  nerve  tonic  (93) 
(81)  (316). 

Acute  Inflammation  of  the  Bowels. — Enteritis. 

Bt  inflammation  of  the  bowels  is  generally  understood  an  inflamed 
condition  of  the  mucous  membrane  which  lines  them ;  but  this,  most 
commonly,  is  only  a  part  of  the  disease ;  it  involves,  more  or  less, 
beside  this  mucous  lining,  the  whole  substance  of  the  bowel. 

Symptoms. —  The  disease  begins  with  a  chill,  and  with  uneasiness 
and  slight  griping  pains,  which  increase  in  severity  until  they  are  in- 
tense and  burning.  Pressure  aggravates  the  pain,  which  is  most 
intense  about  the  navel,  but  extends  more  or  less  over  the  whole 
bowels. 

From  the  beginning  there  is  sickness  at  the  stomach,  and  some- 
times vomiting;  there  is  loss  of  strength,  eostiveness,  great  anxiety, 
thirst,  heat  and  fever,  dry,  furred,  and  red  tongue,  and  but  little  urine, 
with  pain  in  passing  it.  The  matters  passed  from  the  bowels  are 
dark  and  fetid ;  and  the  » Iiole  belly  is  tender  and  sore  to  the  touch. 
The  pulse  is  quick,  hard,  and  small. 

The  stomach  will  be  but  little  aflected,  comparatively,  when  the 
disease  is  at  some  distance  from  it  in  the  lower  portion  of  the  bowels. 
Indeed,  the  nearness  of  the  inflammation  to  the  stomach,  or  its  re- 
moteness from  it,  may  be  judged  pretty  correctly  by  the  degree  of 
disturbance  in  that  organ.  The  length  of  time  after  drink  and  medi- 
cines are  swallowed,  before  they  are  vomited  up,  is  a  pretty  good 
measure,  likewise,  of  the  distance  of  the  disease  from  the  stomach. 

Hoif  to  Discriminate.  —  This  disease  is  Jiable  to  be  confounded 
with  colic,  and  with  inflammation  of  the  peritoneum.  It  is  important 
to  distinguish  it  from  colic,  particularly,  for  the  treatment  for  that 
would  aggravate  this.  In  this  disease,  the  pain  is  increased  by  pres- 
sure ;  in  colic,  it  is  not,  but  is  rather  relieved.  In  enteritis,  the  pain 
remits,  but  never  ceases  wholly,  as  it  does  in  colic.  In  enteritis, 
the  knees  are  drawn  up,  and  the  breathing  is  short ;  in  colic,  it  some- 
times gives  relief  to  stretch  the  feet  down,  and  the  breatliing  is  not 
altered. 

To  distinguish  it  from  inflammation  of  the  peritoneum,  take  notice 
that  diarrhoea  is  much  more  common  than  in  this  latter  complaint, 
while  the  pulse  is  not  as  quick,  nor  the  pain  as  severe. 

Treatment —  This  should  be  very  much  the  same  as  that  recom- 
mended for  inflammation  of  the  peritoneum.     Perhaps  in  both  dia- 


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282 


DISEASES  OE  THE  ABDOMINAL  CAVITY. 


eases,  it  might  be  woll  to  begin  with  covering  the  belly  all  over  with 
leeches.  As  for  taking  blood  from  the  arm,  in  large  quantities,  as 
recommended  in  most  of  the.  books,  I  cannot  think  it  necessary. 

The  tincture  of  veratrum  viride,  in  full  doses,  so  as  to  keep  up  a 
free  perspiration,  cold  compresses,  mustard  poultices,  hot  fomentations, 
poultices,  blisters,  soothing  and  quieting  injections,  and  demulcent 
drinks,  as  slippery  elm,  marshmallow,  flax-seed,  etc.,  if  jud '  ciously  ap- 
plied, will  do  about  all  that  we  have  it  in  our  power  to  E.ccomplish; 
and  under  such  treatment,  the  patient  will  recover  faster,  and  get  up 
better,  than  when  blood  is  freely  drawn. 

In  this  disease  it  is  well  to  inquire  if  the  patient  has  a  hernia,  for  if 
ao,  it  is  liable  to  become  strangulated  without  his  knowledge.  A 
strangulation  of  the  gut  may  be  the  cause  of  the  disease.  When  this 
happens,  the  complaint  is  very  unmanageable.  The  bowel  may  pos- 
sibly, in  such  case,  be  disentangled  by  applying  a  targ-e  dry  cup ;  or, 
what  is  better,  a  number  of  small  ones ;  but  the  tenderness  of  the 
belly  makes  the  use  of  this  remedy  difficult. 

Chronic  Inflammation  of  the  Bowels. 

Like  other  chronic  inflammations,  this  may  follow  the  acute  form, 
but  it  also  results  from  various  other  causes,  as  unripe  fruit,  taking 
cold,  drastic  physic,  and  improper  treatment  of  other  diseases. 

Symptoms.  —  Red  end  and  borders  of  the  tongue,  dull  pain  in  belly, 
increased  by  pressure  and  rough  motion,  abdomen  either  swelled  or 
flat,  skin  dry  and  husky,  feet  and  hands  cold,  small  frequent  pulse, 
thirst,  loss  of  flesh,  low  spirits,  urine  scanty  and  hiirh-colored,  and 
dirty,  slimy  discharges  from  the  bowels,  from  one  to  four  times  a 
day. 

Treatment. —  To  begin  with,  blisters,  or  croton  oil,  or  mustard  poul- 
tices, or  dry  cups,  if  the  tenderness  is  not  great,  or  leeches  if  it  is. 

If  the  bowels  are  hot  and  feverish,  bind  a  cold  compress  upon  the 
belly  over  night,  —  covering  it  well  with  flannel.  The  warm  bath 
should  be  used  twice,  a  week. 

The  diet  must  be  of  the  most  simple,  unirritating  kind, — beginning 
with  a  solution  of  gum  arable,  rice-water,  barley  water,  arrow-root  or 
sago  gruel,  and  gradually  rising,  as  the  symptoms  improve,  to  beef 
tea,  mutton  and  chicken  broth,  tender  beef  steak,  etc. 

When  the  strength  will  permit,  gentle  exercise  must  be  taken  in 
the  open  air,  but  not  on  horseback,  or  in  hard,  jolting  carriages. 

As  soon  as  the  inflammation  is  subdued,  some  mild  laxative  (35) 
may  be  given,  in  connection  with  an  infusion  of  wild-cherry  bark, 
geranium,  and  Solomon's  seal,  equal  parts. 

Wind  Colic— riatulent  Colic. — Interalgia. 

This  is  a  severe  and  distressing  pain  in  the  bowels,  —  sometimes  a 
stoppage,  and  a  swelling  about  the  pit  of  the  stomach  and  the  navel. 
,What  children  call  belly  ache  is  a  mild  form  of  it..    The  wind  passing 


i 


DISEASE*  OF  THE  ABDOMINAL  CAVITY. 


283 


from  one  portion  of  the  bowel  to  another,  causes  a  runnbling  noise. 
The  pain  is  not  increased  by  pressure  ;  and  this  distinguishes  it  from 
the  pain  of  inflammation.  It  moves  about,  too,  from  plai;e  to  place, 
and  is  much  relieved  by  the  escape  of  wind  u|)  or  down. 

The  complaint  may  be  caused  by  a  weakness  in  the  digestive  or- 
gans,  by  eating  indigestible  food,  or  unripe  fruit,  by  costiveness,  and 
by  taking  cold.  Some  persons  always  have  the  colic  excited  by  eat* 
ing  certain  kinds  of  fruit. 

Treatment. —  When  the  complaint  is  caused  by  an  indigestible  sub- 
stance taken  into  the  stomach,  the  offending  matter  should  be  thrown 
otr  by  an  emetic  as  soon  as  possible.  If  this  does  not  bring  relief, 
let  it  be  followed  by  a  dose  of  salts,  salts  and  senna,  compound  infu- 
sion of  senna,  elixir  salutis,  elixir  pro.,  or  sweet  tincture  of  rhubarb. 
If  there  is  no  sickness  of  the  stomach,  a  little  essence  of  peppermint 
or  spearmint  in  hot  water,  or  brandy,  gjn,  or  whiskey,  in  hot  water, 
may  prove  sufficient  to  expel  the  wind,  and  relieve  the  pain.  Ginger 
and  hot  water  does  well  with  some.  If  there  be  costiveness,  and  the 
pain  is  obstinate',  let  the  bowels  be  unloaded  by  a  stimulating  injec- 
tion (248)  (249)  (250). 

Air-SwellingfS. — Tympanites. 

It  is  quite  common  for  persons  in  delicate  health, —  ^particularly 
females,  —  to  have  their  stomach  and  bowels  swell  up,  sometimes 
slowly,  sometimes  suddenly,  so  that  they  cannot  bring  their  clothes 
together.  They  do  not  know  what  to  make  of  it ;  it  sometimes 
alarms  them ;  and  they  ask  their  medical  adviser  what  it  means. 

Explanation. —  This  is  the  meaning  of  it.  It  is  neither  more  nor 
less,  in  many  cases,  than  the  air  within  the  muscles  and  membranes 
swelling  up  and  distending  them  in  consequence  of  their  being  in  a 
weakened  condition.  There  are  two  ways  in  which  the  flesh  may  be 
caused  to  bloat.  It  may  be  caused  by  placing  a  cupping  glass  over 
it,  and  taking  off  the  external  air.  When  this  is  done,  the  air  within 
seeks  to  fill  the  vacuum  above,  and  lifts  up  the  flesh.  So,  likewise,  if 
the  parts  are  weak,  and  lose  their  tone,  they  give  way,  and  let  more 
air  into  their  substance,  and  they  stretch  and  puff"  up. 

But  these  swellings  may  occur  from  an  accumulation  of  air  within 
the  bowels,  and  also  within  the  abdominal  cavity.  This  latter  gives 
the  belly  a  peculiarly  hard  feel,  like  the  head  of  a  drum,  and  when  it 
is  pressed  upon  with  the  fingers,  no  indentvition  remains. 

Treatment — If  the  air  be  in  the  intestinal  tube,  a  stimulating  in- 
jection may  bring  away  the  wind.  It  may  be  composed  of  one  pint 
of  infusion  of  peppermint,  one  gill  of  tincture  of  prickly  ash  berries, 
half  a  gill  of  tincture  of  castor,  and  a  teaspoonful  of  ginger.  The 
bowels  of  the  patient  should  be  rubbed  for  a  long  time ;  and  in  all 
forms  of  the  complaint,  it  would  be  well  to  do  this  every  day.  Some- 
times the  wind  may  be  drawn  off*  by  inserting  into  the  rectum  a  long 
gum-elastic  tub6. 


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284 


DISEASES  OF  THE  ABDOMINAL  CAVITY 


The  best  constitutional  remrdies  are  tonics, — iron,  quinine,  minerul 
acids,  and  bitters,  (48)  (55)  (59)  (60)  (62)  (63)  (&4)  (71)  (73). 

Exercise  in  the  open  air,  and  a  careful  regulation  of  the  diet  will 
do  much  towards  removing  these  troubles.  Costivtuiess  must  be  care- 
fully guarded  against. 

Bilious  Colic. 

This  is  a  dangerous  disease.  There  is  pain  of  a  griping,  twir*tii)jr(, 
tearing  kind,  —  what  the  ancients  called  a/rorfows /jam.  It  is  ehirtly 
about  the  navel,  but  sometimes  tortures  the  whole  belly.  It  cotnes 
and  goes  in  paroxysms.  Sometimes  the  abdomen  is  drawn  in,  i«t 
other  times  it  is  swelled  out,  and  stretched  like  a  drum-head.  At 
first  the  pain  is  relieved  by  pressure ;  after  a  time  the  belly  is  tender  fo 
the  touch.  There  is  thirst  and  heat,  and  a  discharge  of  bilious  mat- 
ter from  the  stomach.  In  the  worst  cases,  the  pulse  is  small,  the  face 
pale,  the  features  shrunk,  and  the  whole  body  covered  with  cold 
sweat.  While  the  head  is  hot,  the  feet  are  cold.  In  advanced  stages 
of  the  disease,  the  action  of  the  bowels  is  sometimes  reversed,  and 
the  fecal  matter  forced  up  through  the  mouth. 

Causes. —  Costiveness,  irritating  substances  in  the  bowels,  thick, 
vitiated  bile,  long  exposure  to  cold,  torpidity  of  the  liver  and  skin, 
great  unna*^  ..al  heat,  with  dampness,  etc. 

Treatment. —  Administer  an  active  purgative  injection  immediately 
(251)  (252).  Internally,  dioscorein,  camphor,  etc.  (340),  every  fifteen 
minutes,  till  relief  is  obtained,  —  at  the  same  time  covering  the  whole 
belly  with  a  large  mustard  poultice  A  strong  decoction  of  the  wild 
yam  root,  drank  freely,  is  a  mediejne  of  some  value,  —  so  is  a  decoc- 
tion of  scuUcap  ar)d  high-cranberry  bark,  equal  parts.  This  latter 
article  is  excellent  in  spasmodic  anections,  on  which  account,  it  has 
gained  the  name  of  cramp  bark.  The  sickness  at  the  stomach  may 
be  allayed  frequently  by  ellervescing  drafts,  to  which  twenty-five  or 
thirty  dro|)s  of  laudanum  are  added.  Croton  oil,  given  in  one-dro') 
d'jses,  done  up  with  crumb  of  bread,  will  sometimes  succeed  well  as 
a  purgative  medicine;  or  castor  oil  and  spirits  of  turpentine,  equal 
parts,  iu  two  great  spoonful  doses,  may  be  tried  before  the  croton 
oil. 

The  warm  bath  is  worth  remembering,  and  trying,  too,  if  the 
means  are  at  hand.  Hot  fomentations  of  the  bowels  with  a  decoc- 
tion of  poppy  leaves,  stramonium  leaves,  hops,  wormwood,  boueset, 
or  peppermint  leaves,  should  not  be  overlooked.  Bottles  filled  with 
hot  water,  or  hot  bricks  rolled  in  fiannel,  should  be  placed  at  the  back 
and  feet,  to  promote  perspiration. 

Persons  subject  to  this  complaint,  may  derive  advantage  from  one 
pill  composed  of  extract  of  high  cranberry  bark,  etc.  (100),  taken  after 
each  meal  for  some  months.  At  the  same  time  a  reasonable  amount 
of  exercise  should  be  taken  out  of  doors,  and  a  sponge  bath,  with 
friction,  be  employed  daily.  Care  should  be  taken  not  to  be  often 
exposed  to  the  hot  sun. 


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DISEASES  OF  THE  ABDOMFNAL  CAVITY. 


285 


Painters'  Colic. — Colica  Pictonum. 

This  form  of  colic  is  caused  by  the  slow  introduction  of  lead  into 
the  system,  —  generally  the  carbonate  of  lead.  It  passes  under  the 
different  English  names  of  painters'  colic,  Devonshire  colic,  and  dr/ 
belly-ache.  The  first  of  tliese  is  the  name  by  which  it  is  most  com- 
monly known,  from  its  frequent  occurrence  among  painters,  who  use 
white  lead  (carbonate  of  lead)  a  great  deal  in  the  preparation  of  their 
colors.  * 

Symptoniit.  —  The  disease  generally  cornea  on  in  a  very  gradual 
way.  At  first,  the  appetite  is  impaired,  there  is  slight  nausea,  belch- 
ing of  wind,  languor,  very  obstinate  costiveness,  transient  pains,  with 
a  feeling  of  weight  and  tightness  in  the  belly,  and  a  disinclination  to 
make  any  exertion. 

By  degrees,  the  pain  in  the  bowels,  and  particularly  about  the  na- 
vel, becomes  more  severe,  and  has  a  twislin<j^  character.  The  belly 
becoTies  hard,  drawn  in,  and  a  little  tender  to  pressure,  and  the  stom- 
ach very  irritable.  The  pain  occasionally  slacks  oft  a  little  ;  but 
never,  even  in  mild  cases,  entirely  stops,  as  in  other  kinds  of  colic. 

In  some  severe  cases,  the  pain  runs  up  to  the  chest,  and  down  the 
arms  ;  also  down  to  the  bladder,  causing  the  urine  to  he  passed  with 
pain  and  difliculty,  and  giving  a  sense  of  weight  and  bearing  down 
in  the  lower  lielly.  During  the  severest  pains,  the  countenance  is 
pale,  contracted,  and  full  of  suflfering ;  cold  sweats  break  out  upon 
llie  lace  and  limbs,  and  anxiety  and  agitation  seize  the  patient. 

When  the  disease  is  not  seasonably  removed,  it  degenerates  into 
the  chronic  form,  the  mental  and  physical  energies  become  torpid, 
the  circulation  in  the  small  vessels  inactive,  the  skin  dry,  harsh,  shriv- 
elled, pale,  sallow,  or  of  a  leaden  hue,  the  temper  irritable,  despond- 
ing and  gloomy,  and  the  body  wasted.  Beside  all  this,  the  muscles 
which  lift  up  the  lower  arm  become  palsied,  so  that,  when  the  arms 
are  raised,  the  hands  hang  down  in  a  helpless  condition.  In  some 
cases,  there  is  a  blue  line  along  the  edges  of  the  gums. 

Treatment  —  For  relieving  the  pain  and  opening  the  bowels,  the 
treatment  should  be  very  much  the  same  as  that  for  bilious  colid. 
There  is  one  article,  however,  which  is  thought  to  have  some  special 
influence  in  curing  this  disease,  after  it  has  become  chronic ;  it  is 
alum.  Fifteen  grains  of  alum,  two  of  aloes,  two  of  jalap,  and  four 
of  Dover's  powder,  may  be  mixed,  and  taken  for  a  dose  two  or  three 
times  a  day.  If  the  muscles  of  the  arm  be  palsied,  one  sixteenth  of 
a  grain  of  strychnine  may  be  added  to  the  above.  The  aromatic  sul- 
phuric acid,  taken  as  a  drink,  fifteen  drops  to  the  tumblerful  of  water, 
is  always  worthy  of  trial. 

The  use  of  the  electromagnetic  machine  may  be  tried  for  the  palsy; 
or  a  splint  applied  to  the  arm  and  hand,  with  vigorous  friction  applied 
once  or  twice  a  day,  will  sometimes  do  much  for  recovering  the  use 
of  the  muscles. 

diit'the  best  remedy  for  the  palsied  muscles  is  iodide  of  potaiisnim 


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286 


DISEASES  OF  TIIK  ABDOMINAL  CAVIT.. 


(146),  taken  freely.  The  sulphuret  of  potassa,  one  ounce  disHolved  in 
a  quart  of  water,  and  taken  in  teaHpoonful  doHeH,  three  times  a  day,  is 
aliio  worth  a  trial.  The  affected  artn  should  be  soaked  an  hour,  once 
or  twice  a  day,  in  the  same  amount  of  this  latter  salt,  dissolved  in  a 
gallon  of  water. 

Neiins  of  l*reventioii.  —  The  numerous  persons  who  work  in  lead, 
should  comb  their  hair  with  a  fine  comb,  wash  their  hands  and  fiiee, 
and  rinse  their  mouth  several  times  a  day,  and  also  wa.>ili  tlir  whole 
person  with  soap  once  or  twice  a  week,  and  with  clear  wafer,  or  sul- 
eratus  and  water,  once  a  day.  Their  working  clothes  should  be  of  a 
kind  to  admit  of  being  washed  once  or  twice  a  week,  and  they  should 
be  put  otf  for  others  when  out  of  the  workshop.  A  paper  cap  should 
be  worn  while  at  work.  The  food  of  the  workmen  should  not  be  ex- 
posed to  the  vapors  or  floating  particles  of  lead,  and  consequently 
should  not  be  carried  into  the  shop ;  and  when  much  of  the  poison  is 
floating  in  the  air  of  the  work  room,  it  is  a  good  plan  to  wear  a  mask 
to  prevent  its  being  drawn  with  the  breath  into  the  throat  and  lungs. 

It  has  been  said  that  those  who  eat  freely  of  fat  meats,  butter,  and 
other  oily  substances,  are  not  attacked  by  the  disease,  though  exposed 
to  the  poison.  I  know  not  what  protection  this  can  give,  unless  the 
skin  is  in  this  way  kept  more  oily,  w  hicth  prevents  the  absorption  of 
the  poison.  This  would  seem  to  afford  a  hint  in  favor  of  anointing 
the  whole  person  once  or  twice  a  week  with  sweet  oil. 

CostivenesB.— Constipation. 

Few  disorders  are  more  common  than  costiveness.  By  this  term 
I  mean  a  sluggish  state  of  the  bowels,  which  causes  them  to  retain 
the  feces  longer  than  is  wananted  by  health.  In  this  complaint,  the 
discharges  from  the  bowels  are  not  always  less  frequent  than  they 
should  be,  but  they  are  less  in  quantity,  are  compacted  and  hard,  and 
are  passed  by  hard  straining,  and  sometimes  with  considerable  pain. 

Symptoms.  —  Headache,  dizziness,  feverishness,  bad  feelings  in  the 
head  not  easily  described,  loss  of  appetite,  sometimes  nausea,  but 
little  desire  to  go  to  stool,  a  weight  and  heaviness  about  the  lower 
part  of  the  belly,  and  a  sense  of  confinement  over  the  whole  body. 

Causes.  —  Sedentary  habits,  particularly  when  connected  with  close 
application  of  the  mind ;  astringent  articles  of  medicine ;  stimulating 
diet,  composed  chiefly  of  animal  food ;  various  diseases,  particularly 
those  of  a  nervous  character,  and  especially,  a  neglect  to  evacuate 
the  bowels  at  proper  periods.  All  these  causes  tend  to  weaken  the 
bowels,  and  gradually  to  arrest  that  peculiar  undulatory  movement, 
or  worm-like  action,  called  the  peristeltic  motion  of  the  bowels.  It 
is  this  continual  contraction  of  the  muscular  ^bres  of  the  intestines 
from  above  downward,  which  pushes  the  contents  steadily  along;  and 
whatever  weakens  the  force  of  this  vernicular  play  of  the  intestinal 
"walls,  brings  on  constipation. 

Treatment. —  One  of  the  first  things  to  be  done  is  to  establish  the 


1 


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habit  of  attempting'  to  evacuate  the  bowels  at  a  particular  hour  every 
day.  The  best  time  for  inuat  petHoiiM  in  Hoon  after  breakfast  in  the 
morning.  Whether  successful  or  not,  the  attempt  to  procure  an  evac« 
nation  should  on  no  at^count  be  omitted.  This  regularity  will  often 
do  much  to  break  up  the  costive  habit. 

Diett  —  To  this  nhould  be  added  a  careful  regulation  of  the  diet. 
The  quantity  of  food  taken  should  be  ik)  greater  than  can  be  easily 
digested.  Full  meals  which  distend  the  wtomach  and  caust;  it  to  press 
upon  the  bowels  embarrass  their  movements.  Bread  made  from  line 
wheat  Hour  is  an  abomination  in  this  disorder.  Eat  only  that  from 
unbolted  Hour.  Cracked  wheat,  prepared  as  directed  among  dietetic 
preparations,  is  excellent  for  the  cure  of  costiveness.  Fresh  vegeta- 
bles, as  peas,  beans,  potatoes,  scpiashes,  and  ripe  fruits,  in  their  sea- 
son, are  all  wholesome,  and  tend  to  relieve  costiveness.  But  rich  pies, 
puddings,  cakes,  doughnuts,  and  all  that  sort  of  trash,  increase  the 
disorder. 

Water  Injections,  etc.  —  One  of  the  best  remedies  is  water,  cold  or 
tepid,  according  to  the  condition  of  the  patient,  injected  into  the  bow- 
els with  the  domestic  syringe.  The  best  syringes  for  this  purpose  are 
Mattson's,  and  Davidson's,  one  of  which  should  be  in  every  family. 
Water  used  externally,  in  the  form  of  the  sponge  bath,  is  also  useful. 

Medicines.  ■- All  the  above  measu" 's  having  failed  to  give  relief^ 
take  Mettauer's  aperient,  or  the  neutrali/ing  mixture.  If  these  fail, 
podophyllin,  etc.  (36),  may  have  a  trial.  A  cold  decoction  of  thorough- 
wort,  drank  daily,  sometimes  has  an  excellent  effect.  It  must  be  re- 
membered that  medicines  may  make  matters  worse,  and  they  should 
be  used  cautiously. 

All  the  causes  of  the  disease  must  of  course  be  avoided. 

Piles.— Hemorrhoids. 

There  are  few  complaints  more  common  than  the  piles,  and 
scarcely  any  which  cause  more  trouble  and  misery.  They  consist  in 
a  fulness  of  blood,  and  languid  circulation  in  the  lower  portion  of  the 
lower  bowel  or  rectum.  In  consequence  of  this  congestion,  either  the 
veins  of  the  gut  become  enlarged  or  varicose,  or  the  blood  gets  infil- 
trated into  the  cells  beneath  the  ijfiucous  membrane,  and  collects  so 
as  to  form  bloody  tumors. 

These  tumors,  which  are  seldom  absent,  are  the  leading  features  of 
the  piles.  They  sometimes  appear  externally,  around  the  anus ;  this 
is  external  piles.  At  other  times  they  are  within  the  bowel ;  the  com- 
plaint is  then  called  irUernal  piles.  They  are  called  bleeding'  piles 
when  blood  is  discharged,  and  blind  piles  when  it  is  not. 

Symptoms, —  Usually  there  is  a  sense  of  weight  and  weakness  in 
the  lower  part  o'  the  back  and  loins,  with  a  painful  itching  about  the 
anus.  On  goin^  o  stool,  there  is  a  burning,  cutting  pain  experienced, 
which  is  foUowe'  by  bearing  down  and  tenesmus.     If  it  be  bleeding 


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288 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


piles,  the  little  tumors  will  bleed  at  every  motion  of  the  bowels. 
There  are  frequently  disagreeable  sensations  in  the  head,  general  las- 
situde, an  irritable  state  of  mind,  and  a  sense  of  fulness  and  anxiety 
in  the  stomach.  The  pains  experienced  range  all  the  way  from  the 
slightest  twinges  up  to  the  most  t  ..rible  sufferings,  which  appear  like 
tearing  the  body  asunder. 

Causes.  —  Everything  that  irritates  the  lower  bowel,  and  causes  a 
determination  of  blood  to  the  part.     All  drastic  physic  has  this  effect, 

—  particularly  aloes,  which  acts  especially  upon  the  rectum.  Habit- 
ual costiveness,  straining  at  stools,  riding  much  on  horseback,  sitting 
a  great  deal,  tight  lacing,  high-seasoned  food,  and  stimulation  gener- 
ally, lifting  and  carrying  heavy  weights,  and  indurations  of  the  liver. 

Females  during  pregnancy  are  much  afllicted  with  piles,  which  are 
induced  by  the  costiveness  so  peculiar  to  their  condition,  and  by  the 
pressure  of  the  enlarged  womb  upon  the  veins  of  the  pelvis. 

Treatment. —  This  should  be  medicinal  and  diptetic. 

Great  care  must  be  observed  nut  to  push  medication  too  far.  Ac- 
tive purging  will  do  great  mischief.  Yet  costiveness  must  in  some 
way  be  corrected.  For  this  purpose,  no  remedy  that  I  have  ever 
tried  has  done  better  in  this  complaint  than  an  electuary  composed 
of  confection  of  senna,  flowers  of  sulphur  and  cream  of  tartar  (6), 
taken  in  ''^oses  just  sufficient  to  procure  one  natural  motion  of  the 
bowels  each  day.  Pills  made  of  extract  of  thoroughwort  are  said  to 
do  well.  If  the  liver  be  in  a  congested  state,  take  some  of  the  arti- 
cles recommended  in  the  chronic  inflammation  of  that  organ. 

For  the  local  treatment,  nothing  is  better  than  two  ounces  of  lard 
and  one  dram  of  the  flowers  of  sulphur  mixed,  and  rubbed  betWteen 
two  plates  of  lead  until  they  are  well  blackened.  This  ointment'  is 
not  only  soothing,  but  curative,  both  in  the  bleeding  and  blind  piles. 
An  ointment  of  almost  equal  excellence  may  be  made  from  one  hand- 
ful each  of  witch  hazel  bark,  white  oak  bark,  and  sweet-appletree 
bark,  boiled  together  in  one  pint  of  water  down  to  one  third  of  a  pint. 
Then  strain,  and  add  two  ounces  of  lard,  and  simmer  away  the  water, 

—  otirring  continually  before  and  after  removing  from  the  fire,  till  it 
cools. 

If  there  is  much  inflammation  and  distress,  an  emolient  and  sooth- 
ing poultice  should  be  applied,  composed  of  slippery  elm  bark  and 
stramonium  or  poke  leaves.  Steaming  thB  parts  is  sometimes  useful, 
by  sitting  over  a  hot  decoction  of  hops,  stramoniun,  and  poke. 

Piles  may  often  be  cured  by  the  use  of  the  domestic  syringe,  Daily 
injections  of  cool  or  cold  water  will  do  much  to  strengthen  the  bowel, 
and  restore  the  dilated  veins  to  their  natural  condition. 

The  food  should  be  of  a  laxative  nature,  corn  bread,  rye  pudding, 
bread  of  unbolted  wheat  flour,  mealy  potatoes,  ripe  fruit,  {.'jdding 
and  milk,  buck wheaV  cakes,  broths,  and  a  Utile  tender  liieat  once  a 
day. 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


289 


Looseness  of  the  Bowels. — Diarrhoea. 

Looseness,  or  relax  of  the  bowels,  is  manifested  by  frequent,  copi- 
ous, and  thin,  or  unusually  liquid  discharges.  The  excessive  discharge 
may  be  caused  either  by  irritating  and  unwholesome  food,  by  inflam- 
mation and  ulceration  of  some  portion  of  the  bowels,  or  by  debility. 

Symptoms.  —  Rumbling  noise  in  the  bowels,  with  more  or  less 
weight  and  bearing  down,  and  uneasiness  in  the  lower  part  of  the 
bowels.  This  pressing  down  and  uneasiness  are  relieved  as  soon  aa 
the  evacuation  takes  place,  but  returns  when  another  is  near  at  hand. 
(Jriping  is  generally  present,  the  strength  is  reduced,  and  the  skin  is 
pale,  dry,  and,  after  a  time,  sallow. 

Treatment. —  When  the  complaint  is  caused  by  irritating  food,  it 
will  geiierally  stop  as  soon  as  the  offending  substance  is  removed,  and 
not  much  medicine  will  be  required. 

To  neutralize  any  acidity,  to  remove  wind,  allay  irritation,  and 
strengthen  the  stomach,  the  compound  syrup  of  rheubarb  and  potassa 
is  well  adapted,  given  in  tablespoonful  doses,  every  hour,  till  it  oper- 
ates. A  little  paragoric  added  to  it  occasionally,  or  essence  of  pep- 
permint, or  spearmint,  may  aid  its  good  effects. 

If  nausea  and  vomiting  are  present,  put  a  mustard  poultice  upon 
the  stomach,  and  give  a  few  drops  of  laudanum.  If  there  is  much 
griping,  give  an  injection  (248),  wi-h  twenty  drops  of  laudanum  in  it. 
A  common  diarrhoea  may  generally  be  arrested  at  once  by  prescrip- 
tions 159  or  162,  in  teaspoonful  doses,  afier  each  discharge. 

When  there  is  inflammation  and  ulceration  of  the  bowel,  the  treat- 
ment must  be  similar  to  that  for  dysentery,  —  fomentations  exter- 
nally, and  the  occasional  use  of  starch  injections,  mild  cathartics  (9) 
(10),  and  Dover's  powder  internally. 

Chronic  Diarrhoea. 

The  acute  form  of  diarrhcea,  not  being  properly  managed,  often 
runs  on,  and  becomes  chronic,  and  is  at  times  exceedingly  difficult  to 
cure. 

Symptoms.  —  Frequent  discharges,  generally  with  some  pain  and 
griping,  restlessness,  thirst,  poor  appetite,  debility,  loss  of  flesh,  dry, 
rough,  pnd  somewhat  sallow  skin,  and  tongue  dry  and  dark-colored. 
The  food  often  passes  through  the  bowels  pretty  much  in  the  condi- 
tion in  which  it  was  swallowed.  The  liver  ia  generally  out  of  order, 
and  the  bowels  are  frequently  afflicted  with  a  low  grade  of  inflam- 
mation. 

Treatment.  —  In  this  form  if  the  disease,  astringents  and  tonics  will 
generally  be  required.  Sometimes  a  teaspoonful  of  brandy,  in  a  little 
sweetened  water,  or  in  clear  water,  several  times  a  day,  will  effect  a 
cure.    Good  cherry  brandy  is  a  valuable  remedy ;  so  is  blackberry 


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brandy.  Many  of  the  worst  cases  have  been  cured  by  taking  no 
nourishment,  for  a  long  time,  except  milk,  with  a  little  lime  water 
in  it. 

When  the  liver  is  involved  in  the  complaint,  as  evinced  by  light- 
colored  stools,  leptandrin,  geranium,  etc.  (341),  may  be  given  with 
advantage. 

In  some  instances,  when  there  is  considerable  debility,  pills  of 
quinine,  catechu,  etc.  (342),  will  do  well. 

A  sponge  bath  must  be  taken  daily,  and  the  skin  be  well  rubbed 
after  it 

Cholera  Morbus. 

The  above  name  is  given  to  a  disease  common  in  warm  weather, 
and  characterized  by  sudden  attacks  of  bilious  vomiting  and  purging, 
with  severe  pain  in  the  belly,  cramps,  and  general  fever  and  subse» 
quent  prostration.  The  great  amount  of  bile  secreted  and  discharged 
has  given  it  the  name  cholera,  from  choler,  bile. 

Symptoms. —  The  disease  begins  by  sickness  and  distress  at  the 
stomach,  which  is  succeeded  by  violent  gri pings,  with  vomiting  of 
thin,  dirty-yellowish,  whitish,  or  greenish  fluid,  with  discharges  from 
the  bowels  similar  to  that  vomited  The  nausea  and  distress,  with 
some  few  exceptions,  continue  between  the  vomiting  and  purging, 
and  the  pain,  at  times,  is  intense.  The  pulse  is  rapid,  soon  becoming 
small  and  feeble,  the  tongue  dry,  the  urine  high-colored,  and  there  is 
much  thirst,  though  no  drink  can  be  retained  on  the  stomach.  It  is 
to  be  distinguished  from  diarrhoea  by  the  biliovs  dischargt^s. 

Treatment.  —  Apply  a  large  mu>  .,ard  poultice  over  the  stomach  and 
liver,  and  give  tablespoonful  doses  of  compound  powder  of  rhubarb 
and  potassa,  every  half  hour,  until  the  vomiting  and  nausea  are 
checked,  adding  to  each  dose  five  to  ten  drops  of  laudanum,  if  neces- 
sary. Perhaps  it  would  generally  be  best,  however,  to  give  liberal 
draughts  of  warm  water,  at  first,  or  flax-seed  tea,  that  all  the  solid  con- 
tents of  the  stomach  and  bowels  may  be  washed  out. 

A  t^aspoonful  of  laudanum  in  a  wineglassful  of  flax-seed  tea,  given 
as  an  injection,  every  two  hours,  will  sometimes  do  excellently  well ;  or 
a  tea  made  of  chamomile  flowers,  or  Colombo,  and  made  sour  by  a  few 
drops  of  nitric  or  sulphuric  acid,  and  given  internally,  will  sometimes 
succeed  better  than  most  other  things.  One  grain  of  morphine  and 
thirty  grains  of  bicarbonate  of  soda  dissolved  in  an  ounce  of  sweet 
tincture  of  rhubarb,  and  given  in  teaspoon  ful  doses,  every  half  hour 
will  often  have  a  fine  effect.     The  prescription  162  is  also  valuable. 

Hot  bricks  should  be  applied  to  the  feet,  and  warm  flannels,  or 
other  kinds  of  dry  heat,  to  the  whole  body. 

Asiatic  Cholera. 

Beside  the  above  name,  this  fearful  disease  has  been  called  epi- 
demic cholera,  malignant  cholera,  spasmodic  cholera,  and  cholera 


ing  no 
!  water 

»y  light- 
en with 

pills  of 

1  rubbed 


weather, 
L  purging, 
nd  subse' 
[iacharged 

;ss  at  the 
uniting  of 
irges  from 
,tress,  with 
d  purging, 
I  becoming 
nd  there  is 
ach.     It  is 

;omach  and 
of  rhubarb 
nausea  are 
n,  if  neces- 
give  liberal 
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rphine  and 
ce  of  sweet 
y  half  hour 
valuable, 
flannels,  or 


..  called  epi- 
and  cholera 


asphyxia.  It  first  attracted  notice  in  Bengal,  in  1817,  whence  it 
spread  westward  through  Europe,  and  in  June,  1832,  it  reached  Que- 
bec, on  this  continent. 

Symptoms.  —  First  Stajfe.  —  The  first,  premonitory  stage,  is  marked 
by  derangement  of  the  digestive  organs,  rumbling  in  the  howels,  paiii 
in  the  loins  or  knees,  twitehings  of  the  calves  of  the  legs,  impaired 
appetite,  thirst,  and  especially,  a  slight  diarrhoea ;  and  these  symp- 
toms continue  from  a  few  hours  to  several  days.  I  should  add  to 
these  symptoms  what  is  said  to  have  been  recently  discovered,  namely, 
that  for  several  days  befot'e  the  attack,  the  pulse  is  down  to  forty  or 
fifty  beats  in  a  minute  This,  if  it  prove  to  be  reliable,  is  a  very  valu- 
able symptom. 

Second  Stil<|^e.  —  This  stage  is  marked  by  vomiting  and  purging  a 
thin,  colorless  fluid,  looking  almost  exactly  like  rice  wator ;  by  severe 
cramps  in  the  calves  of  the  legs,  which  soon  attack  the  bowelb  and 
stomach.  These  cramps  are  excessively  painful,  and  draw  the  mus- 
cles into  knots.  The  tongue  is  pale  and  moist;  the  pulse  feeble, 
though  sometimes  full  and  firm  ;  the  breathing  hurried,  with  distress 
about  the  heart ;  great  thirst ;  a  feeling  of  internal  warmth  ;  and  the 
secretion  of  urine  entirely  stopped. 

These  thin,  colorless  discharges  by  vomiting  and  purging,  are  the 
serum  or  watery  portion  of  the  blood,  which  oozes  through  the  sides 
of  the  blood-vessels,  and  runs  off  rapidly,  leaving  the  crassamenium, 
or  red,  solid  part  of  the  blood,  stranded  upon  the  inner  surfaces  of  the 
arteries  and  veins.  When  so  much  of  this  is  discharged  that  the 
blood  cannot  circulate  freely,  the  patient  sinks  into  the 

Third  Sta^e,  which  is  characterized  by  great  prostration  ;  pulse 
hardly  perceptible  ;  skin  cold  and  clammy ;  face  blue  or  purple,  and 
eyes  much  sunken ;  hands  dark-colored  and  sodden,  looking  like  a 
washerwoman's ;  breathing  short  and  laborious ;  a  sense  of  great  heat 
in  the  stomach ;  and  intense  thirst.  Recoveries  from  this  stage  sel- 
dom take  place. 

Treatment  —  In  the  first  stage,  the  diarrhoea  should  receive  the 
most  prompt  attention.  From  five  to  ten  drops  of  laudanum,  re- 
peated a  few  times,  every  three  hours,  will  generally  put  a  stop  to  it. 
Morphine  (162)  is  also  a  suitable  remedy.  The  compound  syrup  of 
rhubarb  and  potassa,  with  some  other  articles  (343),  in  tablespoonful 
doses,  every  hour,  till  it  operates  genily,  is  worth  a  irial.  The  diet 
should  of  course  be  very  carefully  regulated  at  such  a  time,  though 
not  particdlarly  changed,  except  to  leave  oft'  any  indigestible  article 
which  is  known  to  be  injurious,  and  to  be  made  a  little  more  sparing 
than  in  a  time  of  perfect  health. 

When  the  second  stage  has  set  in,  or  the  stagt,  of  vomiting,  purg- 
ing, and  cramps,  the  treatment  must  be  energetic.  The  sinking  pow- 
ers must  be  sustained  by  chloroform,  opium,  and  ammonia  (119),  or 
by  camphor,  opium,  and  cayenne  (344),  giving  one  pill  every  hour. 
Brandy  may  also  be  given  freely. 


II '^  It  ill! 


H.I 

i  ; 
\  1 


ft  I 
^1 


III 

in 


i  i; 


1      .\W 


:f.'         fe. 


The  warmth  of  the  surface  must  be  promoted  by  all  possible  means, 
hot  bricks  and  bottles,  tincture  of  cayenne,  friction,  elc. 

In  the  third  stage,  the  remedies  recommended  above  are  to  be  pur- 
sued >yith  incieased  energy,  particularly  the  stimulants,  and  the  enorts 
to  promote  the  warmth  of  the  surface. 

Dysentery.— Bloody  Flux. — Colitis. 

This  is  an  inflammation  of  the  mucous  membrane  lining  the  lower 
or  large  bowels.  The  small  bowels  begin  at  the  stomach,  and  are 
eight  or  ten  yards  long ;  beipg  largest  near  the  stomach,  and  dimin- 
ishing in  size  as  they  approach  their  termination  at  the  caecum.  The 
lower  or  large  bowels  are  two  or  three  times  as  large  as  the  small 
ones,  and  from  their  junction  with  the  latter,  they  extend  about  six 
feet  to  the  outlet,  or  anvs.  The  large  bowels  are  composed  of  the 
csBcum,  the  colon,  and  the  rectum.  The  rectum  is  about  one  foot  in 
length. 

In  most  cases  of  dysentery,  the  rectum,  and  about  half  the  adjoin- 
ing portion  of  the  colon,  experience  the  chief  force  of  the  inflamma- 
tion. Sometimes  the  whole  of  the  colon  and  caecum  are  affected. 
Sometimes  the  mucous  membrane  lining  these  ii  ulcerated,  and,  be- 
coming wholly  disorganized,  passes  off"  in  shreds. 

Symptoms.  —  The  disease  cQmes  on  with  loss  of  appetite,  costive- 
ness,  lassitude,  shivering,  heat  of  skin,  and  quick  pulse.  These  are 
followed  by  griping  pain  in  the  bowels,  and  a  constant  desire  to  pass 
their  contents.  In  general  the  passages  are  small,  composed  of  mucus 
mixed  with  blood.  These  passages  are  attended  and  followed  by 
severe  gripings  and  inclination  to'  strain,  learnedly  called  tormina,  and 
tenesmus.  They  are  sometimes,  in  the  early  stages,  attended  by  nau- 
sea and  vomiting.  The  natural  feces,  which  do  not  pass  off"  much, 
are  small  in  quantity,  and  formed  into  round,  compact  balls,  or  irreg- 
ular, hardened  lumps.  This  tenesmus,  or  great  desire  to  strain,  will 
continue,  perhaps  increase,  for  several  days,  —  the  discharges  being 
mostly  blood  in  some  cases,  and  chiefly  mucus  in  others.  Having, 
generally,  but  little  odor,  at  first,  these  discharges  become,  as  the  dis- 
ease advances,  exceedingly  offensive. 

Causes.  —  Dysentery  is  very  frequently  caused  by  sudden  changes 
from  hot  to  cold,  by  which  sweating  is  suddenly  checked,  and  the 
blood  repelled  from  the  surface.  Hot  climates,  and  dry,  hot  weather 
are  predisposing  causes.  All  green,  unripe,  and  unwholesome  food ; 
and  all  indigestible  food  of  every  sort,  may  induce  it 

Treatment.  —  In  mild  cases,  give  a  tablespoonful  of  castor  oil  and 
two  teaspoonfuls  of  paragoric,  mixed,  once  a  day.  Sometimes,  in 
place  of  the  above,  a  dose  of  rochelle  powder,  dissolved  in  water,  with 
thirty  or  forty  drops  of  laudanum,  may  be  taken.  A  moderate  quan- 
tity of  flax-seed  or  slippery  elm  tea,  may  be  taken  as  a  drink,  and  the 
bowels  be  well  emptied  by  an  injection  of  starch. 

When  there  is  much  pain  in  the  bowels,  a  mustard  poultice  Itaid 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


29;i 


upon  them,  will  have  a  good  effect.  The  starch  injections  should,  in 
such  case,  have  half  a  teaspoonful  of  laudanum  mixed  with  it.  The 
compound  syrup  of  rhubarb  and  potassa  will  often  act  favorably,  given 
in  tablespoon  ful  doses. 

If  there  is  reason  to  suppose  the  liver  is  affected,  give  podophyllin, 
etc.  (46). 

The  patietit  should  not  be  allowed  to  sit  up,  and  must  be  kept  very 
still,  and  be  allowed  only  a  very  scanty  diet,  as  flour  porridge,  well 
boiled,  rice  water,  etc. 

Chronic  Dysentery. 

When  dysentery  "runs  on"  for  some  time,  it  may  become 
chronic. 

Symptoms.  —  Looseness  of  bowels,  —  the  discharges  being  un- 
healthy, more  or.  less  bloody,  attended  by  bearing  down,  or  a  desire 
to  strain,  and  being  in  number  from  two  to  forty  a  day.  There  is 
great  debility,  the  pulse  is  weak  and  quick,  the  tongue  slightly  furred, 
the  appetite  lost,  the  face  pale  and  sallow,  and  the  skin  dry  and  parched. 
Sometimes  the  relax  alternates  with  costiveness. 

Treatment. —  In  this  form  of  the  complaint,  astringents  will  be 
necessary  (159)  (161)  (162)  (345)  (346)  (347). 

Injections  may  be  used,  if  necessary,  composed  of  nitrate  of  sil- 
ver, fifteen  grains  to  the  ounce  of  water,  or  an  infusion  of  golden  seal, 
with  a  little  tincture  of  prickly-ash  berries  added  to  it. 

The  diet  must  be  very  light,  easy  of  digestion,  and  nutritious.  In 
some  cases,  it  should  be  composed  chiefly  of  wheat  Hour  porridge,  or 
boiled  milk  and  boiled  rice.  In  other  cases,  a  littie  tender  beef  steak 
should  be  taken  once  a  day. 


Worms. — Vermes. 

The  intestinal  canal  is  subject  to  various  disturbances  from  the 
presence  of  worms.  Of  these  troublesome  tenants,  there  are  three 
principal  varieties. 

The  Ascaris,  or  pin-worm,  called  also  maw  or  thread  worm,  is  a 
small,  whi^e,  thread-like  worm  from  half  an  inch  to  an  inch  in  length. 
These  worms  live,  in  great  numbers,  in  the  rectum,  where  they  excite 
great  irritation  and  itching. 

Tbe  Liuiibriciis,  or  ascaris  lumbricoides,  is  a  round  worm,  about  an 
eighth  of  an  inch  in  thickness,  and  from  an  eighth  to  a  quarter  of  a 
yard  in  length.  Its  color  varies  from  a  niilky  whiteness  to  a  deep 
red.     It  generally  occupies  the  small  bowels. 

The  Tenia  Soltinuni,  or  tape-vmrm,  is  a  flat  worm,  with  four  suckers 
at  the  head,  is  from  a  few  iv.vi  to  some  hundreds  in  length,  and  full  of 
joints.  It  dwells  in  the  small  bowels,  and  feeds  on  the  chyle  as  it 
comes  along,  before  it  is  absorbed  by  the  lacteals.     lu  this  way,  it 


n^'a 


'•>  m 


11  'H' 


294 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


Ki 


robs  t  \e  body  of  nourishment,  and  produces  great  loss  of  flesh,  and 
an  enc  rmous  appetite.    , 

Symptoms.  —  In  the  grown  person  the  symptoms  of  worms  are 
quite  obscure,  except  an  intolerable  itching  within  the  anus,  which 
generally  indicates  pin-worms. 

In  children  worms  are  indicated  by  paleness,  itching  of  the  nose, 
grinding  of  the  teeth  and  starting  in  sleep,  irregular  appetite,  bad 
breath,  swelled  upper  lip,  picking  of  the  nose,  hard  swelled  belly,  and 
one -cheek  constantly  flushed. 

Treatment.  —  For  expelling  worms  various  articles  have  been  used. 
Among  these  spirits  of  turpentine  (155)  has  a  high  reputation.  The 
following  preparation  does  well :  Spirits  of  turpentine,  half  an  ounce  ; 
essence  of  anise,  half  an  ounce;  castor  oil,  one  ounce;  worm-seed 
oil,  one  ounce.  Mix.  The  dose  for  a  child  one  or  two  years  old,  is 
ten  to  twenty  drops,  every  two  or  three  hours.  In  two  or  three  days, 
a  brisk  physic  should  be  given.  The  worm  powder  is  quite  success- 
ful. 

One  of  the  most  popular  remedies  is  the  pink-root.  It  should  be 
united  with  a  purgative.  The  following  is  a  good  preparation :  Fink- 
root  and  .senna,  each  half  an  ounce  ;  bitartrate  of  potasaa,  one  dram  ; 
pulverized  jalap,  half  a  dram  ;  cardamom  seeds,  half  a  dram  ;  extra(!t 
of  liquorice,  two  drams.  Mix,  and  add  half  a  pint  of  boiling  water. 
Let  the  whole  steep  an  hour.  Give  a  tablespoonful  or  two,  occasion- 
ally, till  the  worms  are  expelled. 

An  injection  composed  of  quassia  (66),  or  aloes  (22),  or  oC,  simple 
sweet  oil,  is  very  effectual  in  removing  pin-worms  from  the  lower 
bowel.  So  is  an  injection  composed  of  the  red  iodide  of  mercury, 
one  grain ;  iodide  of  potassium,  half  a  grain ;  and  two  pints  of 
water. 

Most  of  the  above  preparations  are  thought  to  be  successful  in  ex- 
pelling all  kinds  of  worms ;  but  for  the  tape'ivorm,  no  other  remedy 
h^-s  yet  shown  itself  as  eflectual  as  jmmpkiri'Seeds.  The  seeds  should 
be  well  bruised,  and  steeped  in  water.  This  should  be  drank  freely 
for  several  days,  if  need  be.  It  is  believed  to  be  a  sure  remedy,  even 
in  cases  of  several  years'  standing. 

In  all  cases  of  worms,  the  diet  should  be  carefully  chosen,  and  be 
connected  with  proper  exercise,  pure  air,  frequent  bathing,  and  all 
those  measures  which  tend  to  improve  the  general  health. 

After  the  expulsion  of  the  worms,  tonics  should  always  be  taken 
to  strengthen  the  bowels,  that  the  same  evil  may  not  return. 


Acute  Inflammation  of  the  Kidneys. — Nephritis. 

Before  speaking  of  this  disease,  I  wish  to  give  the  reader  a  general 
idea  of  a  kidney,  and  shall  do  so  by  the  use  of  two  cuts. 

Fig.  108  presents  the  external  surface  of  the  right  kidney,  with  its 
renal  capsule  mounted  on  top  ;  t,  being  its  upper  edge  ;  /,  «,  superior 
and  inferior  branches  of  the  emulgent  artery ;  c,  d,  e,  three  branches 
of  the  emulgent  vein  ;  a,  the  pelvis  of  the  ureter ;  6,  the  ureter. 


f  flesh,  and 


worms  are 
inus,  which 

>f  the  nose, 
petite,  bad 
i  beJly,  and 


been  used, 
tion.     The 
an  ounce  ; 
worm-seed 
f^cars  old,  is 
three  days, 
ite  success- 
should  be 
ion :   Fink- 
one  dram ; 
in  ;  extract 
iling  water. 
),  occasion- 

T  oi  simple 

the  lower 

)f  mercury, 

o   pints  of 

!ssful  in  ex- 
ler  remedy 
?eds  should 
rank  freely 
medy,  even 

sen,  and  be 
ig,  and  all 

3  be  taken 

rj. 

phritis. 
sr  a  general 

ey,  with  its 
h^  superior 
e  branches 
reter. 


DISEASKS  OF  THE  ABDOMINAL  CAVITY. 


29.J 


Fig.  109  is  the  same  kidney  laid  open ;  1,  being  the  supra  renal 
capsule ;  2,  the  vascular  portion ;  3,  3,  the  tuberlar  portion,  consisting 
of  cones ;  4,  4,  two  of  the  calices  receiving  the  apex  of  their  corres- 
p'bnding  cones ;  5,  5,  5,  the  three  infundibula ;  6,  the  pelvis  ;  and  7, 
the  ureter. 


Fio.108. 


\tm.\m. 


The  kidneys  are  glands,  and  their  office  is  to  draw  or  strain  off 
from  the  body  those  effete  or  worn-out  particles,  or  products  of  decay 
which  contain  nitrogen^  while  the  liver  takes  away  those  carbonaceous 
matters  which  have  no  nitrogen..  These  useless  substances  which  go 
out  through  the  kidneys  are  generally  in  the  form  of  urea.  In  carry- 
ing off  these  matters,  the  kidneys  may  have  more  to  do  than  properly 
belongs  to  them ;  and  may  be  so  stimulated,  or  irritated,  or  injured 
in  some  way,  as  to  become  inflamed. 

Symptoms. — Like  most  other  inflammatory  diseases,  it  begins  with 
cold  chills  and  rigors,  especially  in  the  back  and  loins,  followed  by 
fever  and  pain.  The  pain  frequently  extends  to  the  bladder,  the  loins, 
and  the  thighs,  and  is  of  a  severe,  lancinating  kind,  —  though  some- 
times obtuse.  Pressure,  motion,  straining,  or  taking  a  full  breath,  add 
to  its  pungency.  The  urine  is  scanty,  high-colored,  sometimes  bloody, 
and  can  only  be  passed  drop  by  drop.  In  the  loins  there  is  a  sense 
of  heat,  gnawing,  and  constriction ;  the  bowels  are  eirher  constipated, 
or  relaxed  by  diarrhoea.  A  numbness  of  the  thigh,  and  drawing  up 
of  the  testicle  on  the'affected  side,  are  marked  and  peculiar  symptoms. 
In  some  cases,  there  are  nausea,  vomiting,  oppression  at  the  stomach, 
faintness,  hiccough,  drum-head  distention,  and  rumbling  of  the  bowels. 
The  skin  is  hot  and  dry,  the  pulse  hard  and  frequent 

Causes.  —  The  use  of  cantharides,  oil  of  turpentine,  and  other  di- 
uretics, taking  cold,  violent  exercise,  mechanical  injuries,  the  transla- 
tion of  rheumatism  or  gout,  the  striking  in  of  skin  eruptions,  and 
gravelly  formations  in  the  kidneys  or  ureters. 


Wt^ 


;>96 


DISEASES  OF  THE  ABDUMINAL  CAVITY. 


Distinctions.  —  This  disease  is  to  be  distinguished  from  colic  by 
the  pain  being  increased  by  pressure,  and  by  the  frequent  but  difficult 
discharge  of  red  urine ;  from  lumbago,  from  its  being  confined  fre- 
quently to  one  side,  and  also  by  the  urinary  troubles,  and  by  the 
nausea  and  vomiting ;  and  from  all  other  diseases,  by  the  numbness 
of  the  thigh,  and  the  drawing  up  of  the  testicles. 

Tenniuntions  of  tlie  Diseuse.  —  It  runs  a  rapid  course,  and  may 
teruiinate  by  resolution,  or  by  suppuration.  When  the  latter  happens, 
it  is  indicated  by  the  decline  of  the  more  violent  symptoms,  a  throb- 
bing and  a  sense  of  weight,  with  chills,  followed  by  nushes  of  heat, 
and  sweating.  The  matter  formed,  generally  small  in  quantity,  may 
pass  into  the  cavity  of  the  kidney,  and  thence  through  the  bladder  to 
a  natural  outlet  with  the  urine. 

Treatment.  —  Either  put  the  feet  into  a  hot  mustard  bath,  or  put 
mustard  drafts  upon  them.  At  the  same  time  apply  a  large  mustard 
poultice  upon  the  small  of  the  back,  and  follow  it  up  with  hot  fomen- 
tations of  stramonium  leaves  and  hops,  or  stramonium  and  worm- 
wood or  tansy. 

Let  perspiration  be  induced  as  soon  as  possible  by  five  to  ten  ten. 
drop  doses  of  tincture  of  veratrum  viride,  repeated  every  hour,  or  by 
teaspoonful  doses  of  the  compound  tincture  of  Virginia  snake-root, 
given  every  half  hour. 

If  costiveness  exist,  the  bowels  must  be  opened  by  epsom  salts, 
cream  of  tartar,  or  salts  of  tartar ;  or  by  copious  injections  of  warm 
water,  containing  a  few  drops  of  the  tincture  of  arnica  leaves.  Such 
injections  not  only  unload  the  bowels,  but  act  as  a  local  bath,  by  lying 
in  the  bowel  near  the  inflamed  kidneys. 

The  drinks  must  be  mucilaginous  and  diuretic.  The  marshmal- 
low  root  and  peach  leaves,  slipjx'ry-elm  bark,  Hax-seed,  mullein,  elder 
blows,  haircap-moss,  and  cleavers,  are  all  valuable.  If  the  disease  is 
caused  by  gravel,  twenty  drops  of  liquor  potasste,  largely  dilated 
with  flax-seed  and  upland-cranberry  tea,  and  taken  freely  as  a  drink, 
is  excellent. 

Chronic  Inflamm-ation  of  the  Kidneys. 

This  is  frequently  the  result  of  the  acute  form  of  the  disease,  but  is 
also  produced  by  injuries,  and  other  causes. 

Symptoms. —  A  weakness  in  the  small  of  the  back,  and  a  dull, 
heavy  pain  in  the  kidneys.  The  urine  is  passed  often,  and  in  small 
quantities.  It  is  alkaline,  —  sometimes  white  and  milky,  —  and  has 
in  it  deposits  of  phosphate  of  lime,  and  triple  phosphates. 

Treatment.  —  Infusions  of  pipsissewa,  uva  ursi,  trailing  arbutus?, 
wild  carrot,  queen  of  the  meadow,  buchu  leaves,  or  foxglove  are  use- 
ful diuretics,  and  may  be  taken  with  advantage. 

The  boweli-  must  be  kept  open  with  some  gentle  physic  (18),  if 
they  are  costive ;  and  the  alkaline  sponge  bath,  with  friction,  be  used 
daily. 


colic  by 
difficult 
ned  fre- 
,  by  the 
[imbness 

nd  may 
happens, 
a  throb- 
of  heat, 
ity,  may 
[adder  to 

li,  or  put 
mustard 
»t  fomen- 
d  worm- 

» ten  ten. 
ar,  or  by 
lake-root, 

r>m  salts, 
of  warm 
s.  Such 
,  by  lying 

jarshmal- 
ein,  elder 
lisease  is 
y  dilated 
a  drink, 


se,  but  is 

d  a  dull, 

in  small 

-and  has 

arbutus, 
are  use- 

c  (18),  if 
1,  be  used 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


29: 


An  eruption  may  be  brought  out  upon  the  small  of  the  back  by 
rubbing  on  a  few  drops  of  croton  oil ;  or,  if  the  patient  prefer  it,  a 
mustard  poultice  may  be  applied  two  or  three  times  a  week. 

The  food  should  be  nutritious,  and  easily  digested,  and  a  little  exer- 
cise be  taken  daily  in  the  open  air. 

Acute  Inflammation  of  the  Bladder. — Cystitis. 

This  disease  affects  the  lining  membrane  of  the  bladder,  —  some- 
times its  muscular  substance.  It  may  attack  the  upper  portion,  the 
middle,  or  the  neck  of  this  organ.     It  runs  a  rapid  course. 

Symptoms.  —  Burning,  piercing,  and  throbbing  pain  in  the  region 
of  the  bladder.  The  pain  extends  to  the  perineum,  and  in  some 
cases,  to  the  testicles  and  thighs,  and  is  much  increased  by  pressure. 
The  perineum,  the  space  between  the  fundament  and  testicles,  feels 
sore  to  the  touch.  The  desire  to  pass  urine  is  incessant,  but  the 
effort  to  do  so  is  mainly  ineffectual.  The  water  passes  off'  drop  by 
drop,  with  great  pain,  or  is  entirely  stopped,  —  causing  enlargement 
of  the  bladder,  and  great  distress.  Mucus  from  the  inflamed  lining 
of  the  bladder  passes  off  with  the  water.  Nausea,  vomiting,  and 
great  anxiety  are  common.  The  bowels  are  bound,  and  when  the 
disease  is  on  the  side  next  the  lower  bowel,  there  is  a  desire  to  empty 
the  bowels;  and  if  the  inflammation  be  in  the  neck,  there  is  great 
pain  in  the  perineum,  and  frequently  an  entire  retention  of  the  water. 
The  pulse  is  full,  hard,  and  frequent,  the  skin  hot  and  dry,  the  thirst 
urgent,  and  the  patient  restless  and  dejected. 

Causes. —  This  disease  may  be  produced  by  taking  cantharides  and 
turpentine ;  by  irritating  substances  forced  into  the  bladder  with  a 
syringe,  or  by  pushing  bougies  or  catheters  into  it ;  by  gravel  stones 
in  the  bladder;  by  retained  urine;  by  external  injuries;  by  gonor- 
rhoea ;  and  by  cold  applied  to  the  feet,  or  to  the  lower  portion  of  the 
abdomen. 

Treatment. —  If  the  urine  be  retained,  it  is  of  the  utmost  impor- 
tance that  it  be  early  drawn  off  with  the  catheter,  lest  a  distention  of 
the  bladder  bring  on  raortificatioii.  Great  care  is  required  not  to  pro- 
duce irritation  by  any  roughness  in  introducing  the  instrument. 

Leeches^  should  be  applied  upon  the  lower  part  of  the  bowels,  the 
perineum,  and  around  the  anus.  When  these  are  removed,  warm 
poultices  should  be  applied.  Cold  compresses  will  often  do  as  well. 
The  bowels  must  be  opened  with  epsom  salts.  Injections  of  warm 
water,  with  a  few  drops  of  tincture  of  arnica  leaves,  will  act  finely  as 
a  local  bath,  —  the  water  being  retained  as  long  as  possible. 

The  tincture  of  veratrum  viride  will  be  required  in  fivie  to  ten-drop 
doses,  or  the  compound  tincture  of  Virginia  snake-root,  to  induce 
perspiration.  Dover's  powders  may  sometimes  be  used  for  the  same 
purpose. 

Drinks  must  be  taken  very  sparingly.  A  small  amount  of  cold  in- 
fusion of  slippery  elm  bark,  or  marshmallow  and  peach  leaves,  or 


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cleavers.     This  mueilaginoua  drink  must  be  the  beginning  and  the 
end  of  the  diet  during  the  active  stage  of  the  disease. 

Chronic  Inflammation  of  the  Bl&ddeT. —  Ci/stirrhcea. 

This  is  much  more  common  than  the  active  form  of  the  disease. 
It  often  arises  from  the  same  causes  which  produce  acute  inflamma- 
tion of  the  bladder. 

It  often  passes  under  the  title  of  "  catarrh  of  the  bladder."  It  is 
a  chronic  inflammation  of  the  mucous  lining  of  the  bladder,  and  is  a 
very  common  and  troublesome  art'ection  among  old  people. 

Symptoms. —  Slight  lancinating  pains,  with  a  feeling  of  heat  in  the 
region  of  the  bladder,  and  a  sense  of  weight  and  tenderness  in  the 
perineum  ;  frequent  and  tormenting  desire  to  pass  water,  with  occa- 
sional spasmodic  action  of  the  bladder.  The  urine  is  loaded  with 
tenacious  mucous,  just  as  the  expectoration  has  large  quantities  of 
mucus  in  it  when  there  is  inflammation  of  the  membrane  lining  the 
windpipe  and  bronchial  tubes.  When  the  water  has  stood  a  while, 
this  mucus  settles  at  the  bottom  of  the  vessel,  leaving  the  fluid  clear 
above.  Great  quantities  of  this  are  sometimes  passed,  —  amounting 
even  to  pints  in  a  day.  The  triple  phosphates  of  magnesia  and  am- 
monia are  often  found  in  the  water. 

Frequently  there  are  derangements  of  the  appetite  and  digestive 
functions,  a  white  or  brown  fur  upon  the  tongue,  a  harsh,  dry  skin, 
with  thirst  and  general  debility,  —  especially  in  the  back  and  loins. 
Sometimes  there  is  a  little  fever. 

Treatment  —  To  reduce  the  inflammation,  apply  leeches,  or  mus- 
tard, or  croton  oil,  or  a  cold  compress  every  night. 

As  a  diuretic,  give  an  infusion  of  buchu,  uva  ursi,  trailing  arbutus, 
queen  of  the  meadow,  etc.  Tincture  of  veratrum  viride  and  sweet 
^irits  of  nitre  (125)  is  a  good  remedy.  The  compound  infusion  of 
trailing  arbutus  is  well  recommended.  So  is  the  compound  balsam 
of  sulphur.    An  infusion  of  the  pods  of  beans  has  been  well  spoken  of. 

An  injection  into  the  bladder,  once  a  day,  of  a  tepid  infusion  of 
golden  seal  root,  with  much  care,  may  be  of  great  service ;  or  an 
infusion  of  equal  parts  of  golden  seal,  witch  hazel,  and  stramonium 
It  may  be  done  with  a  gum-elastic  catheter,  and  a  small  syringe. 

The  bowels  must  be  kept  open  with  the  neutralizing  •rnixtuie,  or 
some  other  mild  physic ;  and  the  skin  bathed  with  saleratus  and 
water  once  a  day,  and  rubbed  well  with  a  coarse  towel. 

Should  there  be  any  scrofulous,  or  gouty,  or  rheumatic  condition  of 
the  system,  the  remedies  for  those  complaints  may  be  used  in  addition 
to  the  above. 

Disease  of  the  Supra-Renal  Capsules. 

The  supra-renal  capsules  are  small  bodies  situated  above  the  kid- 
neys.    (Fig.  109,  1.)     Their  office  is  not  well  understood.     It  has 


Isi-v 


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been  found  of  late  that  they  are  subject  to  a  disorder,  Imving  peculiar 
symptoms.     This  is  a  new  disease. 

Symptoms. —  The  most  marked  L^ymptom  is  a  peculiar  change  in 
the  color  of  the  skin,  called  "bronzing."  This  bronzing  process  be- 
gins in  patches  on  those  parts  exposed  to  the  sun,  and  to  friction, 
as  the  neck,  the  backs  of  the  hands,  the  fronts  of  the  thighs,  and  the 
arms.  These  patches  look,  in  color,  like  spots  upon  a  bronze  statue, 
deprived  of  their  gloss. 

Another  marked  symptom  is  a  peculiar  dehUili/,  which  comes  on 
without  any  a|)pan'nt  cause,  —  there  being,  generally,  no  evidence  of 
organic  disease,  and  no  loss  of  flesh,  —  and  is  attended  with  faint- 
ings,  loss  of  energy  both  of  body  and  mind,  a  peculiar  (labbiness  of 
llesh,  and  an  early  death,  apparently  from  sheer  weakness. 

Tlie  blood  becomes  early  depraved,  and  loses  its  coloring  matter, 
as  shown  by  the  paleness  of  the  skin  where  there  is  Jio  broiizing. 

The  pulse  is  generally  very  soft  and  compressible.  The  stomach  is 
irritable,  the  appetite  gone;  there  is  nausea,  and  sometimes  vomiting, 
with  pain  and  a  sense  of  sinking  at  the  pit  of  the  stomach.  Fre- 
quently there  is  costiveness,  sometimes  diarrhoea,  and  pains  in  the 
back  an«l  loins.  In  some  cases  there  are  epilejjtic  fits,  failure  of 
memory,  change  of  temper,  or  a  numbness  of  the  fingers,  legs,  etc. 

Treatment. —  The  disease  is  a  peculiarly  fatal  one.  As  no  mode 
of  treatment  has  yet  proved  successful,  it  is  well  to  observe  caution 
in  prescribing. 

The  treatment  prescribed  for  chronic  inflamr.iation  of  the  kidneys, 
would  perhaps  be  as  safe  as  any  that  could  at  present  be  proposed. 

Bright's  Disease  of  the  Kidneys. — Albuminuria, 

This  peculiar  disease  was  first  explained  to  the  profession  in  1837, 
by  Dr.  Bright,  of  England,  whose  name  it  took.  It  consists  of  a  dis- 
order of  the  kidneys,  —  probably  a  congestion  and  an  obstructed  cir- 
culation in  them,  from  which  arise  two  most  important  effects ;  first, 
albumen,  an  essential  alimentary  constituent  of  the  blood,  is  secreted 
and  passed  off",  in  larger  or  smaller  quantities,  in  the  urine;  and  sec- 
ondly, urea,  the  worn-out  matters  in  the  blood  which  the  kidneys  are 
made  expressly  to  carry  off',  is  permitted  to  remain.  If  the  urine  of 
a  person  having  Bright's  disease  be  examined,  therefore,  albumen, 
which  should  not  be  there,  will  be  found,  and  urea,  a  natural  constitu- 
ent, will  be  absent.  •      . 

Method  of  Examination,  r—  To  discover  albumen  in  urine  suspected 
to  contain  it,  place  a  little  in  a  test  tube,  and  boil  it  over  a  spirit 
lamp.  If  albumen  be  present  only  in  minute  quantity,  it  may  cause 
only  a  delicate  opalescence  ;  if  in  larger  quantity,  it  may  separate  in 
curdy  flakes,  and  fall  to  the  bottom  as  a  more  or  less  abundant  white 
precipitate.     If  very  abundant,  the  liquid  may  become  nearly  solid. 

The  albumen  is  the  same  as  the  white  of  an  egg,  and  the  boiling  has 
the  same  effect  in  whitening  and  hardening  it,  as  upon  that  substance. 


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DISEASES  OF  THE  ABDOMINAL  CAVITY. 


Albumen  is  sometimes  found  in  the  urine  in  a  coagnlnt(Ml  stnto, 
and  having  llie  shape  of  tube«  or  worms.  (Fig-  110.)  This  is  quite 
common  in  Bright's  disease.     The  deposit  seems  j.^,  no. 

to  be  made  up  of  fibrous  casts  of  the  uriniferous 
tubes  of  the  ki(hicys. 

Symptoms.  —  The  two  unnatural  conditions 
mentioned  above,  give  rise  to  the  symptoms  of 
Bright's  disease.  One  of  them,  however,  is  it- 
self the  most  constant  and  characteristic  symp- 
tom of  the  disease,  namely,  the  presiMice  of  al- 
bumen. This,  too,  being  one  of  the  nutritive 
construents  of  the  blood,  its  abstraction  thins 
the  serous  portion  of  the  blood,  and  causes  it  to  filter  out  of  its  vessels 
into  the  cells,  —  causing  dropsy  of  the  cells,  usually  called  celluliir 
dropsy,  or  anasarca.  This  general  dropsy  begins  freciuently  in  tli? 
face,  and  spreads  rapidly  over  the  whole  body  and  limbs.  In  add). 
tion  to  this,  there  are  pains  in  the  back  and  loins,  a  gradual  failing  ot 
strength,  and  a  derangement  of  digestion.  The  skin  becomes  dry, 
with  a  pale  and  bloodless  appearance,  and  there  are  frecpiently  thirst, 
nausea,  and  vomiting.  The  urine  frequently  has  fat,  blood,  epithelial 
scales,  mucus,  blood  discs,  fibrous  casts  of  the  uriniferous  tubes,  and 
saline  sediments ;  and  is  generally  lighter  by  weight  than  in  health, 
and  less  in  quantity,  and  is  apt  to  be  red,  brown,  or  dingy  in  color. 

The  retention  of  urea  in  the  blood  acts  as  -a  poison,  and  causes, 
toward  the  latter  end  of  the  disease,  when  aceunuxlated  in  large  quan- 
tity, drowsiness,  convulsions,  and  apoplexy. 

A  frequent  desire  to  make  water,  with  a  shifting  back  and  forth 
of  the  bowels  between  costiveness  and  diarrhcea,  are  conmion  symj)- 
toms.  • 

Treatment. —  The  results  of  treatment  in  this  disease  are  often  un- 
satisfactory. Yet  if  taken  in  season,  investigated  with  proper  care, 
and  treated  with  due  diligence,  much  may  be  done  for  its  cure.  It  i» 
one  of  those  harassing  complaints,  which  physicians  in  family  prac- 
tice seldom  have  the  patience  to  investigate  and  manage  with  sutR- 
cient  care. 

Let  the  healthy  an-l  active  condition  of  all  the  vessels  of  the  skin 
be  the  first  object  aim;u!  i '.  This  will  relieve  the  laboring  and  falter- 
ing kidneys  of  a  portion  of  their  burden.  The  alkaline  sponge  bath 
with  vigorous  friction  every  day,  will  secure  this  object. 

In  the  next  place,  the  skin  being  put  in  a  working  condition,  should 
be  made  to  work  by  some  internal  diaphoretic,.,-^  as  the  tincture  ot 
veratrum  viride,  in  doses  of  from  five  to  ten  drops,  or  the  compound 
tincture  of  Virginia  snake-root,  in  teaspoonful  doses. 

The  kidney  may  be  still  further  relieved,  especially  when  there  is 
considerable  tenderness,  and  other  signs  of  inflammation,  by  cupping, 
leeching,  mustard  poultices,  and  croton  oil. 

The  bowels  should  be  regulated  by  some  gentle  physic,  as  cream  of 
tartar  dissolved  in  flax-seed  tea,  or  rochelle  powders,  or  epsom  salts, 
the  lenitive  electuary,  or  the  white  liquid  physic.     In  some  cases, 


itrd  statr, 
ii»  is  quitr 

no. 


its  vessels 
I'd  cellular 
itly  in  til? 
In  addi. 
I  failing  ot 
romes  dry, 
ntly  tiiirsr, 
,  epithelial 
tubes,  and 
1  in  health, 
in  color, 
ind  causes, 
arge  quan- 

:  and  forth 
nion  syinj)' 

•e  often  uii- 
iroper  care, 
cure.  It  is 
ainily  prae- 
!  with  sutli- 

of  the  skin 

and  falter- 

ponge  bath 

Hon,  should 
tincture  of 
compound 

en  there  is 
jy  cupping, 

18  cream  of 
psom  salts, 
lome  cases. 


podophyllin  and  leptandrin  (40),  or  the  compound  powder  of  jalap 
(41),  are  useful. 

When  there  is  dropsy  of  the  cells,  elaterium  may  ho.  used  a«  physio 
(31),  or  the  kidney  may  be  jogged  by  digitalis  (VM)  (129),  its  eftcctn 
JH'ing  carefully  watched.  Cider,  freely  drank,  has  been  found  useful 
in  some  cases. 

To  restore  the  blood,  iron  (73)  (93)  (74)  (7r>)  (72)  (71)  is  the  essen- 
tial article.  "When  there  is  considerable  debility,  some  of  the  vegeta- 
ble bitters,  as  quinine,  (juassia,  gentian,  Colombo,  etc.,  may  be  used 
daily. 

Coffee,  and  all  indigestible  articles  of  food,  as  rich  pastries,  new 
l)read,  high-seasoned  meat,  and  fats  must  be  avoided,  —  in  a  word, 
nothing  nmst  be  taken,  either  in  kind  or  quantity,  which  the  stomach 
cannot  easily  digest. 

Diabetes. 

This  disease  h  a  kind  diarrhcea  of  the  kidneys.  The  amount  of 
urine  secreted  and  discharged  is  large,  sometimes  enormous  in  quan- 
tity,—  amounting  even  to  several  gallons  in  twenty-four  hours. 
Everything  taken  into  the  stomach  seems  to  run  off  by  the  kidneys. 
The  for..!  and  drink  being  mostly  converted  into  urine,  do  but  little 
good.  The  kidneys  having  got  into  an  exalted  stale  of  action,  do  too 
/nurh, — just  as  the  mucous  membrane  of  the  air  tubes  does  in  bron- 
chitis. 

.\»tiire  of  the  I'rliie. — Not  only  is  there  too  much  urine  discharged, 
but,  instead  of  being  lighter  than  healthy  urine,  as  in  Bright's  disease, 
it  is  heavier,  and  instead  of  holding  albumen  in  solution,  it  contains 
grape  svgar. 

To  Detect  Su^ar.-^Put  a  little  of  the  suspected  urine  in  a  test  tube, 
—  add  to  it  a  drop  or  two  of  solution  of  sulphate  of  copper,  which 
will  give  the  fluid  a  pale  blue  tint.  Now  add  liquor  potassa  in  excess; 
if  sugar  be  present,  this  will  throw  dov/n  a  pale  blue  precipitate  (hy- 
drated  oxide  of  copper),  which  will  immediately  re-dissolve,  forming 
a  purplish  blue  liquid.  Boil  this  over  a  lamp ;  if  there  be  sugar,  a 
reddish  or  yellowish-brown  precipitate  (sub-oxide  of  copper)  will  be 
thrown  down ;  if  no  sugar,  a  black  precipitate  (common  oxide  of 
copper)  will  fall  to  the  bottom. 

Another  Test.  —  Place  a  little  urine  in  a  test  tube ;  add  to  it  half 
its  volume  of  liqubr  potassa,  and  boil  five  minutes.  If  there  be  sugar 
present,  the  liquid  will  take  a  brownish  or  bistre  tint 

Growth  of  Tonda  as  a  Test  —  Place  a  portion  of  sacharine  urine 
in  a  warm  place,  and  a  scum  will  soon  rise,  as  if  a  little  flour  had 
been  dusted  on  it  This,  when  examined  under  the  microscope, 
proves  to  be  minute  oval  bodies.  These  expand  and  dilate  the  vesi- 
cle containing  them,  into  the  form  of  a  tube.  They  still  cont*i»ue  to 
enlarge,  and  project  from  the  parent  Uadder,  like  buds.     The  whole 


I)  <' 


Fio.  m. 


then  resembles  a  jointed  fungoid  growili  (Fig.  Ill),  which  finally 
breaks  up,  and  falls  to  the  bottom,  as  a  copious  deposit  of  oval  vesi- 
cles Of  spores. 

Other  Symptoms.  —  Great  thirst,  craving  ap- 
petite, dry  skin,  a  sense  of  weight  and  uneasi- 
ness in  the  stomach  after  eating,  dry  and  parched 
mouth,  white  and  foul  or  clean  and  red  toiigii.., 
wasting  of  flesh,  languor  and  aversion  to  ;  xer- 
cise.  debility,  pain  and  weakness  in  the  loins, 
costiveness,  loss  of  the  sexual  feeling,  and  cold 
feet.  As  the  disease  draws  towards  a  fatal  end, 
the  gums  become  spongy,  the  breath  fetid, 
sometimes  smelling  like  urine. 

Treatment — The  skin  should  have  about  the  same  treatment  as 
that  recommended  in  Bright's  disease.  Also,  the  same  counter-irrita- 
tion over  the  kidneys.  The  bowels  must  be  kept  open  by  some  gentle 
physic  (13)  <12)  (15). 

Tonics.  —  These  will  be  required  to  restore  the  tone  of  the  system, 
particularly  iron,  —  same  preparations  as  recommended  in  Bright's 
disease. 

Astringents  to  check  the  flow  of  urine  will  be  needed.  Alum,  in 
three-grain  dose-;,  three  times  a  day,  or  sugar  of  lead,  or  white  vitriol, 
or  clear  opium,,  will  be  serviceable.  Creosote,  in  one  or  two-drop 
doses,  and  t'lcture  of  cantharides,  have  each  cured  cases. 

One  scruple  of  Peruvian  bark,  one  scruple  of  wild  cr  \nberry  leaves, 
powdered,  und  half  a  grain  of  opium,  mixed  and  taken  three  times  a 
day,  is  a  good  remedy. 

All  articles  which  contain  sugar  and  starch  must  be  forbidden 
in  the  'Uet.  Bread  and  potatoes  contain  a  large  amount  of  starch ; 
and  beets,  parsnips,  and  some  other  vegetables,  have  sugar.  It  is  best 
to  confine  the  patient  almost  entirely  to  tender,  fresh  meats  ;  and  the 
drink,  notwithstanding  the  great  thirst,  must  be  restricted  to  a  very 
small  quantity. 

Bleeding^  from  iLe  Kidneys,  etc. — H<Bmaturia. 

By  this  I  mean  a  discharge  of  blood  from  the  urinary  passage.  It 
may  come  from  the  kidneys,  the  ureters,  the  bladder,  or  the  urethra. 

Symptoms.  —  The  passage  of  the  blood  is  preceded  by  pain  in  the 
region  of  the  bladder  or. kidneys,  and  accompanied  by  fairitness. 
There  is  generally  heat  and  distress  in  the  loins,  and  tenderness 
upon  pressure  in  the  region  of  the  bladder  or  kidneys,  according  to 
the  place  from  which  the  blood  comes. 

it  is  sometimes  difficult  to  decide  whether  the  coloring  matter  in 
the  urine  is  really  blood.  In  such  cases,  the  microscooe  wui  generally 
detect  the  blood  corpuscles,  if  present  They  commoily  appear  as  in 
Fig.  112,  —  having  a  yellow  color,  and  pretty  uniform  size. 


W'''"!'f  l^ii 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


303 


Treatment.  ^ — This  must  of  course  vary  according  to  the  nature  of 
the  case,  and  the  immediate  cause  producing  it.    Where  active  bleed- 
ing exists,  the  patient  must  have  absolute  rest  fw.  112. 
in  bed,  with  applications  of  cold  to  the  hips  and 
loins.    If  the  patient  be  strong  and  full  i)f  blood, 
wet  cups  or  leeches  may  be  applied  over  the 
kidneys,  or  the  bladder.     In  such  cases,  too,  the 
bowels  must  be  freely  moved  with  some  prepar- 
ation of  salts  (14)  (18)  (20)  (25). 

Sugar  of  lei  d  is  a  valuable  remedy;  but  it 
should  be  give-i  in  large  doses  for  a  short  time, 
rather  than  in  small  doses  for  a  long  time.     It  is 
best  taken  in  form  of  solution  (348),  two  great  spoonfuls  every  two 
hours,  until  five  or  six  doses  are  taken. 

But  the  best  remedy  is  gallic  acid.  It  seems  to  have  extraordinary 
power  in  this  complaint.  It  should  be  given  in  live-grain  doses, 
mixed  with  a  teaspoonfui  of  mucilage  of  gum  arable,  and  ten  drops 
of  tincture  of  henbane. 

Suppression  of  Urine. — Ischuria  Renalis. 

This  disease  is,  in  one  respect,  just  the  opposite  of  diabetes. 
While  immense  quantities  Of  urine  are  secreted  in  that,  none  is  se- 
creted in  this.     In  that,  the  kidneys  do  too  much  ;  in  this,  they  do 


,M'      i     '     M  : 


nothiner. 


*^' 


It 


Thif   complaint  is  sometimes  called  paralysis  of  tfie  kidneys, 
usually  occurs  in  old  persons,  and  those  inclined  to  corpulency. 

Symptoms.  —  The  patient  makes  no  water;  and  if  the  catheter  be 
applied,  none  will  be  found  in  i\\v.  bladder.  The  patient  feels  unwell, 
r?stless,  anxious,  with  a  slight  pain  in  the  loinw  and  bowels,  perhaps ; 
but  on  the  whole  not  illness  enough  to  give  any  very  good  account 
of  it.  After  a  little  time,  nausea  comes  on,  and  perhaps  vomiting, 
and  soon  drowsiness,  wanderings  of  mind,  incoherent  talk,  hiccough, 
stupefaction,  and  death.  These  head  symptoms  are  caused  by  the 
shutting  up,  in  the  kidneys,  the  natural  outlet  of  urea,  of  an  excre- 
mep.titicus  n:atter,  which  acts  as  a  poison  to  the  nervous  system. 
Before  death,  the  perspiration  has  a  strong  smell  of  urine. 

Treatment.  —  The  cause  of  this  complaint  not  being  known,  th^^. 
treatment  mu^t  necessarily  be  a  little  uncertain.  We  cannot  go 
amiss,  howcsrer,  in  placing  the  patient  immediately  in  a  warm  bath 
for  fifte'^a  or  twenty  minutes.  Then  apply  wet  cups  over  the  kidneys, 
»nd  follow  these  either  by  mustard  poultices,  or  by  hot  fomentations. 

Let  the  bowels  be  opened  by  the  compound  powder  of  jalap,  or  by 
elaterium  (31).  Epsom  salts  or  cream  of  tartar  might  in  some  cases 
be  substituted  for  the  above.  A  stimulating  injection  is  also  desira- 
ble (246). 

Dinretics,  as  sweet  spirits  of  nitre,  digitalis,  queen  of  the  meadow  a.id 
peach  leaves,  equal  parts,  and  marshmallow,  are  of  course  called  for 


\  '^m 


:  y  \ 

1 

i'' 

'   i 
i  1 

i 

] 

1     ■  ' 

.J'iHiiiEiJ 

1 


i  vM.  ri 


Ik  ^  '^i 


>  1 


!. ; 


MiinVi  l^f  the  pcisop.ous  n;?.ttcr  retained  may  be  got  out  through  the 
skin,  by  a  free  use  of  the  compound  tincture  of  Virginia  snake-root 
or  tincture  of  veratrum  viride  in  full  doses. 

Although  the  symptoms,  in  the  earlier  staj'es  of  this  complaint, 
may  not  attract  much  attention,  or  be  thought  worthy  of  notice,  yet 
the  treatment  should  be  prompt  and  energetic,  as  a  fatal  termination 
is  sometimes  reached  in  the  brief  space  of  forty -eight  hours. 

Retention  of  Urine. 

This  disorder  is  often  confounded  with  suppression  of  the  urine, 
but  it  is  different  in  every  respect.  In  suppression.,  the  urine  is  not 
formed  by  the  kidneys  ;  in  retention,  it  is  formed,  and,  in  some  cases, 
poured  into  the  bladder,  but  is  retained  on  account  of  soiae  inability 
to  pass  it. 

Iscliuria. —  This  is  one  of  the  forms  of  retention.  In  this  complaint, 
the  urine  has  pai^wed  from  the  kidneys  to  the  bladder,  but  from  some 
cause,  generally  palsy  of  the  muscles  of  the  bladder,  it  i  aimot  be 
passed  ofli  In  this  i-ase.  there  is  no  pain,  but  the  tu-r  .;n  f"  prater 
ilows  off"  with  slower  and  nlower  pdce,--the  patient  ha  ';;,(  land 
a  long  time,  and  ii»  .rc  tires. )mr.  eff'ortt*  with  the  abdomiiial  muscles 
to  get  tlK'  bl  ukL)  enif.tied.  As  the  quajitity  discharged  diminishes, 
the  desire  to  urinate  j^tows  niore  ujgent.  Pressure  just  above  thj 
puoes,  gives  pain,  anrl  the  bladder  feels  und^r  the  hand  like  a  large 
hard  Lumor. 

DysiUMa.--  In  this  form  oC  the  complaint,  the  water  is  passed  to 
some  exten",  but  with  pain  and  heat  along  the  water-pipe.  This  is 
generally  cau'sed  \>y  some  inflammation  along  the  urethra. 

StraJigfury.  In  this,  the  water  is  only  passed,  drop  by  drop,  and 
with  great  burning,  scalding,  and  tenesmus  in  the  neck  of  the  bladder. 
"When  there  is  considerable  inflammation,  the  skin  becomes  hot,  the 
pulse  hard  and  quick,  and  the  tongue  covered  with  a  white  fur. 

Causes. —  These  several  forms  of  the  complaint  are  caused  by  pcL  / 
of  the  bladder,  gonorrhoea,  inflammation  in  the  neck  of  the  blat  Icr 
or  the  water-pipe,  mechanical  injuries  of  the  bladder  in  child-bearUij,' 
or  otherwise,  by  tumors  pressing  upon  it,  by  irritation  from  gravel  or 
stone  within  its  cavity,  by  stricture  or  partial  closing  up  of  the  urethra, 
by  disease  of  the  prostate  gland,  by  taking  spirits  of  turpentine  or 
cantharides,  or  by  the  absorption  of  this  latter  article  when  used  as  a 
blister. 

Treatment.  —  It  is  obviously  necessary  in  this  complaint,  that  treat- 
ment, in  order  to  be  of  any  avail,  3hould  be  prompt ;  for  when  the 
retention  is  complete,  the  bladder  will  burst  in  from  two  to  five  '  ys, 
and  cause  the  death  of  the  patient. 

The  treatment  must  vary  according  to  the  cause  of  the  retenti-j 
If  it  be  caused  by  palsy  of  the  bladder,  the  common  flexible  ca<di<  ' 
ter  must  be  used  daily  until  the  muscular  fibrea  recover  their  lost 


mgh  the 
ake-root 

mplaint, 
>tice,  yet 
nination 


le  urine, 

le  is  not 

ne  cases, 

inability 

oniplaint, 
om  some 
an not  be 
f  water 
t  p.-  Land 
I  muscles 
iminishes, 
above  thi.- 
ke  a  large 


passed  to 
This  is 


drop,  and 
e  bladder. 
3  hot,  the 
ur. 


le 


by  pc  1^  ' 
blat  U.' 
d-bearunj 

gravel  or 
le  urethra, 
lentine  or 

used  as  a 

that  treat- 
when  the 
five.  '  ys, 

etentir 
iule  cttut)  ' 
their  lost 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


30S 


power.  When  much  irritation  is  caused  by  introducing  it,  it  is  better 
not  to  withdraw  it,  but  to  close  its  external  orifice  with  a  small  plug, 
which  the  patient  can  remove  as  often  as  necessary  to  let  on  the 
urine.  To  remove  the  paralysis,  the  electro-magnetic  machine  iii 
worth  a  trial,  —  the  current  being  passed  through  the  bladder.  At 
the  same  time  let  the  patient  take  strychnia  (85)  (86)  (83)  (95). 
Cantharides,  in  the  form  of  tincture,  or  in  connection  with  strychnia 
(291),  is  often  useful. 

If  the  retention  be  caused  by  inflammation  of  the  neck  of  the  blad* 
der,  leeches  should  ho.  applied  to  the  perineum,  and  three  or  four  drops 
of  croton  oil  may  be  rubbed  on  just  above  the  pubcs  to  bring  out  an 
eruption.  Warm  fomentations  will  also  be  serviceable,  and  warm 
hip  baths.  Cooling  diuretics,  as  infusions  of  marshmalJovv,  cleavers, 
pumpkin  seeds,  buchu,  sweet  spirits  of  nitre,  etc.,  must  not  be  omitted 

Inability  to  Hold  the  Urine. — Enuresis. 

This  complaint,  generally  called  incontinence  of  urine,  is  quite 
common  among  children.  In  some  cases  the  child  has  no  ability  to 
hold  its  water  at  any  time;  but  generally  it  is  only  passed  off  invol- 
untarily at  night  while  in  bed.  In  adult  life  it  is  less  frequently  met 
with,  except  among  the  old. 

Causes. —  Irritation  of  the  roots  of  the  spinal  nerves  which  go  to 
the  bladder,  mechanical  injuries  of  the  bladder,  palsy  of  the  bladder, 
particularly  in  old  people,  debility  of  the  neck  of  the  bladder,  a  gen- 
eral weakness  of  the  nervous  system,  worms  in  the  bowels,  piles* 
whites,  gravel  or  stones  in  the  bladder,  etc. 

Treatment*  —  As  a  general  rule,  the  change  of  constitution  which 
occurs  at  purberty  cures  this  complaint.  But  as  this  does  not  always 
happen,  it  is  important  that  pare  nts  do  everything  in  their  power  to 
break  it  up  early,  lest  it  become  an  atlliction  for  life. 

Children  who  suffer  from  this  disorder  are  apt  to  drink  largely. 
This;  habit  should  be  restrained.  But  little  drink  should  be  allowed, 
whatever  the  desire  for  ;t  Care  should  be  taken  that  the  child  make 
water  before  going  to  bed,  —  also  that  it  be  roused  at  a  late  hour  for 
the  same  purpose. 

The  skin  should  be  washed  all  over,  every  day,  with  cool  or  cold 
wat'jr,  and  vigorously  rubbed  with  a  coarse  towel.  This  will  cause 
the  excess  >■"  Huids  to  pass  cfF  through  the  skin,  and  lessen  the  action 
of  the  kid.    v  ' 

In  some  ii..  i-ances  children  urinal  e  in  bed  through  carelessness, — 
being  half  con;.oious  of  what  is  occurring,  but  not  caring  enough  to 
rouse  themselves.  In  such  cases,  they  are  often  cured  by  some  de- 
cided correction,  —  the  impending  act  of  passing  water,  connecting 
itself  In  their  minds  with  the  correction,  and  recalling  them  instantly 
to  full  consciousness.  Of  co'irse  this  mode  of  relief  should  be  resorted 
to  with  great  judgment  and  caution. 

When  the  complaint  proceeds  from  debility  or  relaxation  of  the 
iieck  of  the  bladder,  the  comix>und  infusion  of  trailing  arbutus,  and 

39 


(  i: 


'iii 


S'.-'^    I  '■'        '  !-■  ■■ 


the  isinglass  custard  found  among  dietetic  preparations,  may  be  used 
freely.  The  tincture  of  cantharides,  from  ten  to  forty  drops  to  chil- 
dren, may  be  given,  and  increased  gradually  to  a  hundred,  or  until  slight 
difficulty  is  felt  in  passing  the  water.  Then  stop,  and  give  the  articles 
mentioned  above.  Spirits  of  turpentine  is  useful  to  some  extent, 
given  also  in  small  doses,  and  continued  for  some  time. 

If  the  disorder  be  caused  by  irritation  of  the  spinal  nerves,  cold 
water  douched  upon  the  back,  or  croton  oil  rubbed  along  the  spine, 
or  a  warm  stimulating  or  irritating  plaster  upon  the  lower  part  of  the 
back,  will  be  reouired.  The  electro-magnetic  m?chine  may  do  well 
in  ^oine  cases. 


li% 


Urinary  Deposits.— Gravel.— Stone. 

Unnatural,  deposits  in  urine  are  to  be  regarded  simply  as  cvi- 
d  n^^es  of  changes  which  disease  is  making  in  the  body.  As  such 
tb  J  valuable,  —  more  valuable,  in  many  cases,  than  any  or  all 

othc,  iptoms  we  can  study,  and  most  valuable  from  the  ease  with 
which  i,.ey  may  be  investigated.  Yet,  but  very  few  physicians,  com- 
paratively, pay  any  special  attention  to  them,  or  make  any  effort  u) 
acquire  the  small  amount  of  knowledge  needed  for  their  detection. 

Sources  of  tlie  Urine.  —  The  urinary  secretion  has  three  sources. 
The  largest  bulk  of  it  comes  from  the  superabundance  of  drink  taken 
into  the  stomach.  This  is  shown  from  the  free  flow  of  pale  urine 
after  taking  copious  drafts  of  water  or  other  fluids.  Such  quantities 
of  water  as  an;  often  drank,  would  embarrass  the  functions  of  animal 
life,  were  it  not  pumped  ofl"  by  the  kidneys. 

A  second  source  of  supply  for  the  urinary  secretion,  is  to  be  found 
in  the  elements  of  imperfectly  digested  food,  and  also  some  abnormal 
elements  arising  from  incomplete  assimilation.  Oxalic  acid  is  a 
specimen  of  the  latter,  being  sometimes  largely  excreted,  in  dyspep- 
sia, soon  aft(  r  a  meal. 

The  third  source  of  urine  is  found  in  those  old  and  worn-out  atoms 
of  the  system,  which  can  serve  no  further  useful  purpose  in  the  ani- 
mal economy,  and  which  cannot  be  got  rid  of  by  the  lungs  or  skin. 
It  is  only,  however,  one  portion  of  the  dead  tissue,  namely,  that  which 
is  rich  in  nitrogen,  ^vhich  goes  out  through  the  renal  strainer, — an- 
other portion,  which  has  a  preponderance  of  inflammable  elements, 
carbon,  hydrogen,  and  perhaps  sulphur,  takes  the  outward  channol 
through  the  liver,  as  bile. 

Characteristics  of  Urine. — Healthy  urine  has  a  light  amber  color,  ia 
transparent,  and  has  different  degrees  of  density,  —  its  specific  gravity 
varying  from  1.003  to  1.030.  It  hasi  an  aromatic,  violet-like  smell, 
and  a  bitter,  disagreeable  taste,  like  salts. 

That  which  is  passed  a  little  time  after  drinking  largely,  is  pale, 
and  has  a  low  specific  gravity,  varying  from  1.003  to  1.009,  and  is 
called  urina  potus.  That  passed  soon  after  the  digestion  of  a  ivill 
meal,  is  called  urina  chpli,  or  urina  cibi;  it  has  a  specific  gravity  from 
V.020  to  1.030.     That  which  is  secreted  from  the  hlood^  and  is  passed 


ly  be  used 
ps  to  chil- 
iintil  slight 
;he  articles 
JIG  extent, 

erves,  cold 

the  spine, 

part  of  the 

lay  do  well 


ply  as  cvl- 
.  As  such 
any  or  all 
e  ease  with 
icians,  com- 
.ny  effort  tO 
letfiction. 

ree  sources. 

drink  taken 

f  pale  urine 

h  quantities 

of  animal 

to  be  found 
ne  abnormal 
acid  is  a 
in  dyspep 

n-out  atoms 
in  the  ani- 

mgs  or  skill. 

,  that  which 

rainer, — an- 
e  elements, 

ard  channel 

iber  color,  is 
cific  gravity 
t-like  smell, 

gely,  is  pale, 
.009,  and  is 
on  of  a  1  til 
gravity  from 
id  is  passed 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


307 


before  eating  or  drinking  in  the  morning,  is  called  urina  sanguinis ;  and 
has  a  specific  gravity  from  1.015  to  1.02o.  This  is  the  best  specimen 
of  the  average  density  and  nature  of  healthy  urine. 

Healthy  urine  contains  urea,  uric  acid,  sulphuric  acid,  phosphoric 
acid,  lime,  magnesia,  phosphate  of  soda,  etc.  It  is  only  when  these 
are  discovered  in  excess,  that  they  indicate  disease. 

Examination  of  Urine.  —  Let  a  piece  of  blue  litmus  paper  be  first 
dipped  in  the  urine  ;  if  it  be  acid,  the  color  of  the  paper  will  be 
changed  to  red,  or  reddish-brown.  Should  the  bine  color  remain  un- 
changed, then  use  yellow  tumeric  or  reddened  litnuis  paper ;  if  the 
urine  is  alkaline,  the  tumeric  \:\\\  become  brown,  and  the  reddened 
litmus  will  be  changed  to  blue.  If  the  color  in  both  cases  remains 
unaltered,  the  urine  is  neutral ;  that  is,  neither  acid  nor  alkaline. 

This  bein.T  done,  let  the  specific  gravity  be  taken.  This  is  easily 
done  by  the  urinometer  (Fig.  113).  This  instrument  is  known  also 
by  the  names  hydrometer,  and  gravimeter.  It  is  generally  fio.  \n. 
made  of  glass.  When  placed  in  distilled  water,  it  will  sink 
to  a  certain  point;  and  iis  all  bodies  immersed  in  fluid  dis- 
place a  bulk  equal  to  themselves,  it  follows  that  in  a  fluid 
denser  than  water,  the  instrument  will  not  sink  so  deep.  The 
space  above  the  large  bulb  is  marked  off  into  degrees  corres- 
ponding to  difFerent  densities.  When  this  instrument  is  im- 
mersed in  urine,  and  has  come  to  rest,  the  nuinbei  on  the 
graduated  scale,  which  stands  at  the  surface  of  the  liquid, 
when  added  to  1000,  will  represent  the  specific  gravity  of  the 
fluid,  ir.  At  example,  the  surface  of  the  liquid  corresponds 
with  9  on  th^  scale,  the  specific  gravity  of  the  urine  will  be 
1.009 ;  if  at  25,  it  will  be  1.025. 

By  attending  to  the  specific  gravity  of  the  urine,  the  phy- 
sician may  often  gain  important  i;  'brmation  respecting  his  patient, 
as  it  may  be  made  to  show  him  how  much  solid  matter  is  daily  car- 
ried out  of  the  body  through  the  kidneys.  This,  at  the  bed-sid  ,  may 
often  give  useful  hints  in  regard  to  treatment. 

The  following  table,  constructed  by  Dr.  Golding  Bird,  shows  at  a 
glance  the  amount  of  solid  matter  in  1000  grains  of  urine  of  different 
densities : 


BpeoiUo 
Gravity. 

Solid8.|  Water. 

Specific 
Gravity. 

Solids.  Water. 

auec.iflo 
Gravity. 

Solids 

Water. 

Specific 
Gravity. 

Solids. 

Water. 

1001 

2.33  997.67 

1011 

25.63  974.37 

1021 

48.93 

951.07 

1031 

72.23 

927.77 

\002 

4.66  996.34 

1012 

27.96  972.04 

1022 

51.26 

948.74 

1032 

74.66 

925.44 

1003 

6.99  {993.01 

1013 

80.29  969.71 

1023 

53.59 

946.41 

1033 

76.89 

92.i.ll 

1004 

9.32  990.68 

1014 

32.62  967.38 

1C24 

55.92 

944.18 

1034 

79.22 

920.78 

1005 

11.65 

988.35 

1015 

34.95  965.05 

1025 

58.25 

941.75 

1035 

81.55 

918.46 

1006 

13.98 

986.02 

1016 

37.23  962.72 

1026 

60.50 

939.42 

1036 

83.88 

916.12 

1007 

16.31 

983.69 

1017 

39.61  960.39 

1027 

62.91 

937.09 

1087 

86.21 

913.79 

1008 

18.64 

981.36 

1018 

41.94  958.06 

1028 

65.24 

934.76 

1038 

88.54 

911.46 

1009 

20.97  i979.03 

1019 

44.27  955.73 

1029 

67.57 

932.43 

1039 

93.87 

909.18 

1010 

23.30  976.70 

1020 

46.60  953.40 

1030  '69.90 

930.10] 

1040 

9320 

906.80 

The  mode  of  using  the  above  table  is  this.     Having  learned  the 
density  of  the  iirine  passed  in  twenty-four  hours  by  means  of  the 


^i 

1 

iHJ 

1 

1 

^1 

1  1. ' 


i:    ' 


,11' 


■>l;„ 


5  •■ 


urinometer  (Fig.  113),  a  glance  at  the  table  will  show  the  proportion 
of  solid  matter  and  water  in  1000  grains  of  the  urine.  Then,  by 
weighing  the  whole  quantity  of  urine  passed  in  twenty-four  hours,  the 
weight  of  solids  drained  off  by  the  kidneys,  may  be  determined  by  the 
simple  rule  of  proportion. 

Symptoms  of  (iraVel.  —  A  sudden  attack  of  pain  in  the  region  of 
the  kidneys,  so  acute  and  severe,  frequently,  as  to  cause  fainting,  and 
even  convulsions.  The  pain  runs  down  to  the  groin  and  thigh,  caus- 
ing a  numbness  on  the  affected  side,  and  a  drawing  up  of  the  testicle. 
The  pain  is  excessive  at  times,  and  then  remits.  Finally  it  stops  sud- 
denly. 

Leading  from  the  kidneys  to  the  bladder  are  two  small  tubes  about 
the  size  of  a  goose-quill,  called  ureters,  —  being  the  appointed  chan- 
nels of  the  urine.  The  pain,  of  which  I  have  spoken,  is  caused,  gen- 
erally, by  the  passage  of  a  stone  along  one  of  these  small  tubes.  If 
the  stone  happen  to  be  a  little  too  large  for  the  tube,  or  uneven  or 
ragged  upon  its  surface  so  as  to  bruise  and  tear  the  delicate  lining 
of  the  ureter,  severe  pain  is  the  result.  The  pain  is  intense  when  the 
stone  moves  along ;  remits  when  it  stops ;  and  suddenly  ceases  alto- 
gether, when  it  gets  through,  and  drops  into  the  bladder. 

Sometimes  there  is  no  pain,  the  gravel  being  so  fine  as  to  pass 
through  the  ureters  very  easily.  It  then  passes  through  the  urethra 
also,  and  is  found  as  a  sediment  of  the  urine  at  the  bottom  of  the 
vessel. 

These  urinary  deposits  are  various,  and  quite  unlike  each  other  in 
kind.  They  indicate  different  states  of  health,  and  require  to  be 
spoken  of  separately. 

Urio-Acid  Gravel. 

This  form  of  deposit  passes  indifferently  under  the  name  of  uric 
acid  gravel,  or  Hthic  acid  gravel.  The  person  who  is  in  the  habit  of 
passing  this  kind  of  deposit  largely,  ia  said  to  have  the  Uthic  or  uric 
acid  diathesis  or  condition. 


Fia.  114. 


Fro.  115. 


The  urine  of  persons  in  this  state  lets  fall  after  it  has  stood  awhile, 
a  reddish  sediment,  like  brickdust.  This  consists  chiefly  of  urate  of 
ammonia  (Fig.  114  and  115),  tinged  with  certain  coloring  matters. 


\m 


DISEASES  OF  THE  ABDOMINAL  CAVITT. 


309 


proportion 
Then,  \>y 
hours,  the 

ned  by  the 

1  region  of 
inting,  and 
high,  cau9< 
;he  testicle, 
stops  8ud- 

ubes  about 
nted  chan- 
aused,  gen- 
tubes.  If 
•  uneven  or 
icate  lining 
e  when  the 
ceases  alto- 

as  to  pass 
the  urethra 
ttom  of  the 

ch  other  in 
juire  to  be 


ime  of  uric 
he  habit  of 
ithic  or  uric 


tood  awhile, 

of  urate  of 

ing  matters. 


This  coloring  substance  may  be  more  or  less  abundant,  and  give  to 
the  deposit  various  shades,  as  dirty-white,  yellow,  pink,  and  red.  The 
Fio.  H6.  pure  uric  acid  sometimes  ap))ears  as  fine 

sand,  or  large  crystals  (Fig.  116).  The 
urine  is  of  a  dark  copper  color,  about  like 
brown  sherry,  and  is  more  scanty  than  in 
hoalth.  It  is  also  higlily  acid,  giving  to 
litmus  paper  a  dccjicr  shade  of  red. 

Persons  who  pass  this  kind  of  gravel 
largely,  are  apt  to  he  troubled  with  in- 
flammatory complaints;  with  acidity  of 
stomach  and  heartburn  ;  and  some  of 
them  with  gout  and  rheumatism. 

Placed  under  a  blowpipe,  uric  acid  is 
decomposed,  and  gives  out  an  odor  like 
that  of  burnt  feathers,  combined  with  the 
oil  of  bitter  almonds.  It  is  dissolved  by 
liquor  potassa,  from  whi(;h  muriatic  and 
nitric  acids  precipitate  it;  and  by  sulphu- 
ric acid,  from  which  it  is  preci|)itated  by  water.  Acetic,  nitric,  and 
muriatic  acids,  alcohol,  ether,  and  water,  do  not  dissolve  it. 

Causes. —  Uric  acid  is  the  .form  in  which  nitrogen  and  the  effete 
compounds  which  contain  it  are  got  out  of  the  body.  It  is  the  result 
of  the  decomposition  of  the  tissues  of  the  body.  Its  gravelly  particles 
are  the  sands  of  life  daily  washed  out  of  us,  —  reminding  us  always 
that  we  are  wasting  away.  Whatever  causes  the  body  to  waste  rap- 
idly, produces  it  in  excess.  We  find  it,  therefore,  in  the  urine  of 
those  who  suflcr  from  gout,  rheumatism,  dys|)(!psia,  fevers,  debility 
of  the  genital  organs,  straining  of  the  loins,  etc.,  which  produce  loss 
of  flesh. 

Treatnirilf. —  The  remedies  for  this  uric  acid  gravel  are  the  alkalies, 
bicarbonate  of  potash,  bicarbonate  of  sodiA  and  magnesia.  The  first 
named  is  generally  the  best.  It  may  b(!  used  in  the  form  of  the  neu- 
tralizing extract,  —  especially  if  there  be  costiveness.  If  the  bowels 
do  not  need  physic,  let  the  potash  be  taken  in  the  shape  of  lye  made 
from  hard-wood  ashes  (:300).  Fluid  magoesia  is  an  excellcMit  remedy; 
BO  is  licjuor  potassa,  taken  in  tw(!nty  or  tliirty-drop  doses.  Tll(^  urine 
must  be  watched,  and  these  remedies  discontinued  when  it  becomes 
alkaline. 

At  the  same  time  the  stomach  should  be  supported  by  some  hitter 
tonic,  as  the  infusion  of  quassia,  gentian,  columbo,  Peruvian  bark,  etc. 

Iron  is,  in  many  eases,  not  to  be  overlooked.  If  the  patient  be 
pale  and  bloodless,  some  of  the  preparations  of  this  metal  will  be 
needed  (61)  (78)  (74). 

Acids  must  be  carefully  avoided,  both  in  food  and  drink. 

The  diet  nmst  be  plain,  digestible  and  nourishing,  and  quite  mod- 
erate in  amount.     The  qvality  is  of  less  consetjuence  than  the  f/uantit//. 

Exercise  is  of  great  consequeaice,  and  must  be  regular,  and,  if  pos- 
sible, in  the  open  air. 


1 1 


m\ 


k  /' 


iJ. 


I  "!  i 


310 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


The  skin  must  receive  daily  attention  in  the  shape  of  an  alkaline 
sponge  bath,  with  friction.  This  will  throw  upon  the  skin  much  of 
the  labor  done  by  the  kidneys. 

Phosphatic  Deposits. 

Thesk  deposits  are  indicated  by  a  state  of  the  urine  just  the  oppo- 
site of  that  which  contains  the  uric  acid  gravel.  They  are  contained 
in  urine  which  is  either  alkaline  when  passed,  or  becomes  .so  very  soon 
by  standing. 

As  the  urine  cools,  a  white  sand  falls  to  the  bottom,  and  frequently 
a  film  forms  upon  the  surface  of  the  water.  Looking  at  this  film  in 
different  lights,  you  may  see  in  it  the  several  colors  of  the  rainbow. 
Skim  off"  tnis  pellicle,  place  it  upon  paper,  and  let  it  dry ;  and  you 
may  then  see  the  little  shining  crystals.  This  urine  quickly  grows 
putrid  and  offensive.  Sometimes  it  smells  strongly  of  ammonia. 
The  more  phosphates  it  contains,  the  sooner  it  becomes  alkaline. 

These  deposits  are  generally  the  triple  phosphates.  Healthy  urine 
contains  the  phosphate  of  magnesia  in  a  state  of  solution.  Under 
some  circumstances,  the  urea  of  the  urine  is  decomposed  in  the  kid- 
neys, and  ammonia  is  disengaged.  This  combines  with  the  phosphate 
of  magnesia,  and  forms  the  triple  salt  of  the  phosphate  of  ammonia 
and  magnesia,  which  is  not  soluble. 

Symptoms.  —  A  sallow  complexion,  a  languid,  spiritless  state  of 
mind,  and  an  exhausted,  debilitated  condition  of  body.  The  urine  is 
pale,  rather  copious,  slightly  turbid,  has  a  low  specific  gravity,  and 
smells  unhealthy,  having  sometimes  the  faint  odor  of  weak  broth. 
There  is  generally  derangement  of  the  digestive  organs,  windy  stom- 
ach and  bowels,  nausea,  constipation,  or  diarrhtEa,  stools  of  various 
colors,  and  sometimes,  in  diarrhoea,  resembling  yeast,  and  an  aching 
pain  and  v.eakness  in  the  loins. 

Causes.  —  These"  deposits  are  produced  by  great  debility  of  the 
constitution,  by  injuries  of  the  spine,  dyspepsia,  defective  assimula- 
tion  of  food,  bad  diet,  irritation  of  the  neck  of  the  bladder,  and  or- 
inranic  diseast^  of  the  kidneys.  But  they  are  caused  more  es|iecially  by 
whatever  wears  and  exhausts  the  nervous  st/stem,  as  heavy  cares,  de- 
pression of  spirits,  sedentary  habits,  great  mental  exertions,  mastur- 
bation, and  venerea!  excesses. 

Treatment. — These  deposits  being  connected  with  great  debility, 
care  must  he  taken  not  to  make  the  matter  worse  by  taking  active 
purgatives,  by  extreme  fasting,  or  by  any  means  which  will  increase 
the  weakness. 

On  the  contrary,  the  strength  must  be  supported  by  all  the  mean.'* 
that  can  be  commanded.  With  this  view,  the  citrate  of  iron  P5} 
may  be  taken.  Morphia  combined  with  iron  (80),  to  allay  irritability, 
and  impart  strength  at  the  same  time,  may  be  used.  The  valerianate 
of  iron  (93)  is  excellent  for  the  same  purpose. 

Connected  with  a  state  of  urine  just  the  opposite  to  that  which 


rery  soon 


increase 


DISEASES  OF  TlIK  ABDOMINAL  CAVITY. 


811 


holds  the  uric  acid  deposits,  this  form  of  gravel  calls  for  the  opposite 
rt'tnedies.  Instead  of  the  alkalies,  the  acids  are  wanted.  The  nitric 
and  muriatic  acids,  with  a  vegetable  tonic  (76),  may  be  used.  Opium 
is  spoken  of  in  high  terms,  and  is  thought  by  some  to  have  great 
|M)vvcr  in  turning  alkaline  urine  acid.  The  compound  balsam  of  sul- 
phur is  highly  spoken  of,  and  the  compound  infusion  of  trailing  arbu- 
tus is  also  mentioned  with  approbation. 

It  is  all-important  to  throw  off  care,  and  to  give  the  mind  a  chance 
to  rise  up  with  all  the  elasticity  it  has.  To  bring  this  about,  journeya 
and  amusements  are  useful.  The  society  of  livt-ly,  laughing,  witty 
friends  will  do  a  great  deal  to  give  the  spirits  a  rebound,  and  the 
whole  health  an  upward  movement.  Such  jjersons  an;  a  blessing  to 
the  world  ;  and  he  who  reckons  a  few  of  them  atnong  his  friends  will 
live  the  longer  for  it. 

The  skin  should  have  the  benefit  of  tiie  daily  tonie  effect  of  a 
sponge  bath,  with  water  at  first  tepid,  and  afterwards  cool ;  and  exer- 
cise, out  of  doors,  should  be  habitual,  and  connected,  as  mueli  as  pos- 
sible, with  objects  of  pleasure. 

The  drinking  of  hard  water  is  highly  injurious;  and  if  none  other 
can  be  had,  it  should  be  distilled,  and  then  spread  out  to  the  atmos- 
phere, in  shallow  vessels,  that  it  may  recover  its  pleasant  taste  by 
reabsorbing  air  and  carbonic  acid. 

Oxalic  Deposits. 

Oxalate  of  lime  in  the  urine  is  the  cause  of  this  kind  of  gravel 
It  appears  in  the  form  of  dumb-bells,  and  octahedral  crystals.  (Figs. 
117,  118,  and  119.) 


Fio.  117. 


Fio.  U8. 


Fio. lift 


The  urine  has  a  specific  gravity  of  1.015  to  1.025,  and  is  generally 
of  a  dark  amber  color,  and  clear,  and  bright ;  it  is  generally  acid, 
though  occasionally  alkaline  or  neutral.  Urea  is  generally  found  in 
it,  and  epithelial  cells  (Fig.  120).  Unlike  the  uric  and  phosphatic 
urines,  it  is  quite  free  from  sediments,  except,  as  often  happens,  there 
is  a  large  amount  of  urea  in  it,  in  connection  with  the  oxalate  of 
lime. 

When  the  urate  of  ammonia  is  combined  with  the  oxalate  of  lime, 
it  often  happens  that  the  latter  has  to  be  dissolved  with  a  little  liquor 
potassa,  before  the  former  can  be  seen  with  the  microscope. 


'  I 


r  m 


>\  ; 

w 


H   ,V.  '■'•'■1-f"' 


i 


312 


DISEASES  OP  THE  ABDOMINAL  CATITY. 


Fio  120. 


Symptoms.  —  Great  depression  of  spirits,  excitable  state  of  the  ner- 
vous system,  painful  susceptibility  to  external  impressions,  dyspeptic 
symptoms,  and  disturbances  of  the  liver,  a  fear 
and  dread  of  consumption,  emaciation,  inability 
to  make  exertion,  —  the  smallest  exertion  caus- 
ing fatigue,  —  in  men  a  doficient  sexual  power, 
a  pain  and  weiglit  across  the  loins,  and  some 
irritability  of  the  bladder. 


Causes. —  These  deposits  are  supposed  to  re- 
sult, like  most  other  deraiigeinents  connected 
with  loss  of  Hesh,  in  too  great  a  degree  of  oxi- 
dation. Vegetables  produce  oxalic  acid  by  just 
the  opposite  proc(;ss,  namely,  dcoxidation. 

Whatever  depresses  the  vital  powers,  may  generate  this  deposit  t 
as  mental  depression,  overwork  of  the  brain,  burdensome  cares,  idle- 
ness of  mind  or  body,  masturbation,  debaucheries,  intemperance,  vene- 
real excesses,  and  injuries  of  the  spine. 

This  deposit  may  also  be  produced  by  certain  articles  of  diet,  which 
contain  the  oxalic  acid.  Among  these  may  be  named  the  rhubarb 
plant,  which  in  summer  is  largely  used  for  tarts  ;  and  sorrel. 

Treatment. —  The  treatment  for  these  deposits  should  be  very  much 
like  that  for  the  phosphatic.  The  stomacli  and  liv<!r  should  receive 
some  special  attention.  A  pill  of  leptandrin,  podophyllin,  etc.  (39), 
may  be  used  with  advantage.  The  preparation  of  nitric  and  hydro- 
chloric acids  (7G)  nmst  generally  be  taken  for  some  time.  In  cases 
of  great  irritability,  the  sulphate  of  zinc  (8:2)  does  well. 

The  diet  should  be  plain,  digestible,  and  nourishing,  —  all  articles 
containing  the  oxalic  acid  being  rejected,  as  the  rhubarb  plant,  sorrel, 
tomatoes,  onions,  etc. 

For  the  rest,  follow  the  directions  for  the  treatment  of  phosphatic 
deposits. 

Urate  of  Ammonia  Deposits. 

TuE  urine  which  contains  these  deposits  is  generally  pale,  and  of 
low  specific  gravity,  about  1.012.  It  becomes  opaque  on  cooling, 
from  the  deposition  of  a  nearly  white  urate  of  amtnonia.  Instead  of 
falling  down  readily,  this  forms  ropy  masses  in  the  fluid,  and  looks 
like  mucus  or  j)us,  or  something  between  the  two.  Its  real  nature  is 
discovered  by  applying  a  little  heat,  which  (juickly  dissipates  it. 

Microscopic  Cliiiract^rs. —  Place  a  drop  of  this  turbid  urine  between 
two  slips  of  glass,  and  examine  it  closely  with  a  microscope ;  you 
will  see  myriads  of  minute  globules  adhering  together  in  linear 
masses.  Now  place  a  drop  of  the  turbid  urine  in  a  watch-glass,  and 
gently  warm  it ;  as  soon  as  it  has  become  clear,  add  a  drop  of  hydro- 
chloric acid  to  it,  and  when  it  is  cold,  examine  it  with  the  microscope. 
The  muddiness  will  be  gone,  and  you  will  now  see  lozenges,  or  thick 
cohering  prisms  of  uric  acid  (Fig.  121).     The  explanation  of  this  id, 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


sn 


that  the  hydrochloric  acid  combines  with  the  ammonia,  forming  muri* 
ate  of  ammonia  in  solution,  and  liberating  the  uric  acid  crystals. 


Fio.  121. 


Fio.  133. 


Urate  of  soda  (Fig.  122)  is  sometimes  found  in  urine,  which  Aas 
similar  chemical  roiictioiis  with  unite  of  atnirionia. 

Causes. —  These  deposits  are  generally  produced  by  some  overeat- 
ing, or  derangement  of  the  skin. 

The  treatment  is  the  same  as  that  for  uric  acid  gravel. 


M\ 

*''*■  -'-ill 


Hippuric  Acid  Deposits. 

Thrse  deposits  a])j)ear  in  the  healthy  urine  of  the  cow  and  the  horse ; 
and  also  in.  that  of  human  beings,  but  in  such  siiiuil  (piaiitities  as  to 
be  scarcely  appreciabl(\ 

They  sometimes,  however  appear  in  unhealthy  proportions;  but 
they  never  show  tiiemsclves  as  a  sediment,  until  after  the;  addition  of 

a  stronger  acid.     TIk;  urine  containing  them  is 
Fio.  123.  generally  slightly  acid   or   neutral,  —  sometimes 

alkaline,  —  having  a  low  speeifK!  gravity,  from 
1.00()  to  1.008.  The  tripl(!  j)li()spliates  are  often 
found  in  it. 

To  detect  these  desposits,  fill  a  large  watch- 
glass  with  urine,  and  evaporate  it,  over  a  lamp  to 
a  few  drop; .  Then  add  to  it  about  half  its  bulk 
of  hydrochloric  acid,  and  set  it  aside.  The 
additioi:  of  the  acid  produces  a  bright  pink 
color,  and  an  odor  like  new  hay.  After  a  few 
hours,  if  the  hippuric  acid  be  present,  its  peculiar  crystals  will  be 
seen.     (Fig.  123.) 

Cause.  —  In  man,  this  deposit  is  supposed  to  d(>pend  on  the  al>- 
sence  of  food  having  a  good  share  of  nitrogen.  Tin;  urine  of  vege- 
table eaters  contains  it  in  largest  quantiti(!s. 

Treatnieut.  —  The  only  treatment  required  is  a  diet  composed  in 
good  proportion  of  animal  food,  a  j)roper  attention  to  the  skin  by 
bathing,  etc.,  and  when  debility  exists,  tonic  medicines,  as  iron  and 
bitters,  with  out-door  exercise  enough  to  keep  the  muscles  in  working 
order. 


B14 


DISEASES  OF  THE  ABDOMINAL  CAVITT. 


Cystine  Deposits. 

The«e  do  not  occur  in  healthy  urine,  and  rarely  as  an  clement  in 
diseased  action.     They  contain  twenty-Hix  per  cent  oi  sulphur. 

Urine  which  contains  cystine  in  of  a  pale  yellow  color,  and  has  a 
low  specific  gravity.  It  frequently  has  an  oily  appearance,  and  its 
smell  is  peculiar,  resembling  that  of  sweet  brier.  Sometimes  its  odor 
is  fetid,  like  putrid  cabbage.  On  being  kept  for  a  short  time,  it  has 
its  surface  covered  with  a  pellic^le  which  looks  oily,  and  consists  of  a 
mixture  of  crystals  of  cystine,  and  the  phosphate  of.  ammonia  and 
magnesia. 

The  cystine  deposit  apj)ears  to  be  diffused  through  the  urine,  which 
is  alway^  turbid  when  boiled.  It  is  a  white  or  fawn-colored  powder, 
and  falls  to  the  bottom  as  a  seidment.  It  undergoes  no  change  by 
warming  the  urine,  and  this  distinguishes  it  from  white  urate  of  am- 
monia. It  is  not  soluble  in  diluted  hydrochloric  or  strong  acetic  acid, 
which  distinguishes  it  again  from  the  earthy  phosphates. 

To  test  this  deposit,  add  licpior  ammonia  to  u  portion  of  it,  and 
shake  them.  If  the  deposit  be  cystine,  it  will  dissolve  readily.  Allow 
a  few  drops  of  the  solution  to  evaporate  on  a  slip  of  glass,  and  the 
six-sided  tables  of  cystine  will  remain,  which  may  be  examined  under 
the  microscope.     (Fig.  124.) 


Fio.  124. 


Fia.126. 


rxr  1» 


•  o 


It  is  to  be  remembered  that  occasionally  the  chloride  of  sodium  or 
common  salt  crystalizes  in  octahednil  forms  (Fig.  IS-'}),  whi(tli,  in 
some  positions,  may  look  very  much  like  cystine.  Tlie  ready  solu- 
bility of  the  chloride  in  water,  and  the  absence  of  all  color  when  they 
are  examined  by  polarized  light,  will  prevent  mistaking  these  crystals 
for  cystine.  If  urine  containing  common  salt  be  quickly  evaporated 
on  a  slip  of  glass,  and  be  then  examined,  instead  of  the  octahedrons, 
we  find  crosslets  and  dagsfcrs.     (Fig.  126.) 


*&&'• 


Causes. —  An  excess  of  sulphur  in  the  tissues,  a  scrofulous  consti- 
tution, and  hereditary  predisposition,  with  defective  oxidation,  and 
torpidity  of  the  liver.  It  is  often  found  in  the  urine  of  girls  who  have 
the  green  sickness.-      *       *  . 

Treatment — The  great  object  is  to  improve  the  general  health, 
which  is  to  be  done  by  attending  to  the  skin,  and  the  administration 


'P    \    .: 


i:::l 


OI8EASRS  OF  THE  ABDOMINAL  CAVITY. 


316 


of  iron  and  bitters,  and  also  alteratives.  The  syrup  of  iodide  of  iron 
is  a  valuable  remedy.  Podopliyllin  and  leptandrin  (34)  are  wanted 
to  regulate  the  liver.     The  nitro-niuriatie  ac^id  (7())  should  be  tried. 

The  daily  sponge  bath,  and  daily  exercii^e,  us  in  niUiiit  chronic  com- 
plaints, muat  on  no  account  be  neglected. 

Stone.— Calculus. 

It  often  happens  that  the  proper  treatment  for  removing  urinary 
deposits  is  not  adopted  in  s(;iison.  In  such  cuscjh,  gravelly  particles, 
tinding  a  lodgment  for  u  time,  in  the  kidneys  or  bhidder,  are  apt  to 
draw  other  particles  to  themselves,  which  become  fast^MU'd  to  them, 
and  form  a  layer  quite  round  them.  Over  this,  other  layers  form  in 
succession,  until  a  stone  is  produced  so  large  that  it  eannot  pass  oiX. 
These  grow  to  various  sizes,  —  being  sometimes  so  large  as  to  till  the 
bladder. 

Uric  Acid  Calculus.  —  The  most  common  of  these  formations  i«  tlie 
uric  acid  calculus.  It  is  generally  smooth  or  slightly  tuberculated  on 
the  surface,  and  varies  in  color  from  a  pale  yellowish-fawn,  to  a  red- 
dish-brown. When  sawn  through  the  centre,  its  layers  will  be  found 
tolerably  regular,  but  of  diHerent  thickness.     (Fig.  127.) 

To  test  it,  place  a  small  fragment  upon  platinum  foil  under  the 
blowpipe.  If  uric  acid,  it  blackens,  and  gives  out  an  odor  like  burnt 
feathers  mixed  with  the  oil  of  bitt< .  almonds. 


Flo.  137. 


Fio.  128. 


Fio.  129. 


Mixed  Cillfulus. —  These  calculi  are  frequently  composed  of  two  or 
more  ditl'erent  kinds  of  matter  arranged  in  irregular  layers.  Fig.  128 
is  a  mixed  calculus,  —  the  dark  layers  being  oxalate  of  lime,  the  light 
ones,  uric  acid. 

In  testing  such,  fragments  of  each  ingredii^nt  should  be  separately 
examined. 

Urate  of  Ammonia  Calculus. —  We  occa.sionally  meet  with  a  caK 
cuius  composed  of  the  urate  of  ammonia.  These  calculi,  vvhen  found, 
are  generally  small  in  size,  smooth  or  slightly  tuberculated  upon  the 
surface  (Fig.  129),  and  of  a  pale  slate  or  clay  color.  When  heated 
before  the  blowpipe,  it  gradually  disappears. 

Phosphate  of  Lime  Calculus. —  This  has  a  smooth  polished  surface, 
and  quite  regular  layers,  which  separate  easily  when  the  calcubis  is 
cut  asunder.     It  has  a  pale  fawn  or  stone  color.     (Fig.  130.) 


\    ■ 


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! 

1 

i 

i 

!i' 

(  . 

I 

( 

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ii^^ 


!i  I 


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7S^. 


^  chars  before  the  blowpipe,  and  gradually  becomes  white  as  the 
carbon  burns  away.  Diluted  nitric  o"  hydrochloric  acid  dissolves  it 
without  efFervescence. 

Oxalate  of  Lime  Calculus.  —  This  is  frequently  met  with  unconi- 
bined  with  others,  but  more  generally  its  nucleus  is  uric  acid  or  unite 
of  lime.  It  commonly  li:xs  a  brown,  dark  olive,  or  dirty-jMirpie  color. 
Its  sui-face  is  irregular  and  somewiiat  rough.  It  looks  like  the  fruit 
of  the  mulberry,  tind  is  known  as  the  mulbern/  calculus.     (Fig.  lol.) 

It  dissolv'K  without  ctiervcsccnce,  in  dilutc^d  nitric  or  hydrochloric 
acid.  When  f^ius  dissolved,  the  addition  of  a  little  anuuonia  will 
cauise  it  to  fall  vo  the  bottom  as  a  white  precipitate.  '' 


Fio.  lao. 


Fia.  131. 


Fio.  132. 


Fusible  Calculus. —  This  is  a  mixture  of  phosphate  of  lime,  and  thr 
phosphate  of  ammonia  and  ma^.'csia.  It  is  the  most  common  of 
all  the  calculi,  except  the  uric  acid.  It  has  an  oval,  irregular  form 
(Fig.  132),  and  is  white,  soft,  and  ''riablc,  like  chalk.  tSometimes  it  is 
hard. 

It  may  be  known  by  the  readiness  with  which  it  melts  down  before 
the  blowpipe,  without  being  consumed. 

Causes.  —  The  causes  of  the  diHerent  kinds  of  gravel  Lave  been 
already  explained.  (Generally  stones  of  the  bladder  are  formod  in  the 
kidney,  and  descending  through  the  ureters  into  the;  bladder,  are  pre- 
vented from  passing  out  through  the  water-pipe  by  an  enlarged  pros- 
trate gland.  Remaining  in  the  bladder,  they  soon  get  encrusted  over 
by  other  matters  in  the  urine,  and  grow  by  accretkin  to  be  stones. 

Syniptoiais. —  When  a  stone  in  the  bladder  reaches  a  certain  size, 
especially  if  it  is  rough,  it  always  produces  sutlcring.  A  dull,  annoy- 
ing pain  is  felt  at  the  end  of  the  penis.  Th'^  desire  to  make  water  y 
frequent,  and  there  is  a  siMise  of  wcMglit  in  the  perineum.  Sometime;^ 
the  stream  of  urine  is  suddenly  stopped  by  the  stone  falling  on  the 
orifice  of  the  urethra.  As  the  bladder  becomes  ni!iu-ly  emptied,  it 
embraces  the  stone,  and  the  pain  is  increased.  Jolting  in  a  carriage 
cau.ses  great  pain.  Mrcus  pas.ses  off  with  the  urine,  and  soiaetimes 
blood.  Art(>r  a  time,  the  appetitt;  fails,  hectic  sets  in,  albumen  ap- 
pears in  the  urine,  and  the  patient  sinks  under  inllummation  of  the 
bladder. 

These  symjjtoms  being  found  in  diseases  of  the  kidneys  and  blad- 
der, no  one  is  authorized  to  pronounce  upon  the  existence  of  stone, 
until  tfie  stone  has  been  touched  by  a  inetalio  sound  introduced  into 
the  bladder. 


^^•«: 


i»'J:ii^ 


ite  as  thf 

issclves  it 


1  uncom- 

.1  or  uriito 

r|)lc'  color. 

1li«!  fruit 

ii,'.  135.) 
(Irocliloric 
loiiia  will 


'I 


o.  132. 


'  '■'■'^S';  ■? 


e,  and  tht 
iininoii  ot" 
ular  form 
times  it  is 

wii  before 


Lave  hoen 
iw(]  ill  the 
r,  are  pre- 
rged  pros- 
usted  over 

itOlKJS. 

rtain  size, 
ill,  annoy- 
e  water  if 
iometime^ 
Hi;  on  the 
'mptied,  it 
a  carriage 
soiuetimes 
mnien  ap- 
ion  of  tlie 

and  blad- 
i  of  stone, 
lueed  into 


Treatment-  —  The  only  effectual  treatment  is  a  choice  between  two 
operations,  —  lithotrity  and  IWiotomy. 

The  former  consists  in  introducing  an  instrument,  a  kind  of  forceps, 
into  the  bladder,  through  the  urethra,  taking  hold  of  the  stone,  ana 
crushing  it.  The  preparatory  treatment  consists  in  correcting  the  un- 
healthy state  of  the  urine,  and  the  frequent  introduction  of  bougies  or 
sounds  to  enlarge  the  water-pi [je  for  the  easy  entrance  of  the  crush- 
ing forceps.  The  after  treatment  consists  in  diluent  drinks  to  increase 
the  urine,  injections  of  warm  water  to  wash  out  the  fragments,  with 
hip  baths,  soothing  injections,  and  leeches  or  cupping  upon  the  peri- 
neum. 

Lithotomy  consists  in  making  an  incision  into  the  bladder  through 
the  perineum,  and  taking  out  the  stone  or  stones  whole. 

Dropsy  of  the  Belly. — Ascites. 

This  is  a  collection  of  v/ater  in  the  cavity  of  the  belly;  sometimes 
the  fluid  is  outside  of  the  peritoneum,  and  next  to  the  muscles. 

Symptoms. —  An  enlargement  of  the  belly,  with  a  sense  of  disten- 
sion and  weight,  —  particularly  on  the  side  on  which  the  patient  lies. 
When  the  collection  of  water  is  large,  the  breathing  becomes  short 
and  ditlicnlt,  and  the  swelling  is  uniform  over  the  whole  aodomen. 

In  some  insti^uces  the  iluetuation  of  the  water  may  be  distinctly 
heard  when  the  patient  moves  about, — just  as  we  may  hear  the 
water  in  a  half-filled  barrel  when  it  is  rolled  over.  This  sound  of  the 
fluid,  when  heard,  distinguishes  the  complaint  from  pregnancy,  and 
from  the  drum-head  state  of  the  bowels.  This  fluctuation  mi*y  some- 
times be  produced  by  pressing  upon  one  side  of  the  belly  while  the 
patient  is  standing  or  sitting,  and  striking  the  other  side  with  the  enrls 
of  the  fingers  of  the  other  hand. 

In  some  cases,  there  is  loss  of  appetite,  dry  skin,  costiveness,  scanty 
urine,  oppression  of  the  chest,  cough,  colic  pains,  and  variable  pulse. 

Causes. —  A  frequent  cause  of  this  complaint  is  chronic  inflamma- 
tion of  the  serous  membrane  which  lines  the  abdomen,  —  I  mean  the 
peritoneum.  It  may  also  be  produced  by  scarlet  fever,  fever  and 
ague,  disease  of  the  heart,  particularly  dilatation  of  the  right  cavities/ 
and  diseases  of  the  liver,  particularly  the  shrivelled,  hobnail  condition 
of  the  liver,  —  in  short,  whatever  <:  auses  a  pressure  upon  the  portal 
veins,  and  obstructs  the  venous  blocd  returning  from  the  intestines. 

Treatment. —  The  remedies  i.ir  this  disease  are  mainly  diuretics 
and  purgatives.  The  bowels  may  sometimes  be  reduced  in  a  few 
days  from  an  enormous  size,  by  medicines  which  excite  the  action  of 
the  kidneys.  Digitalis,  combined  with  acetate  of  potash,  etc.  (130), 
forms  an  excellent  pniparation.  The  patient  should  have  as  a  con- 
stant drink,  a  strong  infusion  made  from  two  parts  of  h.*".-cap  moss, 
and  one  each  of  juniper  berries  and  dwarf  elder  bark ;  also  an  infu- 
sion of  queen  of  the  meadow. 

The  purgatives  used  iu  this  complaint  are  those  which  produce 


n 


I.  \M\ 


318 


BWRASRS  OP  THE  ABDOMINAL  CAVITY. 


watery  stools.  One  of  the  best  of  these  is  elateriurn.  It  will  some- 
times carry  off  the  water  with  great  rapidity ;  combined  with  some 
active  cathartics  (31),  it  will  have  all  its  good  effects  without  the 
griping  it  is  apt  to  occasion  alone. 

Cream  of  tartar,  taken  in  large  doses,  every  day,  will  sometimes  do 
well.     Epsom  salts  produces  watery  stools,  and  is  a  good  remedy. 

For  promoting  absorption  of  the  fluid,  the  iodide  of  potassium, 
taken  in  from  three  to  ten-grain  doses,  three  times  a  day,  is  a  valua- 
ble medicine  in  many  cases.  The  compound  infusion  of  parsley  is 
said  to  be  still  better. 

The  skin  must  receive  careful  attention.  The  alkaline  sponge  bath, 
with  friction,  will  increase  the  transpiration  of  fluid  through  that 
organ.  Exercise  does  much  to  keep  up  an  active  circulation,  and  to 
lessen  dropsical  effusions. 

The  strictest  temperance,  both  in  eating  and  drinking,  must  be 
observed.  A  light  and  nourishing  diet,  with  water,  tea,  and  the 
diuretics  named  above  for  drinks ;  beyond  these  the  patient  must 
not  go. 

A  kneading  and  shampooing  of  the  bowels  once  a  day  has  an  ex- 
cellent effect ;  it  gives  activity  to  the  circulation  in  obstructed  veins. 
A  bandage  tied  close  around  the  bowels,  and  tightened  as  the  water 
diminishes,  has  an  effect  upon  the  sluggish  vessels  similar  to  that  of 
the  laced  stocking  in  varicose  veins  of  the  legs.  It  lessens  the  liabil- 
ity of  a  return  of  the  complaint. 

Dropsy  of  the  Cells.— General  Dropsy. — Anasarca. 

Just  under  the  skin  is  a  membrane  composed  chiefly  of  cells,  called 
the  cellular  membrane.  When  a  considerable  part,  or  the  whole  of 
these  cells  are  filled  with  a  watery  fluid,  we  call  the  complaint  ana- 
sarca, or  cell  dropsy.  If,  beside  this,  there  is  a  collection  of  water  in 
the  large  cavities,  we  give  it  the  name  of  general  dropsy. 

Symptoms.  —  The  disease  generally  begins  with  a  swelling  around 
the  ankle  and  leg,  which  is  more  visible  at  night  after  standing  and 
walking,  and  is  less  perceptible  in  the  morning  in  consequence  of  the 
horizontal  posiiion  of  the  night.  To  the  touch  of  another  person, 
dropsical  feet  and  legs  feel  a  little  colder  than  natural;  and  when  hard 
pressed  with  the  finger,  a  pit  will  be  sunk  in  the  flesh,  which  remains 
some  time  before  it  fills  up.  As  the  disease  advances,  the  skin  of  the 
legs  becomes  smooth,  shining,  and  sometimes  even  cracks  open  to  let 
out  the  water.  The  limbs,  and  indeed  the  whole  person  become  stift^ 
heavy,  and  clumsy. 

As  the  disease  advances,  and  ascends  to  the  belly  and  chest,  there 
is  shortness  of  breath,  a  sense  of  suffocation  on  moving  or  lying 
down,  a  tightness  and  distress  across  the  epigastrium,  thirst,  dryness 
of  skin,  wakefulness,  loss  of  appetite,  scanty  and  deep-colored  urine, 
and  a  slow  fever. 

Causes.  —  General  dropsy  is  caused  by  whatever  weakens  the  gen- 
eral system,  and  by  such  circomstances  as  obstruct  the  circulation  in 


mm 


11  Bome- 
th  some 
lout  the 

times  do 
ledy. 
itass'mm, 
a  valua- 
>arsioy  is 

ige  bath, 
ugh  that 
1,  and  to 

must  be 

and  the 

;nt  must 

18  an  ex- 
ted  veins, 
he  water 
;o  that  of 
the  liabil- 


isarca. 

Us,  called 
whole  of 
aint  ana- 
water  in 

g  around 
ding  and 
ice  of  the 
r  person, 
/hen  hard 
1  remains 
tin  of  the 
36  n  to  let 
ome  stiflj 

lest,  there 
or  lying 
t,  dryness 
red  urine, 

s  the  gen- 
alation  in 


DISEASES  OF  THE  ABDOMINAL  CAVITY. 


319 


the  veins.     The  most  frequent  causes,  therefore,  are  certain  diseases 
of  the  heart  and  kidneys. 

Explanation.  —  Modern  physiology  has  demonstrated  that  the  veins 
do  a  certain  part  of  the  work  of  absorption.  The  serous  membranes 
which  line  the  larger  cavities  of  the  body  (exhale  watery  fluid  enough, 
and  no  more  than  enough,  to  keep  them  moist,  and  cause?  the  organs 
within  to  play  smoothly  upon  their  surface.  If  the  fluid  were  not 
taken  away  as  fast  as  it  is  poured  out,  the  cavity,  —  being  a  shut  sac, 
• — would  become  full,  and  we  should  have  dropsy.  It  is  the  office  of 
the  veins  to  absorb  this  fluid  and  convey  it  away  in  the  general  cur- 
rent of  the  blood. 

This  is  the  method  of  their  doing  it :  The  walls  of  the  veins  are 
so  constructed  as  to  permit  watery  fluids  to  pass  throij^'h  thevi,  either 
in  or  out.  When  they  are  comparatively  empty,  or  only  moderately 
full,  fluids  on  the  outside  pass  in,  and  mingle  with  the  contents. 
Thi«  is  called  endosmOsis.  When  they  are  very  full,  the  watery 
portion  of  the  blood  will  filter  through,  and  pass  out.  This  is  called 
exosmosis. 

Now,  if  the  reader  will  think  a  little,  he  will  easily  see  that  if  the 
veins  are  barely  full  enough  not  to  allow  any  fluid  to  pass  in,  '  iie 
natural  exhalations  of  the  shut  sacs  would  bring  on  dropsy ;  but  if 
the  veins  are  so  full  as  to  cause  water  to  flow  out,  then  the  dropsical 
accumulation  will  be  still  more  rapid. 

Such  being  the  office  and  nature  of  the  veins,  the  reader  may 
learn  how  disease  of  the  right  side  of  the  heart  will  cause  dropsy. 
When  the  right  ventricle  is  so  dilated  and  weakened  that  it  cannot 
send  the  blood  forward  to  the  lungs,  of  course  the  veins  which  bring' 
it  to  the  right  side  of  the  heart,  will  become  full,  and  greatly  distended. 
Exosmosis  will  then  occur;  the  wiiu-ry  portion  of  the  blood  will 
begin  to  run  out,  either  into  th  large  cavities,  or  into  the  cells,  and 
dropsy,  either  general  or  local,  wut  he  the  result. 

Treatment. — This  must  be  governed  very  iimch  by  the  cause  of  the 
disease. 

In  dropsy  from  disease  of  the  heart,  we  may  use  diuretics  and 
such  other  measures  as  are  recommended  for  dropsy  of  tlu'  belly. 
If  the  urine  is  strongly  acid,  depositing  the  brick-dust  s.  liment, 
the  alkaline  diuretics  will  be  the  best,  as  the  acetatr  and  bicarbon- 
ate of  potash  combined,  and  dissolved  in  water.  'J'lie  bitartrate  of 
potassa,  to  act  upon  the  bowels,  is  a  proper  remedy.  If  the  disease 
arise  from  general  debility,  the  following  powder  will  be  useful : 
digitalin,  three  grains ;  cinchonia,  half  a  dram ;  phosph;i  i>  of  iron, 
half  a  dram ;  and  white  sugar,  one  dram.  Mix,  and  t  r  ate ;  divide 
into  sixteen  powders,  and  give  one,  in  pumpkin-seed  tea,  four  times 
a  day. 


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U,}r, 


■i;*'...-.;,- ; ., 


VENEREAL  OR  SEXUAL  DISEASES. 


Or  all  the  diseases  to  which  flesh  is  heir,  none  bring  so  mach 
misery,  moral  and  physical,  as  those  called  sexual  or  venereal.  To 
the  physician,  they  are  the  source  of  the  greatest  anxiety  and  per- 
plexity. They  bring  him  into  possession  of  the  most  delicate  secrets, 
—  secrets  which  invjlve  the  peace  of  families  and  neighuorhoods, — 
secrets  which  his  honor  as  a  man,  and  his  truth  as  a  physician,  compel 
him  to  lock  fast  in  his  own  breast,  and  hold  sacredly  apart  even  from 
his  nearest  companions, — secrets  which,  if  revealed,  would  fill  domes- 
tic circles  with  unutterable  bitterness  and  heartburnings,  and  whole 
neighborhoods  with  scandal  and  immorality.  These  secrets  are  often 
a  burden  to  him.  They  are  in  his  breast  like  undigested  food  in  the 
stomach,  —  disturbing  the  whole  nature. 

The  patient,  if  a  man  of  sensibility,  suffers  even  more,  cf  course, 
than  his  physician.  In  many  cases,  he  in  a  man  of  virtuous  inten- 
tions, and  perhaps  of  religious  habits,  who  has  fallen  in  a  moment  of 
temptation ;  and  he  fears  that  the'  effect  of  his  sin.  will  spread  itself 
through  his  whole  system,  and  extend  to  the  end  of  life ;  or,  still 
worse,  that  having  poisoned  the  fountain  of  his  life,  it  will  go  down 
as  a  heritage  of  misery  to  his  offspring ;  or,  what  he  would  deprecate 
'\s  almost  equally  calamitous,  that  the  partner  of  his  bosom  may  be- 
come the  innocent  partaker  of  his  disease. 

In  this  state  of  apprehension,  he  turns  to  his  physician,  not  merely 
to  keep  his  secict,  but  to  cure  his  disease.  How  great  a  pity,  that  in 
such  circumstances,  he  does  not  always  fly  immediately  to  an  honor- 
able physician,  instead  of  seeking  the  advice,  as  many  do,  of  those 
miserable  quacks,  who  lure  him  to  their  dens  only  to  get  his  money, 
having  no  intention  or  ability  to  cure  his  complaint. 

These  diseases  are  dividea  into  two  great  branches,  characterized, 
in  part,  by  different  symptoms,  and  generally  held  to  be  entirely  dif- 
ferent complaints.     The  first  to  come  under  consideration  is 

Pox. — Syphilis. 

This  disease  had  a  very  early  origin.  It  was  known  among  the 
Jews,  as  we  learn  very  clearly  from  the  15th  chapter  of  Leviticus. 
Dr.  Adam  Clarke's  Commentary  upon  this  chapter,  at  least,  makes  it 
apparent.     David,  the  king  of  Israel,  has  unconaciously  left  on  record. 


VENEREAL  OR  SEXUAL  DISEASES. 


321 


in  the  XXXVIII  Psalm,  a  most  graphic  description  of  Tertiary 
Syphilis,  experienced  in  his  own  person.  Dr.  Clarke  says :  "  It  is 
most  likely  the  Psalm  was  written  in  reference  to  some  severe  afHic* 
tion  that  David  had,  after  his  illicit  commerce  with  Bathsheba ;  but 
of  what  nature,  we  are  left  to  conjecture  from  the  third,  fifth,  and 
seventh  verses."  The  Psalm  is  dated  not  quite  a  year  after  the  act 
alluded  to,  —  about  the  right  time  for  the  terrible  symptoms  David 
describes  to  make  their  appearance. 

The  term  syphilis  is  from  a  Greek  word  signifying  filthy.  There 
lb  one  unvarying  sign  of  this  disease,  —  the  existence  of  an  ulcer  or 
ulcers,  usually  upon  the  genital  organs.  The  French  call  this  ulcer  a 
chancre.  The  conmion  name  is  simply  venereal  sore,  or  ulcer.  A 
pimple  first  appears ;  on  the  summit  of  this  a  pustule  forms ;  then  the 
rupture  of  the  top  of  this,  brings  to  view  the  ulcer  or  sore.  This  ulcer 
is  shallow,  more  or  less  circular  or  oval  in  form,  bounded  by  a  perpen- 
dicular and  slightly  jagged  border,  and  furnished  with  a  smooth,  yel- 
low base,  moistened  by  an  imhealthy  secretion.  The  skin  around  the 
sore  is  a  little  thickened  and  inflamed.  This  is  a  simple  venereal 
ulcer.     It  generally  lasts  about  five  weeks,  and  then  heals. 

But  it  is  not  always  thus  simple.  It  may  be  an  inflammatory 
chancre,  attended  by  excessive  inflammation.  It  may  be  what  is 
called  a  stoug-hing"  chancre,  characterized  by  the  perishing  and  falling 
oft' of  large  parts  of  flesh.  It  may.be  gang-tenons,  or  marked  by  a  ♦^en- 
dency  to  mortification.  It  may  be  plugedeuic,  or  eating,  —  being  dis- 
tinguished by  a  rapid  loss  of  substance,  or  eating  away  of  flesh.  Or, 
finally,  it  may  be  indurated,  —  being  noted  for  the  peculiar  hardness 
of  the  base,  and  of  the  flesh  immediately  around  it. 

A  venereal  sore  is  the  result  of  impure  connection  with  a  person 
having  the  syphilitic  disease.  The  poisonous  secretion  of  a  sore, 
applied  to  the  skin  of  a  healthy  person,  produces  inoculation,  and  a 
new  sore  upon  the  previously  healthy  person  is  the  result.  This 
chancre  appears  in  a  few  days  after  coition,  —  a  certain  time  being 
required  for  it  to  produce  its  eftect,  as  in  the  application  of  vaccine 
matter  to  the  arm. 

BabOi — The  nert  symptom  in  the  order  of  occnrrence,  which  fre- 
quently follows  the  ulcer,  is  the  bubo.  It  is  nan'ed  from  a  Greek 
word  which  means  groin,  -from  its  usually  appearing  in  that  part. 
It  is  a  painful  swelling  of  th  inguinal  gland  in  the  groin,  and  is 
caused  by  the  absorption  oi  /irus  or  poisonous  matter  from  the 
chancre.  This  gland  is  one  of  the  lymphatics,  a  class  of  vessels  a£ 
numerous,  all  over  the  system,  as  the  veins  and  arteries.  They  are 
Ukewise  called  absorbents.  Those  that  originate .  from  the  private 
parts,  absorb  the  poison  from  a  venereal  sore,  and  convey  it  to  the 
glands  in  the  groin,  which,  being  poi.-<oned  by  it,  inflame  and  swell. 

The  bubo  generally  appears  in  from  one  to  two  weeks  from  the 
appearance  of  the  ulcer.  It  is  usually  upon  the  same  side  which  the 
chancre  occupies  upon  the  penis.  When  the  bubo  advances  to  sup- 
puration, and  becomes  an  open  sore,  it  is  then  a  glandular  chancre. 

YegetatioilS.  —  T'  ose  are  peculiar  growths  appearing  upon  diffcsr- 

41 


I  I 


!  j 


ifejf 


i^ll 


ii^ 


322 


VENEREAL  OR  SEXUAL  DISEASES. 


ent  parts  of  the  skin,  which  resemble  certain  vegetables.  They  ^re 
found  most  frequently,  in  the  male,  on  the  head  of  the  penis,  and  on 
the  membrane  lining  the  foreskin.  In*  the  female,  they  are  found  at 
the  entrance  to  the  ragina,  and  notunfrequently,  in  the  vagina  itself. 
They  sometimes  appear  on  the  neck  of  the  uterus. 

Primary  Disease.  —  Thus  far,  the  diseases  noticed  are  what  are 
called  primary.  If  properly  treated,  and  cured  in  season,  the  consti- 
tution is  not  infected,  and  no  subsequent  troubles  appear.  But  a 
result  so  fortunate  ^s  this,  is  not  common.  Generally,  the  treatment 
is  either  too  long  delayed,  or  is  too  brief  and  superficial.  The  poison 
is,  i^  1  onsequence,  absorbed  into  the  circulation  ;  the  whole  constitu- 
tion ij'  "omes  infected ;  the  fluids  and  solids  are  so  acted  on  and 
altered,  in  fact,  that  a  special  constitution  is  created.  For  this  reason, 
the  afFections  of  the  sjkin,  the  mucous  membranes,  the  bones,  etc., 
which  follow,  are  called 

Constitutional.  —  These  constitutional  diseases  never  appear  imme- 
diately, as  the  result  of  an  impure  connection,  but  only  after  those 
affections  already  noticed.  The  primary  diseases  are  local ;  the  con- 
stitutional affections  are  general. 

The  first  t'ling  which  strikes  the  eye  in  these  constitutional  com- 
plaints, is  the  color  and  appearance  they  give  the  skin.  It  has  a  red- 
dish, coppery  tinge,  and  a  peculirly  dirty  appearance. 

The  order  in  which  the  several  parts  are  afTeeted,  are,  first,  the  skin 
and  mucous  membranes  ;  second,  the  hard  substance  surrounding  the 
bones,  called  periosteum,  the  tendons,  and  the  bones  themselves. 
Those  affections  which  appear  upon  the  skin  and  mucous  membrane 
are  usually  called  secondary,  because  they  are  the  second  to  appear ; 
while  those  affecting  the  bones,  etc.,  are  denominated  tertiary,  be- 
cause, in  the  order  of  their  appearance,  they  are  in  the  third  class. 

Eruptions  of  tlie  Sliin,  and  Ulcers.  —  Of  the  constitutional  erup- 
tions, there  is  a  great  variety, — so  great  that  I  cannot,  in  small  space, 
give  a  minute  description  of  them.  The  breast  and  arms  are  not 
unfrequently  the  first  to  be  affected.  Attending  these  eruptions,  then> 
is  little  uneasiness,  and  no  pain ;  though  there  is  sometimes  a  sliglit 
itching.  The  first  breaking  out  is  usually  of  a  copper  color,  some- 
what paler  than  it  subsequently  is.  The  eruption  is  often  in  the 
form  of  blotches,  —  elevated  only  a  very  little  above  the  skin.  They 
are  composed  of  small  prstules,  with  a  little  fluid  in  them,  which 
soon  dries  away,  and  the  whole  may  be  rubbed  off  like  bran.  This 
may  leave  the  skin  looking  tolerably  sound,  and  inspire  the  belief 
that  no  further  mischief  is  to  be  experienced.  No  hope  can  be  more 
delusive.  Parts  affiicted  with  this  complaint,  show  no  tendency  to  heal 
The  first  crop  of  pimples  is  soon  followed  by-a  second,  which  pro- 
duces a  thicker  crust,  and  yields  a  larger  amount  of  bran.  This 
rubbed  off,  small  ulcers  appear  underneath. 

Tesicular  Eruptions.  —  There  is  another  syphilitic  affection  of  the 
skin,  which  appears  in  the  shape  of  vesicles,  like  small-pox.  These 
dry  and  leave  a  scab. 


.  They  ^re 
enis,  and  on 
re  found  at 
'agina  itself. 

e  what  are 
I,  the  consti- 
ear.  But  a 
le  treatment 

The  poison 
Die  constitu- 
ted on  and 
this  reason, 

bones,  etc., 

>pear  imme- 

after  those 

al ;  the  con- 

itional  corn- 
It  has  a  red- 

irst,  the  skin 
ounding  the 
themselves. 
3  membrane 
I  to  appear ; 
tertiary,  be- 
Ird  class. 

tional  erup- 
small  space, 
rms  are  not 
ptions,  then* 
mes  a  sliglit 
color,  somo- 
jften  in  the 
skin.  Thcv 
them,  which 
bran.  This 
e  the  belief 
can  be  more 
lency  to  heal 
,  which  pro- 
bran.     I"hi9 


sction  of  the 
pox.     These 


f'i      ■! 


t      1 


1* 


*>ki,'l  iw 


F'''l 

N.'v ,  I   ^ 

1 

\f 

If            • 

f 

*.* 


VKXEkEAL  OH  gBXCAl.  PISRASKK. 


«rt*]y  Frnptlons. —  Thrre  is  i«^i^  .iinttw.-  uik-ciiuii,  •. ;"<'hidiii  \hv 

i<-M  (»f  Hulcs,  iUfi  onr  scale  \v>il  ;«■  j.»IUm]   u|>r-n  Hiitji'h'-r.     It  b-  ;,i!i«t 

'\  an  eruption  of  etipper'folorf<l  bluMhcs,  which  b»."<tHne  covered 

-.  pcalc'f^;  tliPdc  nrr  uuiCaetU'd  by  i^-abs, -ijtd  "wh»  a  th€sw  Ml  off, 

'';>vv  iilcerri  nrr  left  viih  copfKrt-rnl.ored  cU|j%JS.     (Fig.  iii'i.*     'I'hi^ 

rtiiibborn  form. 


i^.»i  —ir^  v 


1  >«d<'i'cnliir  fcni|aiii«>i.       hi  anoifw  r  varic'ty  >•!'  0»c  d;^<;aj«:,  oroacl, 

•(..  «i.>pp>'r-c(j|o«'d  !ub<?i  'lt:t<,  ui  hard  ficvaiioii?*  tipjHar,  mo»t  coin- 
i....,riy  ahtjiii  th«^  rud«\^  of  the  no.-'e,  or  on  the  cho'ks.  f  Jradnally,  t.hfv 
«u«.4»iiraio,  niid  are  pvucecded  t>y  Jtep  ulcors.  t>-rpiii\fniiig"  jii  :cais. 
Tl  i*^  is  an  unfjivomble  'ioan  of  tin-  tlisrastu-aiKi  u^uaUy  appears  sorrir 
(m*i<ilerablf.  time  iifier  tbf  priiuarv  siynipfom-s  iu  pt:rsnns  '.viioso  eun? 
M;ti!»'«!u  hus  bv'i-n  sV/ittcred-     Plait  V 

Tiu-H  rathoT  beiont;-?  to  th*.'  tur^Hiry  for»n  of  ui«M?»v-»^»t";  »md  in  f»dt; 
*ioii  to  tlio  abovf,  p;UoUti«  (4'  unheuitliy  ji!ii(»:Mn;ot4«»<>  c"   apt  to  inrni 
.  ti   UH'  tongtie,  unrt  afUT  a  time,  l>rf.'ak,  di»e:io*i?jg  rigged,  orjing"^- 
olorevlulcer?.     J*i.Air,  VI      F«5f.  f? 

Many  other  formi?  <  »«i(»t}  bui  In  a  pf^pukjr  Wv»^Ji  U^e 

'•J5i.  it  vould  be  ii.^«.w-  ;     -    ;:. '.»»i  ;h«  ntcA.-  d»»timfkMit»  wfek-fe  thfi"" 
>-5»cTipuon  would  {Fi;{iiif<*, 

Some  of  the  svor«t  fonns  oi  the  sff«ndtt»*v  *ffci.'tious,  are  fouad 
•ithMi  the  mucous  rncnibran**  of  iitf'  nu-iuh  a:i'l  lhrt>.it.     Thctte  <!OrM*»- 


'>tKl,-iii   Dumber 


••in\ 


kind,  with  tii*-  Rli-r-iioh-'  of  ihc  skin.     Thrv 


Jit'ct  thcvlip.1,  iht!  iirtvmai  suh's  of  the  checks,  the  ti^ngutf,  febt*  toritiii^ 
•>t»j  phnrynx.  tho  .-ol?  p;dau%the  najrai  cavilled,  cfr%     'rh<»y  ar*-  tMTJb 
•■'S'Iriu'iivH  ill  th'ir  •  Hocts,  —running  j^Mjjing  ulcers,  and  <  atino;  det;p' , 
;rU>  the  parts.     Ti;v->y  otl.en  n«akt    shik  kin^'  vnrk  in  the  wlml'-  inont.. 
!id   rhroat;   and.  vvlion   atti  nded   vtjth   tviHidftmbh*   intia!nmRfi<;»u 
tAkc  it  almost  iinpossibl'?  to  swaiiov\.  ■.iiiyth!%".  nr  "V^n  to  ojxir;- 
•.outh.     I  h.vve  oftrii  wf!)  breai!it'«  turouc'b  tiu"  psdatirit^  U'^h  (Vi.A'y> 
VI,  Fig.  1),  and  «^vou  th<^  Avholo  arch  destroy*?;!  (B*.*tk  VJ,  Fig.  2) 
"  r'()!)rt  havf'  often  ditd  frorn  starVkilion.  —  flot  linn^  alile  ♦'>  PWaTlow 
■   ulcem  soinetime.'?  take  hold  nf    i.:  tojj.sii..  und  '  d*"  them  o.i*-  ft«< 
'  n  were  done  with  a  punch." 

!'h(et»e  uireratious   nffect    ihi;    r'.'K'Olli^    n  itc'tv  ui    >vm-   gtnirai 

-v'^ans.     In  lite  finuah;,  tht-y  oft<  n  v,iTec«  ttw  -:♦<».'    '  ''  Mu-  neck  of 

-   wnmb  (Plait,  VII,  Fig.  2) ;  hvA  thvm  m«v  »  ^        •      ihtasfthuo, 

<e  t%'iU5i^  of  whiter,  witliouf.  bomg  su^pcvf v. «!  o*  smh..     They  nffrct 

'i.M;'  mucoij.s  lining  of  'he  fu:»d;k  ■  »;i;  ind  t}»n  ^^rg■^'  bowt''      Tliry 

.  ftimfs  cxih!  in  the  car,  and  rtr-re  <"•**  -m   ':i  the  t".t-.     This  l;iTff? 


?li 


1  '■  i 


cuoii  pa^eeti  under  tho  nairu- 


Pr.AT 


^ ! 


%:■ 


\  f-f 


f- 


if 


>« 


}* 


!!.  .    i«! 


r»! 


"■it-^  ■•••?; 


ass^' 


f 


VKNKREAL  OR  SEXUAL  DISEASES. 


32:i 


Scaly  Eruptions.  —  There  is  still  niiotlnT  affection,  which  ia  in  the 
form  of  wales,  and  one  scale  will  he  piled  u|)()n  another.  It  begins 
with  an  eruption  of  copper-colored  blotches,  which  become  covered 
with  scales ;  these  are  succeeded  by  scabs,  and  when  these  fall  off, 
shallow  ulcers  are  left  with  copper-colored  edges.  (Fig.  133.)  This 
is  a  stubborn  form. 

Fio.  133. 


Tiiberfiilnr  Eniptions.  —  In  another  variety  of  the  disease,  broad, 
red,  copper-colored  tubercles,  or  hard  elevations  appear,  most  com- 
monly about  the  sides  of  the  nose,  or  on  the  cheeks.  Gradually,  they 
suppurate,  and  are  succeeded  by  deep  ulcers,  terminating  in  scars. 
This  is  an  unfavorable  form  of  the  disease,  and  usually  appears  some 
considerable  time  after  the  primary  symptoms,  in  persons  whose  con- 
stitution has  been  shattered.     Platfc  V. 

This  rather  belongs  to  the  tertiary  form  of  the  disease;  and  in  addi- 
tion to  the  above,  patches  of  unhealthy  inflammation  are  apt  to  form 
on  the  tongue,  and  after  a  time,  break,  disclosing  ragged,  orange- 
colored  ulcers.     PLAiii  VI.     Fig.  2. 

Many  other  forms  of  eruption  exist ;  but  in  a  popular  work  like 
this,  it  would  be  useless  to  make  the  nice  distinctions  which  their 
description  would  require. 

Some  of  the  worst  forms  of  the  secondary  affections,  are  found 
upon  the  mucous  membrane  of  the  mouth  and  throat.  These  corres- 
pond, in  number  and  kind,  with  the  affections  of  the  skin.  They 
utl'ect  the  lips,  the  iuternal  sides  of  the  cheeks,  the  tongue,  the  tonsils, 
the  pharynx,  the  soft  palate,  the  nasal  cavities,  etc.  They  are  terribly 
destructive  in  their  effects, — forming  gaping  ulcers,  and  eating  deeply 
into  the  parts.  They  often  make  shocking  work  in  the  whole  mouth 
and  throat;  and,  when  attended  with  considerable  inflammation, 
make  it  almost  impossible  to  swallow  anything,  or  even  to  open  the 
mouth.  I  have  often  seen  breaches  through  the  palatine  arch  (Plate 
VI,  Fig.  1),  and  even  the  whole  arch  destroyed  (Plate  VI,  Fig.  2). 
Persons  have  often  died  from  starvation, —  not  being  able  to  swallow. 
The  ulcers  sometimes  take  hold  of  the  tonsils,  and  "dig  them  out  aa 
if  it  were  done  with  a  punch." 

These  ulcerations  affect  the  mucous  membranes  of  the  genital 
organs.  In  the  female,  they  often  affect  the  vagina,  and  the  neck  of 
the  womb  (Plate  VII,  Fig.  2) ;  and  thus  may  exist  for  a  long  time, 
as  the  cause  of  whites,  without  being  suspected  n-..  such.  Thay  affect 
also  the  mucous  lining  of  the  fundament  and  the  large  bowel.  They 
sometimes  exist  in  the  ear,  and  more  often  in  the  eye.  This  latt-er 
affection  pa&ses  under  the  name  of  syphilitic  iritis.     Li  Plate  V, 


( 


\  i 

i    ! 


I    ,     1 


h'  : 


t\ 


the  arti»t  hus  well  represented  this  form  of  constitutional  distease  in 
the  eye. 

The  disorder,  having,  by  frightful  ulcers,  run  riot  upon  the  delicate 
structures  of  the  skin  and  mucous  membranes,  advances  boldly  on- 
ward,  attacking  the  muscles,  the  tendons,  the  hard  covering  of  the 
bones,  and  the  solid  bones  themselves.  No  part  of  the  human  frame, 
—  not  even  the  skt'lcton,  —  can  escape  this  devouring  complaint. 
The  bones  of  the  nose  and  l".»ce  are  generally  the  first  to  be  attacked. 
These  perish  slowly,  —  falling  away,  piece  by  piece,  —  the  nose,  in 
the  mean  time,  sinking  down  nearer  to  a  level  with  the  cheeks. 
From  these  parts,  the  disease  may  spread  to  the  bones  of  the  whole 
system. 

Tiiese  affections  of  the  bones,  are  attended  by  pains  of  almost 
every  kind  and  degree.  These  pains  are  sometimes  fixed  in  one 
place  ;  at  other  times,  wandering, — the  whole  skeleton  b«*ing  painful. 
In  these  latter  cases,  they  seem  to  the  sufferer  to  reach  the  very  mar- 
ro\..  Sometimes  when  the  pain  is  fixed  in  one  place,  the  feeling  is 
such  a.i  might  be  supposed  to  be  ex|)erienced  if  the  bone  were  'xhig 
bored.     These  pains  are  most  terrible  during  the  night. 

Upon  those  pavts  where  the  skin  is  near  the  bone,  as  the  forehead, 
or  shin,  syphilitic  nodes  or  tumors  often  appear,  which  are  hard,  like 
cancerous  iumors.  Beside  the  above,  there  are  the  loss  of  the  hair 
(alopecia),  blindness,  deafness,  and  various  other  mischiefs,  resulting 
from  syphilis  which  need  not  be  described. 

Is  the  Constitutional  Disease  Coiiiinunicable  ? —  Many  believe, — 
even  among  those  who  are  eminent  in  the  profession,  —  that  the  f^on- 
stitutional  forms  of  the  disease  are  not  communicable.  A  few  yefirs 
ago,  indeed,  this  latter  opinion  wad  generally  received.  It  is  row 
quite  extensively  doubted,  or  rather,  disbelieved.  Facts  are  con- 
stantly occurring  under  the  eye  of  unprejudiced  physicians,  which 
make  it  very  evident  that  the  constitutional  disease  may  be  commu- 
nicated from  one  person  to  another. 

The  Disease  Hereditary. —  It  is  no  small  amount  of  suffering,  bodily 
and  mental,  which  the  individuals  endure  who  contract  this  disease. 
But  the  inflictions  visited  upon  them,  severe  as  they  are,  are  small, 
compared  with  the  aggregate  of  ills  entailed  by  it  upon  the  long  line 
of  their  posterity.  Whether  it  be  the  man  or  the  woman  whom  the 
syphilitic  virus  has  inoculated,  if  it  be  allowed  to  be  absorbed,  so  as 
to  affect  the  constitution,  it  will  be  very  likely  to  be  sent  down  to  the 
children,  and  children's  children.  The  divine  law  which  links  the 
sins  of  the  fathers  with  the  sufferings  of  even  the  third  and  fourth 
generation,  is  nowhere  more  painfully  illustrated  than  in  the  scourg- 
ing descent,  through  many  generations,  of  this  terrible  disease.  It 
may  be  passed  down  to  posterity  by  either  of  the  parents ;  but  if 
both  be  diseased,  its  transmission  will  be  the  more  certain.  If  the 
mother  be  infected,  she  will  infect  the  child  while  carrying  it.  If 
the  father's  constitution  be  poisoned,  the  child  will  receive  the  infec- 
tion from  him,  through  the  semen,  and  will  be  likely,  while  in  the 
womb,  to  infect  the  mother.     I  recollect  but  one  author  of  note 


i!.:ILl 


^il 


l(  '4l 


liAcase  in 

)  delicate 
oldly  on- 
rig  of  the 
an  frame, 
omplaint. 
attacked. 
B  nose,  in 
le  cheeks, 
the  whole 

of  almost 
•d  in  one 
ig  painful, 
very  mar- 
feeling  is 
vere  ' u  ing 

I  forehead, 
!  hard,  like 
)f  the  hair 
3,  resulting 

believe,  — 
it  the  ron- 
few  years 
t  is  row 
are  con- 
ans,  which 
je  comma- 


ring,  bodily 
lis  disease. 

are  small, 
long  line 

whom  the 
rbed,  so  as 
own  to  the 
.  links  the 
and  fourth 
the  scourg- 
lisease.  It 
Its;  but  if 
in.     If  the 

ing  it.    If 
the  infec- 

hile  in  the 

or  of  note 


(Ram^botham)  who  has  mentioned  this  mode  of  infection.     I  have 
myself  seen  two  cases  of  it. 

This  constitu  ioiial  disease,  whether  it  exist  in  the  mother,  or  be 
communicated  lo  the  child,  and  thence  to  her,  by  an  infected  father, 
is  a  frequent  cause  of  abortion.  Throughout  nature,  blight  is  the  re- 
sult of  a  diseased  parentage.  Mature  fruit  is  seldom  obtained  from 
infected  seed. 

Is  the  Constitutional  Disease  Curable?  —  No  (lucstion  connected 
with  the  complaint  possetM!s  a  greater  interest  than  this.  None  is 
pressed  more  earnestly  upon  the  physician.  In  a  certain  sense  the 
disease  is  curable.  Its  outward  manifestation  may  be  wholly  re- 
pressed. The  health  of  the  person  suffering  from  it  may  be  restored, 
and  become,  in  an  important  sense,  good.  But  this  eyre  is  never 
brought  about  by  nature ;  it  maif  be,  and  is  often  effected  by  medicine. 
I  have  never  failed  to  effect  such  a  cure  in  any  case  which  has  come 
under  my  treatment.  Such  results  may  properly,  in  general  terms, 
be  called  cures. 

Yet  there  is  a  sense  in  which  a  cure  never  occurs.  It  is  a  well- 
attested  fact,  that  a  system  once  thoroughly  pervaded  by  the  poison, 
is  never  completely  purged  of  it.  It  may  be  shorn  of  all  its  active 
malignancies ;  but  it  has  too  intimately  permeated  the  tissues  and 
solid  bones,  to  be  wholly  expelled.  Pursue  it  as  we  will  with  the 
remedial  forces  of  our  art,  it  still  takes  refuge  in  the  most  subtle  pro- 
cesses of  animal  life,  —  still  infects  the  currents  of  being,  and  finds 
expression  in  the  scrofula,  in  the  lupus,  and  in  the  scaly  atfections  of 
other  generations.  Dr.  Erasmus  "Wilson,  the  great  authority  in  skin 
diseases,  says :  "  I  feel  convinced  that  a  considerable  proportion  of 
those  diseases  which  pass  under  the  name  of  scrofula,  are  the  produce 
of  the  syphilitic  poison,  —  are,  in  fact,  not  scrofulous,  but  syphilitic." 
Astruc  thought  the  same,  and  suggested,  what  is  doubtless  true,  that 
the  transmission  of  syphilis  must  occur  through  several  generations 
before  it  becomes  scrofula.  Bierchn,  Camper,  Stoll,  Portal,  Hufeland, 
and  Alibert,  have  all  advocated  the  same  opinion. 

This  is  doubtless  right,  though  there  are  many  authorities  on  the 
other  side.  He  must  be  a  poor  observer  who  cannot  discover  a  prob- 
able filial  relationship  of  scrofula  to  syphilis. 

A  variety  of  facts,  admitted  by  the  whole  profession,  go  far  towards 
demonstrating  this  relationship.  Scrofula  is  always  hereditary.  It 
is  a  disease  of  the  parent,  imparted  to  the  offspring.  But  there  is 
scarcely  any  disease  so  certainly  sent  down  to  posterity  as  syphilis. 

Scrofula  is  like  syphilis  in  many  of  its  characteristics.  It  is  like  it 
in  its  power  of  propagating  itself  from  parent  to  child.  It  is  like  it  in 
affecting  nearly  all  the  children  of  diseased  parents.  It  is  like  it  in 
the  variety  oi  the  structures  it  attacks,  —  affecting  the  skin,  the 
mucous  membranes,  the  bones,  etc.  Like  syphilis  it  produces  nard 
tumors,  ulcers  of  the  skin,  abscesses,  and  decaying  of  the  bones. 
And  finally,  the  great  remedy  for  tertiary  syphilis,  iodide  of  potas- 
sium, is  likewise  the  great  remedy  for  scrofula ;  and,  indeed,  almost 
every  remedy  which  acts  favorably  upon  one,  is  found  useful  for  the 


I 

i    ! 


'^       '    I 


f    I 


'^tb 


i 


32« 


VENEREAL  Oil  SEXUAL  DISEASES. 


other.      This  could  hardly  occur  were  not  the  diseases  identical  in 
nature. 

We  can  scarcely  be  surprised  that  u  disease  so  widely  diffused  as 
scrofula  should  be  the  product  of  syphilis,  when  we  reflect  how  fright- 
fully [^""evalent  were  the  causes  of  this  latter  affection  during  the 
earlier  and  liie  middle  ages  of  the  world. 

To  pass  over  the  records  of  earlier  times,  with  merely  mentioning 
Abraham,  and  Lot,  and  Jacob,  and  Reuben,  and  Samson,  and 
David,  and  Solomon,  and  numerous  females,  of  whom  some  singular 
things  are  written  in  the  elder  scriptures,  mvl  omitting  all  mention 
of  the  incredible  and  almost  miiversal  debauciery  and  prostitution 
of  Greece,  and  Rome,  and  Persia,  and  Media,  and  Egypt,  I  may 
say  that  Europe,  in  the  middle  ages,  was  loeU-nigh  converted  into  a 
vast  broth'  l. 

Foremost  in  the  race  of  profligacy,  were  the  priests,  bishops,  kings, 
and  emperors.  The  licentiousness  of  Childeric  knew  no  bounds.  He 
carried  off  and  violated  the  wives  and  daughters  of  his  vassals,  with- 
out regard  to  any  right,  human  or  divine.  His  successors  were  gen- 
erally a  race  of  lecherous  men,  who  spread  debauchery  on  every  hand. 
The  French  monarchs,  from  Pepin  and  Charlemagne,  were  a  race  of 
debauchees.  Their  courts  were  national  brothels,  in  which  the  finest 
women  in  the  land  were  trained  in  the  arts  of  seducrion  and  lust. 
Francis  L.  in  1515,  endeavored  to  invest  prostitution  with  elegance 
and  chivalry,  and  even  to  ennoble  it,  by  abandoning  the  public 
women  of  the  palace  to  his  subaltern  orticers,  and  subsrituting  for 
them,  ladies  of  noble  blood.  In  this  movement,  the  nobles  and  the 
clergy  gave  the  king  their  support.  The  right  of  sleeping  with  their 
female  vassals  the  first  night  after  marriage  was  ndigiously  insisted 
on  by  bishops  and  abbes,  as  high  barons,  and  exercised  as  their  privi- 
lege. The  inferior  clergy  were  content  to  haunt  the  taverns  ar.d 
stews,  and  the  monks  paid  their  pimps  with  the  wealth  of  the  church. 
The  grand  vicar,  in  some  dioceses,  sold  indulgences  to  rommit  adul- 
tery for  a  year ;  in  others,  a  cask  of  wine  j)aid  for  the  right  of  forni- 
cation for  a  lifetime. 

Brantome  justifies  Francis  in  his  selection  of  girls  of  noble  blood, 
on  th(^  ground  that  "  they  could  not  communicate  the  venereal  dis- 
ease to  the  noblemen  of  the  courts,  like  the  common  prostitutes.' 
But  the  king,  who  was  previously  diseased,  infected  them  ;  and  these 
noble  women,  so  called,  passing  from  the  arms  of  the  prince  to  those 
of  the  courtiers,  presented  to  them  the  fatal  infection  received  from 
the  king. 

The  way  in  which  Francis  himself  was  infectefl,  illustrates,  in  a 
most  shocking  manner,  tl'.e  moiuln  of  the  times.  Mis  illicit  loves  v.jtli 
the  Belle  Ferronit^re,  wer*^  not  (concealed  from  her  husband,  who, 
though  obliged,  outwardly,  to  regard  the  dalliance  of  iiis  wife  with 
the  monarch  as  an  honor,  was  inwardly  indignant,  and  determined 
to  become  infected  himself,  and  thus  disease  liis  wife,  and  revenge 
himself  upon  tlu?  king.  Th'-'  ,)lan  was  suggeated  to  him  by  a  monk, 
who  had  another  motive,  namely,  that  of  punishijig  Francis  for  his 
liberality  to  the   Lutheraiis.     "  How,"  said  the  husband,  when  the 


^irwf 


dentical  in 

diffused  as 
how  fright- 
during  the 

Bentioning 
msoii,  and 
lie  singular 
.11  mention 
)roHtitution 
('pt,  I  may 
rieil  into  a 

lopa,  kings, 
)unds.  He 
Sisals,  witli- 
.  were  gen- 
:very  hand. 
e  a  race  of 
1  the  tinewt 
1  and  lust, 
h  elegaiuie 
the  public 
ituting  for 
>s  and  the 
with  their 
ly  insisted 
their  privi- 
verns  aiicl 
he  church, 
unit  adul- 
it  of  forni- 

)ble  blood, 
iiereal  Jis- 
•ostitutea. ' 
and  these 
e  to  those 
^ived  frotu 

rates,  in  a 

OV«'H  ^Vlth 

iJiid.  v.'lio, 
wife  witli 
erermined 
d  revenge 
y  a  monk, 
cis  for  his 
when  the 


VENEREAL  OU  SEXUAL  DISEASES. 


327 


suggestion  was  made,  "  shall  I  give  this  disease  to  my  wife,  when  we 
are  both  sound?"  "  Go  visit  an  infected  girl,"  said  the  monk,  "and  to 
render  the  matter  certain,  as  I  am  inftjted,  I  will  see  your  unfaithful 
wife."  The  result  was  such  as  the  husband  desired ;  and  in  1547, 
Francis  I.,  t'le  gay  and  chivalric  monarch,  perished  of  the  most  foul 
and  loathsome  of  all  fliseases. 

Debauchery  did  not  die  with  him.  It  was  cherished  by  his  succes- 
sor, Charles  IX.,  and  his  mother,  Catherine  de  Medicis,  and  his  grand- 
son, Henry  HI.  The  reigns  of  Henry  IV.,  Louis  XIII.,  Louis  XIV.. 
the  Regency,  and  of  Louis  XV.,  were  stained  by  the  same  licentious- 
ness and  disregard  of  public  decency,  until  the  whirlwind  of  the  revo- 
lution came  to  purify  the  moral  atmosphere. 

The  reader  will  now,  I  think,  be  in  no  mood  to  wonder  that  the 
kings  and  queens  of  Europe,  and  the  whole  royal  progeny,  whether 
the  dishonored  occupants  of  thrones,  or  the  moi*e  private  recipients 
of  the  public  bounty,  are  a  scrofulous  and  degenerating  race.  Nor 
need  it  be  much  wondered  at,  that  so  large  a  portion  of  men  and 
women  everywhere  have  more  or  less  scrofula  in  their  frames.  Happy 
are  those  who  can  find  no  trace  of  this  complaint  in  their  constitu- 
tion! They  should  rise  up  and  call  their  virtuous  progenitors  blessed. 
They  should  especially  thank  God  that  they  have  sprung  from  the 
loins  of  a  race  more  noble  and  kingly  in  the  eyes  of  Heaven  than  all 
the  royal  lines  of  all  Europe. 

Ti'eatmeiit  of  Syphilis. —  In  the  treatment  of  this  disease,  the  first 
thing  which  requires  attention  is  the  pimple,  pustule,  or  sore.  This 
irust  be  instantly  touched  with  caustic.  There  should  be  no  delay, 
ior  if  the  sore  be  not  syphilitic,  the  caustic  will  do  no  harm ;  and  if 
it  be,  the  most  terrible  results  may  be  averted.  The  general  b«;lief  is 
that  poison  remains  in  the  sore  for  a  time  before  it  is  absorbed  into 
the  constitution.  It  is  of  the  utmost  importance  that  it  be  destroyed 
before  the  absorption  takes  place. 

The  caustics  used  are  nitrate  of  silver  (stick  nitrate),  nitric  acid, 
chloride  of  zinc,  potassa  with  lime,  caustic  potassa,  and  the  painless 
caustic. 

The  nitrate  of  silver  is  much  used,  but  the  best  surgeons  now  re- 
gard it  as  useless.  It  does  not  prevent  the  absorption  of  the  poison. 
The  caustic  potassa,  the  potassa  with  lime,  and  the  painless  caustic, 
are  the  sure  remedies,  —  that  is,  if  applied  in  season.  But  they  must 
be  employed  with  caution.  It  will  not  do  to  trust  them  in  bungling 
liands.  A  little  vinegar  and  water  must  l)e  immediately  used  to  neu- 
tralize the  caustic  when  it  has  accomplished  what  we  desire.  After 
the  sore  is  cauterized,  a  piece  of  lint,  dipped  in  a  solution  of  watery 
extract  of  opium,  one  dram  to  four  ounces,  should  be  laid  on  it ;  and 
the  organ  inv<lo|K»d  in  another  pi«H*e  of  lint  soaked  in  tepid  water, 
and  covered  in  oiled  silk.  The  patient  should  renuiin  at  rest  as  much 
as  possible,  —  keeping  the  penis  elevated,  and  repeating  the  opium 
dressing  to  the  wound,  and  th»^  wat«"r  dressing  to  the  whole  organ, 
iiight  and  morning.  In  addition,  the  patient  should  take  two  pills 
(19)  to  be' followed,  night  and  morning,  for  three  or  four  days,  with 


ii': 


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fflHSR|^a[.fi 

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m 

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1 

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a  tablespoonful  of  (20).  In  some  cases,  a  piece  of  lint,  wet  with  the 
tincture  of  muriate  of  iron,  diluted  and  kept  upon  the  chancre,  will 
cause  it  to  heal  kindly,  and  with  safety  to  the  patient. 

If  this  treatment  be  adopted  early  and  properly^  the  patient  is  cured, 
and  nothing  further  is  needed.  But  time  is  generally  lost.  The  poi- 
son is  absorbed  before  the  patient  is  seen  by  the  physician ;  and  the 
.juestion  then  is,  how  it  is  to  be  driven  out. 

To  accomplish  this,  the  diet  should  be  regular  and  unstimulating ; 
alcoholic  drinks  and  tobacco  should  be  forbidden  ;  the  mind  should 
be  kept  at  rest ;  a  cold  or  tepid  bath  should  be  taken  daily  ;  the  ac- 
tion of  the  bowels  and  kidneys  should  be  kept  properly  regulated. 
These  things  will  put  all  the  expelling  agencies  in  proper  condition 
for  work ;  and  no  single  medicine  will  put  them  all  into  action  like 
mercury.  For  this  reason,  no  other  single  drug  has  enjoyed  a  repu- 
tation for  curing  pox  so  wide  as  this. 

But  it  must  be  used  with  judgment.  No  remedy  is  more  safe,  if 
judiciously  employed,  or  more  destructive,  if  abused.  The  profuse 
and  ill-considered  way  in  which  it  was  used  in  former  times,  raised  a 
prejudice  against  it,  which  is  unreasonably  cherished  at  the  present 
day.  Abuse  made  mercury  a  cur^e;  judicious  use  makes  it  a  blessing, 
-—at  least  in  this  disease. 

The  blue  pill  is  one  of  the  best  forms  of  it  (148)^  combined  with 
extract  of  henbane.  One  pill  at  night  is  the  usual  amount  to  be 
taken.  Some  prefer  the  mercury  with  chalk  (149) ;  others,  the  corro- 
sive sublimate  (150) ;  others,  the  proto-iodide  of  mercury  (136).  Some 
one  of  these  should  be  given  about  five  days,  in  the  doses  named 
under  the  recipes,  —  being  careful  not  to  produce  salivation.  After 
the  fourth  or  fifth  day,  we  can  generally  inerease  the  frequency  of  the 
dose.  Should  salivation  be  accidentally  induced,  it  should  be  arrested 
l:)y  a  solution  of  chlorinated  soda  (205),  one  part  to  twelve  of  water. 
The  mercurial  treatment  should  continue  for  a  week  after  the  sore 
has  disappeared ;  and  in  the  case  of  the  indurated  sore,  as  long  as 
there  is  any  hardness. 

Water  should  be  taken  freely,  and  various  diluent  drinks.  They 
wash  the  poison  out  through  the  millions  of  avenues,  called  pores, 
just  as  we  wash  filth  out  of  cities  by  pouring  water  into  the  sewers. 

Recently,  Rieord,  the  great  French  authority  on  tliis  subject,  has 
introduced  a  new  treattnent  of  syphilis  by  iron.  One  part  of  the 
potassio-tartrate  of  iron  is  dissolved  in  six  parts  of  water,  and  two 
teaspoonfuls  are  given  three  times  a  day.  The  same  solution  is  ap- 
plied to  the  external  sore  or  chancre.  Rieord  says  that  no  secondary 
symptoms  have  been  known  to  occur  after  this  treatment.  The  Lon- 
doa  Lancet  sanctions  this  treatment  as  being  capable  of  doing  all 
that  Rieord  claims.  Should  its  success  prove  equally  great  in  this 
country,  it  will  take  rank  among  the  greatest  gifts  to  the  profession. 
I  sincerely  hope  that  in  a  future  edition .  of  this  book,  a  full  trial  of 
the  remecly  on  this  side  of  the  Atlantic  will  permit  me  to  record  such 
success. 

I  should  mention  that  there  are  those  who  claim  to  cure  the  disease 
with  other  remedies,  without  mercury,  and  I  am  not  disposed  to  be 


ni 


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VT.''TF;KliA!.  UK  SL^i'AL  DISKASKS. 


.'nufnl  i>f  »!^),     In  wme  ciisef,  a  piece  of  Jint,  v.'(  >  ;^ 
'^"  ol"  rrtnr»ui-e  t»f  \xov..^  dilutrd  antl  kt-pt  upon  Ihc  chiK!*::- 
;t  to  henj  '  udlv,  and  with  .•^afcty  to  tiif  patient. 
'.'=}  tr«;iiaa«'nt  be  adupti  d  tarlij  a»>d  properlij,  Hj»'  putit-nt »»  v  ??•*«*. 
f.iMl  nothi'-rT  fu rrhi*- is  jie«^dt'd.     But  tirne  is  g'Micrally  Jo^t.     'i\ 
•otj  ift  ai».*;'rt:>td  iw-ibro  the  patient  i^  st  mi  by  the  phy!*i«;iaa;  ^Vm     -. 
•4uc'.*t,i»>n  tb<'ti  is,  how  it  i---  to  ini  driven  out, 

'A»  ac-.-Drnplirth  this,  the  diet  should  hr  rpgular  and  ^ln^li^itna^?^»^j; , 
aKX'!i()hf.  drinks  and  Uih',\oi<)  .-hoiild  !>p  furhitldpu  :  the  mmu  .-i.-ti/-;' 
b«>  iitjpt  at  H'at;  a  <'«)id  or  tepid  hath  ^h'-.rdd  be  taken  daily.  U  -r.  ■■ 
tion  of  fh<'  howeln  aud  kidneys  !?h:'Uld  be  kept  proptrly  rei^ui^t usa. 
Tlie.H  tiiiiigs  will  pnt  ViW  th«  «»rpelit>j«;  f^gtMiric?*  in  proper  *orhiiiMt«» 
fur  work  ;  nud  no  tjM;!;ic  medit-rif  v-.  il!  j>ut  them  all  into  actioij  lik« 
nificnrv.  For  this  rt-anop.  mo  uitwr  tsinglu  diug  hasi  «^nji)ye<J  a  np'^ 
talion  for  en  ring  }h)x  hO  vri»5»?  ^-^  ebs». 

]'»ul  It  rnn^nr  rx*  »««'.]  wttb  5j;djc;n>prit.  No  rrrriPtly  is  more  «(rtf  .  i* 
jn(1i«iou;^-v  '^^'MipMr,*  d,  r  nj!'-:  ■f*-'Htrue.tivc.  if  uhu.-<t'd.  The  piotun: 
wnd  ill-i-onj^uUifd  w„.v  im  wi-ioh  it  whs"  uwd  in  former  tiin«'«,  fBtsHHl  -x 
prejudii:;!  .»«;il?k-l  it.  wh*.  h  h  tr.rr*-.iion?ib!y  i^h'-ri-shed  at  the  presfm 
('ly.  Abh-'!  *'imk  I'.f^rr-viTy  ^  t^ttr*:,  itKbrinUM  Urfe  makes  it  a  biei>..i!ig. 
--  «t  kMsr  in  thi/-  dt"?aii^:. 

Th'j  W(w»  piU  i»  •uu'of  the  best  forrn^^  of  it  (I 'S),  couibined  with 
exlfnis  of  h»>nbane.  ("5^'  pdl  at  niyht  i---  the  ii-^uai  aaiount  to  t>e 
take.!.  Borne  prtfor  die  mercury  with  ehalk  {i4M);  others,  the  corro- 
sive subiir'.atc  {ioO] ;  others,  the  proto-iodide  of  mereury  ( VM).  Some 
one  of  Uiese  shonlfl  be  :jiv(;n  abon.  five  days,  in  the  di>ses  named 
under  the  reeipes, — ••bt-ing  e-irefnl  not  to  produce  salivaiton.  Alter 
the  ^oarth  or  liftli  day,  w»^  .dti  generally  increarte  the  frequency  of  th»? 
dof'\  ShouJd  ^iiUvation  be  aeeidetitt\llv  induced,  it  should  t>t;  arre:<f<'u 
by  a  -ohnion  of  ehlorinnted  .-ixia  ^  iOJf,  one  pari  to  iwelve  of  wuVi. 
The  niereuiia!  rreatu»;it  should  eoiuinne  for  a  week  after  he  jm^w? 
has  d!sa|)|Hian'(]  :  »mi  in  the  '-a-e  of  the  indurated  dorr,  as  long  fc* 
there  i.-*  any  h.irjlne>«f 

VVater  sh.iutd  be  taker  fntly.  arwl  various  ililueni  drinkH.  They 
v.'tisjj  the  poison  out  througli  tite  iHiUionii  of  avenues*,  called  pore*, 
just  a->  we  was!;  ftlUi  out  of  eittes  by  |^)Ufirts»  wat-r  uito  'lie  <MVt'r«. 

R'.renfjy.  Ri'-M-*!.  t!ic  g  <-^:.!    Frenti.  :i'ifhority  on  this  sfubjeet.  hl'^ 
mirodueeti  a  new  treatrnejii  of    .<yphiii«  by  iron.     One   part  of  ibe 
poniHsio-tartrate  of  iron  i-^  dis!«olvt-d  iu  "iv   parts  of  watc!-.  and  tw< 
tcHs-poonfuls  are  given  three  tiine^  a  day.     The  same  st»(ution  i-'  np 
plieci  io  the  external  ^.)^e  or  i  hanere.      Ricoid  says  that  no  secoii*^; 
»yn.pto!»;»  have  been  known  to  occur  afier  this  tjfattnent.     The  l»  • 


•!Of. 


i    - .  :>Mons   tbi?  treatment  :i^   b«'?)g  eapabl-'  '^f  doinf 
i   ■  .;(ifns.     Should  its  Himens  prf-vn  equally  great  in  '  n 
>  ill  take  rank  among  the  «^«^ate«t.  gifts  to  th«   protee^j" 
■pc  <hat  iit  a  tnrnre  '•<>!:  in   cf  (hi'»  book,  a  full  U' 


:<*)  i;- 

.  .id 

'  o\ 

th. 

■  Atl 

)  ■  ■■  '< 

'It, 

P'Tllll 

\.  r-Ae  to 

reo>M  '     • 

8u. 

I  sho^ 

fii. 

it  th 

er<! 

are 

i.nuoc 

\^ 

'h' 

ej;iin. 

to  cure 

;iu.  '•- 

with  other 

rt.- 

«     ;>        "*  *.^ 

■'ho 

» t  ^ 

pvr  ■• 

!:rv. 

If 

•1 

'    un 

•lot   di  , 

lU-et'     , 

.    .  . .. 

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VENEREAL  OR  SEXUAL  DISEASES. 


829 


dogmatical,  and  say  it  cannot  be  done.  For  this  purpose,  perhaps  as 
good  a  recipe  as  has  been  proposed,  is  the  compound'syrup  of  stillin* 
gia,  tincture  of  poke  root,  tincture  of  sheep  laurel,  each  four  ounces^ 
mixed ;  of  which,  from  a  teaspoonful  to  half  a  tablespoonful  is  to  taken 
three  times  a  day.  I  think  well  of  this  remedy,  especially  if  it  be  in 
connection  with  a  small  amount  of  mercury. 

The  Bnbo,  if  not  attended  with  pain,  may  be  treated  with  compres- 
sion ;  by  a  piece  of  plaster  of  ammoniac  with  mercury  ;  or  by  touch- 
ing it  with  nitrate  of  silver.  Should  there  be  inflammation,  and  the 
formation  of  matter  be  inevitable,  the  bubo  should  be  opened  by 
touching  it  with  the  caustic  potassa ;  and  the  resulting  sore  must  be 
treated  with  the  solution  of  opium  and  water  dressing.  Should  the 
sore  need  stimulating,  it  may  be  touched  lightly  with  nitrate  of 
silver. 

Eruptions  upon  the  Skin.  —  In  treating  the  disease  after  it  appears 
upon  the  skin,  etc.,  we  shall  derive  great  advantage  from  the  use  of 
either  the  warm  or  the  vapor  bath  once  a  day.  With  this,  if  the  case 
be  not  very  old,  we  may  employ  (148)  or  (150) ;  but  if  the  disease  be 
an  old  one,  showing  itself  in  the  throat,  or  attacking  the  bones  of  the 
face,  we  must  give  iodide  of  potassium  (138),  combined  with  com- 
pound decoction  of  sarsaparilla.  This  is  the  great  remedy  for  tertiary 
syphilis ;  but  when  the  case  is  obstinate,  it  may  sometimes  be  discon- 
tinued, and  the  corrosive  sublimate  (139)  be  substituted  for  it. 

It  is  to  be  observed  that  the  older  the  disease  grows,  and  the  more 
chronic  its  character,  the  more  does  mercury  lose  its  control  of  it 
In  the  first  attack,  the  blue  pill  is  the  best ;  in  the  second,  as  a  gen- 
eral thing,  the  iodide  or  the  biniodide  of  mercury ;  in  tiie  third,  the 
corrosive  sublimate  ;  in  the  attacks,  subsequent  to  this,  particularly  in 
the  tertiary  form  of  the  disease,  the  iodide  of  potassium.  When  the 
throat  and  nose  are  so  ulcerated  as  to  make  a  case  absolutely  terrible 
to  contemplate,  it  is  surprising  to  see  how  rapidly  the  recovery  will 
often  take  place  under  the  influence  of  this  latter  remedy. 

For  syphilitic  iritis,  apply  frictions  twice  a  day  on  the  eyelids  and 
eyebrows  with  ointment  (172)  (173) ;  and  admi..-:ter  internally  two 
pills  of  (136),  daily. 


Case  I. 

from  the 


-  Mr.  — 

State  of 


-,  aged  sixty,  was  sent  to  me  by  his  physician, 
.     He  had  deep  and  extensive  ulcers  in  the 


upper  cavity  of  the  throat,  extending  to  the  tonsils,  and  to  the  arch 
of  the  palate.  Swallowing  had  become  very  difficult,  and  much  fear 
was  felt  both  by  the  patient  and  by  his  physician,  that  death  would 
follow  at  no  distant  day,  from  absolute  inability  to  swallow  at  all. 
The  ulcers  had  the  peculiar  yellow  color  which  so  clearly  marks  these 
sores.  I  informed  him  that  his  disease  was  tertiary  syphilis.  lie 
said  he  had  once  had  the  disease,  many  years  before,  but  had  sup- 
posed himself  cured.  The  letter  brought  me  from  his  physician,  a 
most  respectable  man,  shovved  that  he  also  had  no  suspicion  of  tlie 
real  nature  of  the  complaint.  This  case  is  well  represented  by  Platk 
VI.,  Fig.  1. 


St ,      -  *  < 


1.1  .       Ati 


sso 


VENEREAL  OR  SEXUAL  DISEASES. 


I  put  this  patient  upon  a  preparation  of  iodide  of  potassium,  and 
several  other  articles,  which  I  keep  on  hand,  and  syringed  his  throat 
once  a  day,  with  a  weak  solution  of  the  acid  nitrate  of  mercury  (226), 
and  in  one  week,  he  swallowed  his  food  easily.  In  three  weeks,  he 
went  home,  his  throat  was  nearly  well,  and  his  bodily  health,  which 
had  been  much  shattered,  restored.  His  physician,  much  astonished 
at  his  altered  condition,  wrote  immediately  to  know  what  I  had  done 
for  him.  This  patient,  though  in  humble  circumstances,  has  ever 
since,  sent  me  an  annual  present,  which,  though  not  of  great  value,  is 
highly  prized  by  me  as  evincing  a  gratitude  not  forgetml  of  peculiar 
benents. 

Case  II.  —  In  the  summer  of  1856,  a  gentleman  of  distinction  came 
to  me  from  a  distant  state  ;  and,  being  so  much  reduced  as  to  make 
it  doubtful  whether  he  would  ever  reach  Boston,  he  brought  his  family 
physician  with  him  to  render  him  assistance  on  the  journey  in  case 
of  possible  emergency. 

His  voice  was  reduced  very  nearly  to  a  whisper.  I  found  a  breach 
through  the  palatine  arch,  and  considerable  ulceration  in  the  back  of 
the  pharynx,  though  not  as  much  as  is  represented  in  Plate  VI., 
Fig.  1.  He  was  harassed  with  a  cough,  and  his  flesh  and  strength 
were  so  far  reduced  that  his  high  official  duties  had  been  fo*-  some 
time  laid  aside.  He  was  supposed  by  his  friends  to  be  verging  tow- 
ards the  last  stages  of  consumption ;  and  their  consent  was  gained 
for  his  journeying  to  Boston,  only  because,  as  they  supposed,  no  hope 
opened  to  him  in  any  other  direction. 

My  pronouncing  it  a  case  of  tertiary  syphilis  surprised  the  very 
excellent  physician  who  came  with  him,  and  who  failed  to  recognize 
the  nature  of  the  complaint  only  because  he  had  not  been  accustomed 
to  seeing  cases  of  the  kind.  The  disease  was  of  eighteen  years  stand- 
ing,—  being  the  lingering  constitutio"il  result  of  a  case  of  g-oforrhcBa 
(and  I  have  seen  several  such  resul*  of  gonorrhoea,  whatever  Ricord 
may  say  to  the  contrary),  contractet  in  a  single  lapse  from  virtue  in 
early  manhood. 

The  treatment  was  almost  identical  with  that  in  Case  I.,  except 
that  tonics,  —  particularly  some  of  the  preparations  of  iron,  —  were 
required  to  bring  up  the  strength.  The  iodide  of  potassium  showed 
its  usual  specific  power,  and  I  had  the  pleasure  to  send  the  patient 
home  in  a  tolerably  good  state  of  health. 

Case  III.  —  One  of  the  worst  cases  I  have  ever  treated  was  pre- 
sented in  the  person  of  Mr. ,  who  came  from  a  considerable  dis- 
tance to  consult  me  in  reference  to  a  badly  ulcerated  throat,  for  which 
all  tried  remedies  had  proved  useless.  The  first  glance  at  the  throat, 
showed  the  ulceration  tp  ])e  syphilitic.  The  uvula  and  the  entire 
palatine  arch  were  gone  ;  the  ulceration  had  gone  deep  into  the  phar- 
ynx. These  two  circumstances  made  swallowing  extremely  difficult ; 
indeed,  nothing  could  be  swallowed,  except  the  most  bland  liquids, 
and  death  by  starvation  was  near  at  hand. 

No  time  was  to  be  lost.     I  put  the  patient  upon  large  doses  of 


of 


VENEREAL  OK  SEXUAL  DISEASES. 


•Ml 


iodide  of  potassium,  with  compound  infusion  of  gentiiai'.  and  fluid 
extract  of  sarsaparillu,  and  showered  the  throat  every  other  day  with 
a  weak  solution  of  acid  nitrate  of  mercury  (226),  and  in  ten  days, 
tender  beef  steak  was  chewed  and  swallowed  with  comfort. 

This  patient  stayed  in  Boston  six  weeks,  and  went  home  with  ten 
pounds  more  flesh  than  he  brought  with  nim;  and  by  using  the  above 
remedies  six  months,  has  regained  excellent  health.  Plate  VI., 
Fig.  2,  is  a  representation  of  this  throat  as  it  appeared  when  it  came 
under  treatment. 

Fortunately,  these  cases,  terribly  destructive  as  they  are.  are  almost 
always  curable,  if  properly  managcl 

Clap. — Gonorrhoea. — Blenorrhagia. 

The  reader  is  aware  that  the  nose,  mouth,  and  lungs,  are  lined  with 
a  mucous  membrane,  which  is  liable  to  become  inflamed  from  various 
causes.  This  inflammation  we  call  a  cold  or  catarrh.  During  its 
continuance,  mucus,  and  other  matters  of  different  color  and  degrees 
of  consistency,  are  more  or  less  freely  discharged. 

The  nmcous  membrane  of  the  private  parts  of  both  sexes,  iS  just 
like  that  of  the  mouth  and  throat,  and  subject  to  similar  inflamma- 
tions and  discharges.  But  these  inflammations  of  the  private  parts, 
instead  of  being  produced  by  changes  of  weather,  etc.,  generally  result 
from  the  application  of  the  specihc  poison  of  gonorrhoea.  When  a 
woman  abandons  herself  to  unlimited  intercourse  with  different  men, 
the  private  parts  become  stimulated  to  so  unnatural  an  extent,  that 
the  secretions  of  the  parts,  which  are  largely  augmented,  at  length 
become  altered  in  their  nature,  acrid,  and  finally  poisonous,  —  so  acrid 
and  poisonous  that  they  cause  inflammation  of  the  parts,  and  when 
applied  to  the  male  organ,  in  the  sexual  act,  they  poison  and  inflame 
that. 

This  is  the  shortest  and  plainest  explanation  I  can  give  of  clap. 
From  this  explanation,  one  may  learn  why  a  man  will  sometimes 
take  a  disease  from  a  woman  who  has  never  had  any  evidences  of 
being  diseased  herself.  If  she  have  indulged  her  sexual  propensities 
unreasonably,  though  not  enough  to  produce  inflammation  upon 
herself,  her  secretions  may  yet  have  become  acrid  enough  to  poison 
one  whose  organs  are  delicate  and  sensitive.  And  more  than  this. 
The  secretions  of  a  female  may  become  aCrid  and  poisonous  from 
other  causes  than  excessive  venery.  The  discharges  in  bad  cases  of 
whites  will  sometimes  irritate  and  inflame  the  male  organ,  and  induce 
a  disease  which  has  evefy  appearance  of  gonorrhoea.  A  husband,  in 
great  distress  of  mind,  sometimes  submits  a  case  of  this  sort  to  the 
physician's  inspection,  and  lays  upon  him  the  delicate  and  resix>n8ible 
duty  of  deciding  whether  the  wife  has  been  unfaithful.  No  act  in  a 
whole  professional  life  can  be  more  momentous  than  a  decision  of 
this  sort.  If  a  man  be  well  skilled  in  his  art,  he  may  give  an  answer 
in  such  case,  which  shall  dispel  the  most  terrible  apprehensions,  and 
save  the  peace  of  a  loving  family. 

The  poison  when  applied  by  a  diseased  person  to  the  male  or 


>'t. 


If!' 

''-'•  'M 

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female  organs*,  requires  a  certain  time  to  produce  its  peculiar  effect, — 
generally  from  three  to  eight  days. 

SyiiiptomSi  —  The  first  symptom  of  the  disease  is  uneasiness  in  the 
end  of  the  penis,  accompanied,  generally,  with  a  little  redness,  and 
difficulty  in  passing  water.  The  color  of  the  first  dit^charge  may  be 
white  or  straw-colored.  There  is  tenderness  where  the  parts  are  retl. 
Scalding  in  passing  water  is  sometimes,  not  always,  present  at  first. 

This  is  the  beginning,  or  first  stage  of  clap.  Now  is  the  time  to 
cure  it  easily.  But,  unfortunately,  the  physician  seldom  sees  a  cast> 
in  this  early  stage.  Before  he  is  allowed  to  inspect  it,  the  secoiui 
stage  has  generally  appeared,  which  is  known  by  violent  scalding 
when  water  is  passed,  by  chordee,  or  painful  erections  of  the  ponifi, 
and  by  an  increased  discharge  of  greenish  matter  often  tinged  with 
blood,  and  coming  from  much  farther  down  the  urethra,  or  water- 
passage.  The  matter  sometimes  comes  from  as  far  down  as  opposite 
the  scrotum,  or  bag  which  holds  the  testicles.  There  is  more  or  less 
pain  in  the  loins  and  back.  The  whole  body  of  the  penis  may  be- 
come affected,  and  abscesses  form. 

A  third  and  more  terrible  stage  of  the  disease  begins  when  the  in- 
flammation has  reached  the  lowest  part  of  the  water-passage,  just 
where  it  enters  the  bladder.  Around  this  part  of  the  passage,  and 
lying  upon  the  bladder,  is  a  gland  in  size  and  >hape  like  the  largest 
chestnut.  It  is  called  the  prostate  gland.  On  ther  side  of  it,  lie  the 
receptacles  of  the  semen,  each  of  which  sends  s  duct  into  the  water- 
passage.  When  the  inflammation  extends  through  this  gland,  it  irri- 
tates the  neck  of  the  bladder,  and  causes  a  distressing  desire  to  pass 
water  ;  and  from  its  proximity  to  the  larger  bowel,  it  sends  its  irrita- 
tion thither  likewise,  and  impels  a  terrible  effort  to  evacuate  the 
the  bowels,  called  tenesmus.  It  is  the  same  awful  feeling  experienced 
in  dysentery.  Few  things  can  be  more  terribie  than  these  two  dis- 
tressing feelings  conjoined,  —  the  desire  to  pass  water  and  to  empty 
the  bowels.  Racked  with  terrible  pains,  and  awful  tenesmic  dis- 
tresses, and  often  with  painful  erections,  the  patient  passes  back  and 
forth  between  the  bed  and  stool,  —  often  vowing,  in  the  sincerity  of 
his  heart,  that  if  he  can  but  recover  from  this,  he  will  never  be  caught 
again.  The  enlargement  of  this  prostate  gland  may  become  chronic 
and  permanent,  and  be  the  affliction  of  a  man's  life. 

Stricture.  —  One  of  the  most  troublesome  and  persistent  conse- 
quences of  gonorrhoea  is  a  partial  closing  up  of  the  water-pipe,  at- 
tended generally  by  quite  a  serious  obstruction  to  the  passage  of  the 
water.  It  ia  called  stricture.  The  mucous  membrane  which  lines 
this  passage,  being  long  inflamed,  becomes  thickened  and  less  pliable 
or  elastic.  The  tissues  which  lie  underneath  this  membrane,  also 
become  swollen  and  hardened,  and,  pressing  upon  the  water-passage, 
lessen  it  still  further,  —  making  the  stricture  more  difficult  of  cure. 

In  stricture,  the  stream  of  urine  is  altered  in  size,  length,  and  force. 
Its  course  is  changed,  when  the  stricture  is  lateral.  The  stream  is 
often  flattened,  like  the  blade  of  a  pen-knife,  or  twisted  like  a  gimlet, 
or  forked,  —  one  stream  reaching  beyond  the  other.     Inconsequence 


I  I 


■^^HB  m 


VENEREAL  01'.  SEXUAL  DISEASES. 


333 


of  obstruction,  the  bladder  is  not  entirely  emptied,  and  the  desire  to 
urinate  immediately  returns,  and  is  very  urgent. 

Gleeti — Another  very  troublesome  result  of  gonorrhcEa  is  ffleet, — 
a  thin,  colorless  discharge,  which  persists,  in  a  chronic  form,  after  all 
active  inflammation  has  subsided.  It  is  very  annoying,  and  very  ob- 
stinate. It  is  often  dependent  on  the  altered  condition  of  the  mucous 
membrane  occasioned  by  stricture. 

O^cliitiii.  —  Another  very  severe  result  of  clap  is  swelling  of  the 
tt  sticles,  called  orchitis.  It  begins  frecpiently  with  cliills  and  fevor, 
with  a  feeling  of  weight  in  the  sirotnin,  and  pains  in  the  loins.  The 
swelling  rapidly  increases,  and  reaches  its  height  in  from  three  to  five 
days. 

Reside  the  above,  there  are  still  other  mischiefs,  which  follow  this 
disease,  such  as  inflammation  of  the  prostate  gland,  already  described, 
of  the  bladder,  and  of  the  kidneys. 

In  the  female,  gonorrhceal  inflammation  affects  the  external  geni- 
tals called  the  vulva,  the  water-pipe,  the  vagina,  and  the  neck  of  the 
womb. 

There  is  a  difference  of  opinion  as  to  whether  gonorrhoea  ever  pro- 
duces secondary  or  const itntional  sy'..,,>(onis.  Ricord,  the  great 
French  authority  on  this  subject,  affirms,  and  with  him  a  great  num- 
ber of  followers,  including  most  of  the  profession  in  this  country, 
that  constitutional  syniptonis  never  follow  clap  ;  that  they  never  re- 
sult from  anything  but  a  sijpkililic  ulcer.  Vidal,  a  French  authority, 
safer,  in  my  jtidgment,  than  Ricord,  though  not  as  renowned,  says,  on 
I  he  contrary,  that  secondary  and  tertiary  complaints  do  follow  viru- 
lent gonorrhcea.  "Wilson,  the  highest  Euglish  authority,  and  many 
others,  agree  with  him.  Unprejudiced  observers  feel  well  tionvinced 
that  this  latter  opinion  is  right.  I  have  myself  seen  not  less  than 
half  a  dozen  cases  of  secondary  and  tertiary  syphilis,  which  were 
preceded  by  gonorrhoea,  and  nothing  more.  Case  I.  was  of  this 
kind. 

Treatment — In  the  first  stage  of  the  disease,  there  are  two  meth- 
oda  of  treatment,  either  of  which  may  be  adopted  with  success.  The 
first,  which  has  many  advocates,  is  the  local  treatment.  An  injection, 
with  a  glass  syringe,  is  immediately  made,  of  a  solution  of  nitrate  of 
silver,  of  the  strength  of  five  to  ten  grains  to  the  ounce  of  water.  It 
should  be  retained  from  one  to  five  miimtes,  by  pressing  the  head  of 
the  penia  between  the  thumb  and  finger.  If  doiie  before  the  third 
day,  this  will  generally  cure  the  disease. 

The  physician  should  have  entire  control  of  the  patient,  and  com- 
pel him,  if  possible,  to  keep  his  room,  and  live  for  a  few  days  on 
crackers  and  water,  or  something  equally  simple.  All  meats  and 
atimulating  drinks  are  to  be  excluded. 

The  other  mode  of  treatment,  which  is  perhaps  the  more  commonly 
adopted,  ia  more  general  in  its  nature.  It  embraces  the  use  of  warm 
baths,  warm  sweating  drinks,  and  rest  If  the  patient  is  full  of  blood, 
and  strong,  from  five  to  fifteen  leeches  are  applied  to  the  space  be- 
tween Hie  scrotum  and  fundament.*  These  things,  with  a  low  diet, 


Hi 


! 'fi'  n 


it  -i:i: 


' 


I 

I 

K 


I 


i 


Mr  »" 


334 


VENEREAL  OR  SEXUAL  DISEASES. 


will  frequently  reduce  the  disease  in  a  few  days.  If  the  discharge 
Hhould  continue,  after  a  fair  trial  of  the  above,  then  copaiba  and 
eubebs  (272)  are  to  be  used.  Several  articles  are  added  in  the  above 
prescription,  to  make  the  copaiba  acceptable  to  the  stomach.  This 
preparation  can  De  takoi,  by  most  persons,  and  generally  produces 
very  gratifying  results.  Vidal  strongly  reconuuends  an  electuary,  or 
thick  paste  (273),  of  wliieh  a  piece  twice  as  large  as  a  nutmeg  is  to 
be  taken  in  the  eours«;  of  the  day.  The  prescriptions  wliicli  contain 
copaiba  and  cubebs  are  numerous ;  but  the  above  two  are  as  gotnl  as 
a  hundred.  With  these  articles,  the  baths,  the  leeches,  and  the  repose, 
are  to  be  united. 

Vidal  says  he  never  resorts  to  injections  first,  but  employs  the  anti- 
inflammatory course  first.  If  that  fail,  then  he  uses  the  injection 
(207)^  three  or  four  times  a  day;  and  if  he  employs  the  nitrate  of 
silver  at  all,  it  is  only  as  an  astringent  (208).  Prescription  (304)  is  a 
valuable  injection. 

When  the  second  stage  sets  in,  and  the  symptoms  become  more 
violent,  injections  must  not  be  used.  For  the  very  severe  scalding  in 
passing  water,  whicli  is  now  felt,  take  thirty  drops  of  a  solution  of 
potassa  in  half  a  tumblerful  of  water,  twice  or  three  times  a  day. 
Persons  of  full  habit,  may  be  benefited  by  dissolving  a  grain  or  two 
of  tartar  emetic  in  a  tumbler  of  water,  and  taking  to  the  extent  of 
producing  a  little  nausea.  Relief  is  occasionally  obtained  by  holding 
the  penis  for  some  time  in  warm  water. 

For  the  painful  ehordee,  or  erections,  camphor  and  opium  (120)  are 
required,  —  from  one  to  three  pills  a  day.  Thirty  drops  of  laudanum 
may  be  given  when  the  patient  retires.  Cold  applications  to  the  gen- 
ital organs,  or  walking  barefooted  upon  the  ci^ld  lloor,  will  frequently 
give  relief.  WIhmi  other  things  fail,- three  })ills  a  day  may  be  taken 
of  extract  of  hyoscyamus,  containing  from  one  to  four  grains  each. 
The  quantity  of  drinks  must  be  diminished,  and  cold  lotions  must  be 
applied  to  the  penis  on  going  to  bed,  —  the  patient  covering  himself 
lightly. 

Gleet  is  generally  very  obstinate,  and  often  requires  a  very  pro- 
tracted treatment.  If  there  be  any  tenderness  along  the  under  side 
of  the  penis,  it  is  well  to  apply  three  or  four  leeches.  Occasionally 
recipe  (272)  will  have  an  excellent  effect.  But  gleet  is  an  unhealthy 
action,  sustained  by  habit,  and  may  often  be  cured  by  simply  exciting 
a  new  action  which  shall  break  the  old  habit.  It  is  always  well, 
therefore,  to  resort  to  injections.  Sugar  of  lead  and  sulphate  of  zinc 
(207)  answer  a  good  purpose;  or  sulphate  of  zinc  and  tannin  ^209) 
may  be  tried.  Chloride  of  zinc  (210)  does  well  in  some  obstinate 
cases. 

But  gleet  is  often  dependent  on  stricture,  and  when  this  is  the  case, 
we  must  learn  the  location  of  it  by  exploring  the  water-pipe  with  a 
bongie.  When  the  instrument  reaches  the  constricted  part,  the  pa- 
tient feels  pain,  or  tiie  surgeon  meets  an  obstruction,  —  often  both. 
When  the  stricture  is  found,  it  is  either  to  have  the  solid  nitrate  of 
silver  applied  to  it  with  an  instrument  called  the  parte  caustique^  or  a 


VENEREAL  OU  SEXUAL  DISEASES. 


335 


solution  of  nitrate  of  silver  (211),  or  of  acid  nitrate  of  inorcury  (226), 
with  a  shower  syrinc(>  which  I  have  had  prepared  for  the  pur|)08e. 
When  these  means  Tail,  we  must  pass  a  srrall  bongie  gently  through 
the  stricture ;  then  a  lurger,  and  then  a  still  larger  one,  mitil  the  ol)- 
structlon  be  removed.  They  should  Ix*  ust'd  once  or  twice  a  day,  and 
not  be  retained  long  in  the  passage.  They  freciucntly  have  to  ^te 
used  ten  or  twelve  weeks,  and  should  not  In?  discontinued  till  the  cure 
is  complete.  Put  no  coniidence  in  those  quacks  who  promise  to  cure 
these  old  troubles  in  a  few  days.  They  want  your  money,  'Ut  have 
no  expectation  or  ability  to  cure  you  at  all. 

For  inflammation  of  the  t*.'sticles,  apply  leeches  at  once.  To  this 
should  be  added  warm  fomentations,  and  poultices.  If  these  means 
fail,  more  serious  measures  are  to  be  adopted,  which  it  would  be  out 
of  place  to  describe  in  this  book. 

Inflammation  of  the  prostate  gland  is  also  to  be  treated  with 
leeches  and  poultices,  —  likewise  a  warm  hip-bath.  The  water  must 
be  drawn  otf  with  a  catheter  until  it  can  be  passed  in  the  natural 
way. 

Prevention  of  Sexual  Disennei^. — I  have  several  times  been  in  doubt 
as  to  the  best  method  of  presenting  some  of  the  topics  which  the  wide 
scope  of  this  book  has  brought  before  me ,  but  no  one  subject  has 
perplexed  me  like  the  one  announced  in  the  above  heading,  —  not 
that  it  is  not  easy  enough  to  furnish  the  rules  for  preventing  venereal 
disease,  but  that  it  is  a  grave  (juestion  in  morals  whether  to  instruct 
the  world  in  the  methods  of  such  prevention  is  right.  Is  it  proper  to 
give  any  other  advice  than  the  simple  direction  to  abstain  from  all 
liability  to  disease  ?     That  is  the  question. 

If  such  advice  would  be  heeded,  of  course  no  other  should  be  given. 
But  it  would  not.  If  the  person  disregarding  it  Would  alone  sufl'er 
the  penalty  of  the  trangression,  it  might  then  be  best  to  embody  the 
whole  advice  in  the  simple  imperative  word,  abstain!  But  this  can- 
not be.  The  infection  will  be  imparted  to  a  third  |)crson,  and  onward 
to  thousands  ;  and  many  of  these  thousands  will  be  iimocent  wives, 
who  will  perish  of  the  disease,  or  send  the  infection  down  to  the 
second,  the  third,  the  fourth,  and  to  all  generations !  While  a  strict 
morality  might  seem,  therefore,  at  first  view,  to  forbid  the  inculcation 
of  rules  for  avoiding  infection,  the  good  of  the  race  would  appear  to 
justify  and  require  it 

The  first  requisite  for  prevention  is  cleanliness.  Frequent  washing 
is  of  prime  importance. 

The  precautions  should  not  be  the  same  before  and  after  the  vene- 
real act,  when  a  person  is  about  to  expose  himself  to  risk.  Before 
the  act,  the  parts  should  be  carefully  examined,  to  see  if  there  be  any 
break  in  the  skin.  The  least  breach  in  this  covering  of  the  penis 
greatly  promotes  contagion.  Before  coition,  there  should  be  no  wash- 
ing with  soap,  for  this  deprives  the  parts  of  the  mucus  and  oil, — 
thus  rendering  the  naked  and  exposed  skin  liable  to  infection.  On 
the  contrary,  to  apply  a  solution  of  alum,  tannin,  or  a  decoction  of 
oak  bark,  or  aromatic  wine,  constringes  or  hardens  the  covering  of  the 


336 


VENEREAL  OR  SEXUAL  DISEASEa 


ll 


m 


organ,  and  renders  contagion  more  ditlicuit.  An  article  called  con- 
dom is  often  used  to  ward  ort  disease.  It  is  a  sack  made  of  gold 
Lw^ater't*  rtkin,  and  is  drawn  over  the  pt'nis  like  a  glove  over  the  finger, 
and  tiius  protects  it  from  cf>ntact  with  jjoisonous  matter. 

or  stiii  greater  importance  are  prompt  measures  of  prevention 
after  the  acL  Ixuion?  «hould  b<'  immediately  applied  to  every  part 
of  the  organ,  and  in  the  ease  of  females,  should  be  U3«?d  as  injections. 
These  lotions  slionld  be  acids  or  alkalies.  A  mixture  of  vinej/ar  and 
water  h  is  been  recommended  as  an  exceUent  wash.  Record  reeom- 
uu'IkIs  aromatic  wine ;  Malapert,  coiTosive  sublimate  ('212),  in  the 
form  of  -••oiution.  ]*robably  the  l)est  preventive  is  com|K)sed  mainly 
of  alcohol  ami  noap  (213),  as  reconnnended  by  Langlelwrt. 

An  expo.-.<(l  person,  n^ing  any  one  of  these  solutions,  particularly 
the  last,  or,  m  th«'  absence  of  all  these,  washing  thoroughly  with  soap 
and  water,  will  be  likely  to  escape  contagion. 

9l(Mli('iill  l*oli<'t». —  What  is  called  general  prophylaxis,  or  prevention, 
or  medical  |M)liee,  is  not  a  subject  of  legislation  in  this  country.  The 
moral  sense  of  llie  Amerieim  people  doi-s  not  admit  its  necessity.  In 
Eurojx*,  the  autliorities  walcli  ov<'r  prostitution.  They  even  go  so 
far  as  to  regulate  it.  They  appoint  practitioners,  wlu)se  duty  it  m  to 
act  as  a  sort  of  medical  poli<'e,  and  particularly  to  visit  housci  of 
prostitution  once  or  rwice  a  wi-ek.  and  examine  all  the  iraTiates. 
When  a  girl  is  found  discaKcd,  she  is  innnediafely  removed  to  a  hos- 
pital, and  not  \)ermitted  to  return  until  she  is  weli. 


hi'- 


!i 


Self- Pollution.  —  Masturhation.  —  Onanism. 

Tar, HE  is  probably  no  vice  to  which  so  many  boys  and  young  men, 
and  even  girls  and  younp;  women,  are  addicted,  and  from  which  so 
many  constitutions  break  down,  as  self-pollution.  Suiall  boy«  and 
girls  learn  i\w  vile  practice  of  the  larger  ones  at  school,  and  generally 
continue  it  up  to  maturity,  without  the  h.'ast  suspicion  that  they  are 
inflicting  upon  themselves  either  a  moral  or  a  physical  injury. 

This  comrs  of  the  false  modesty  and  b^istard  morality  which  with- 
holds frt)m  the  young  all  knowledge  of  the  pro|)er  functions  of  their 
sexual  organs,  and  of  the  ineon'.;eivable  tnisehitf  resulting  from  their 
abuse.  A  gentleman  of  distinction  lately  said  to  me  :  "  \  ii.struct  my 
boys  as  faithfully  on  ih'  "subject  as  u|>on  any  other  moral  or  physical 
question,  and  I  t(;ll  my  wife  it  is  her  duty  to  do  the  sauie  with  the 
girls."  This  is  w^ise.  Yei,  how  few  parents  ever  speak  to  their  boys 
or  girls  on  the  subject,  or  give  them  the  least  reason  to  suppose  there 
is  any  better  rule  for  tiieir  conduct  than  their  own  desires ! 

SjTWptcnis. —  These  are  very  numerous.  The  principal  are,  head- 
ache, wakefulness,  restless  nights,  indolence,  indisposition  to  study, 
melancholy.  desjK)tKlenoy,  forgetfulncss,  weakness  in  the  back  and 
private  organs,  a  lack  of  confidence  in  one's,  own  abilities,  cowardice, 
mability  to  look  another  full  in  th«?  face,  and,  among  females,  hysterics, 
whites,  and  a  desirt;  Ibr  seclusion  from  society  and  solitude. 


r 


VENEREAL  OR  SEXUAL  DISEASES. 


337 


ack  and 

vartUce, 

lysterics, 


I  have  already  spoken  of  the  receptacles  of  semen,  lying  on  each 
side  of  the  prostate  gland.  From  the  fore  part  of  these  receptacles, 
the  M>m(.>n  passes  through  two  duets,  about  a  finger's  breadth  in 
length,  into  the  urethra  or  water-pi|>e,  just  in  front  of  the  prostate. 
From  excessive  s(>lf-pollutioii,  these  ducts  become  very  irritable,  and 
also  debilitated  and  relaxed,  —  so  much  so  that  they  will  not  retain 
the  s(>men  ;  and  during  lascivious  dreams,  it  flows  off.  These  semi- 
nal lossijs  are  called  "  nocturnal  emissions."  S<>  constant  is  the  drain 
tht!y  keep  up  u|X)n  many  young  men  who  have  abused  themselves 
exct!S!*ively,  that  the  whole  man,  mentally,  morally,  and  physically, 
lx*('oiiM'H  ii  v/nu'k.  There  are  few  objects  njore  pitiable  to  b<;hold 
than  a  young  man  in  this  condition,  —  his  nervous  system  feeble, 
treiiiulous,  and  broken  ;  his  memory  weakened  and  fading  out ;  his 
eyr-  UMt^teady  and  incapa'.'e  of  looking  a  friend  in  the  face ;  his  loins 
and  h\wk  wj'akcned,  givin-;  aim  the  feeble  gait  of  old  age;  his  once 
en'ct  form  cowed  ano  bent;  his  high  sense  of  manliness  all  oozed  out 
of  him  ;  his  mind  taking  up  and  dropping  th<'  simplest  threads  of 
thouglit,  losin^its  way  in  the  plairjest  paths  of  reflection,  and  often 
starting  back  affrighted  at  the  glimpse  of  chaotic  insanity  opening 
Ix'fore  him,  —  turning  here  and  there  for  relief,  but  finding  little  hope 
of  recovery,  excj'pt  in  marriage,  and  yet  knowing  himself  unfitted  to 
be  the  husband  of  an  intelligent  woman ! 

Tretltnieilt.  —  Every  kind  of  treatment,  no  matter  how  judicious  or 
well  applied,  will  be  uiisuceessful,  unless  the  vice  which  has  prmluced 
the  disease?  be  absolutely  and  entirely  abandoned.  This  is  the  first 
thing  to  be  secured.  It  may  be  extremely  difficult  for  the  patient  to 
do  this,  with  bis  mental  and  moral  nature  all  broken  and  in  ruins, — 
with  no  heart  to  feel,  and  will  to  execute ;  and  yet  it  must  be  done, 
or  a  cure  cannot  be  eflV'(;ted. 

To  bring  this  about,  everything  must  be  done  by  the  physician  to 
strengthen  the  moral  nature  of  the  patient,  and  to  raise  his  self-respect 
and  hope.  The  most  careful  directions  nuist  be  given  for  restraining 
the  imagination.  The  p;«tient  must  be  directed  and  encouraged  to 
drive  out  from  the  mind,  instantly,  and  upon  all  occasions,  every 
lascivious  thought ;  to  cultivate  the  society  of  the  most  intellect- 
ual and  virtuous  females;  to  make  himself  6M.vy  with  useful  and,  if 
[x>ssible,  agreeable  employment ;  to  avoid  solitude ;  and  to  sleep 
with  some  friend.  He  should  sleep  on  a  mattress,  and  never  on 
feathers. 

Where  there  is  considerable  debility,  tonics  will  be  required,  as  the 
mineral  acids  ((iO)  (62)  (78),  and  bitters  (77)  (07)  (Gti)  (.09),  and 
strychnine  (83)  (9rj)  (8^j),  and  iron  (80)  (93)  (72)  (73)  (71).  In  addi- 
tion to  some  of  the  above  preparations,  the  syrup  of  the  hypophos- 
phites  should  be  taken  ft)r  some  time. 

The  food  should  be  nutritious  and  easy  of  digrstion,  and  the  cold 
alkaline  spong*-  bath  should  be  taken  once  a  day,  with  brisk  rubbing; 
and  the  private  parts  should  particularly  be  washed  daily  with  ooid 
water. 

In  conclusion,  I  say  emphatically  to  parents,  do  not  let  your  aoru 

43 


^1       ! 


S38 


VENEREAL  QR  SEXUAIi  DISEASES. 


and  daughters  remain  ignorant  on  this  subject.  It  is  plainly  your 
duty  to  enlighten  and  to  warn  them.  It  is  a  matter  in  which  young 
persons  are  generally  disposed  to  do  right,  if  rightly  instructed, 
^vqil  yourself  of  your  right  to  give  counsel,  and*  if  need  be,  to  us«' 
authority. 


ainly  your 
ich  young 
instructed, 
be,  to  us«' 


iPfi 


FEMALE    DISEASES. 


In  addition  to  +he  diseases  common  to  both  sexes,  women  are 
subject  to  a  class  of  distressing  complaints  peculiar  to  themselves, 
and  denominated,  in  general  terms,  female  diseases.  Involving  con- 
siderations of  a  delicate  nature,  these  complaints  have  too  genemlly 
and  too  long  been  shut  out  from  works  intended  for  popular  distribu- 
tion. Hence  there  is  a  general  ignorance  of  a  class  of  diseases  which 
are  fast  imfitliiig  woman  for  the  high  duty  of  continuing  the  race; 
and  the  subjects  of  these  maladies  are  generally  themselves  so  unin- 
formed of  the  true  nature  of  their  suflerings,  that  they  are  neither 
prepared  to  "^eck  relief  in  the  prop<'r  direction,  or  to  submit  tt)  the 
remedy,  if  it  chance  to  be  proposed. 

It  is  intended  here  to  sp«'ak  of  these  disorders,  as  I  have  done  of  all 
others,  in  a  plain  and  simple  way,  to  describe  them,  so  far  as  the 
present  state  of  medi(;ine  permits,  just  as  they  are,  and  to  make 
known  the  only  modes  of  treatment  which  have  been  found  available 
for  their  cure.  The  sutl'erings  of  woman  recpiire  this  ;  the  interests 
of  humanity  recjuire  it;  and  the  writer  is  impelled  to  it,  as  he  thinks, 
by  a  just  sense  of  responsil)ility. 

Physicians,  in  my  judgment,  are  chargeable  with  a  great  wrong  in 
e4)ncealing  •  ithin  their  own  breasts  information  U|K)n  what  are  called 
delicat**  sulje  -ts,  —  information  which  the  good  of  the  worhi  requires 
should  Yh^  f'ivulged,  and  whieli  they  ought  to  pour  into  the  public 
mind,  and  nkake  common,  and  which  they  would  thus  |)opulari/e,  but 
for  their  stiti'  oride  and  conservaTlsm. 

The  id«-d  that  our  knowh-dge  cannot  be  impart<'d  to  the  world 
without  injuring  the  public  morals,  is  simply  absurd.  We  are  more 
a/raid  of  bringing  the  conunon  people  t(X)  near  to  u.s,  of  letting  down 
our  dignity,  and  of  o|X'ning  our  profound  secreets  to  |Mipular  eyes. 
The  re.><ult  is  an  it  should  be,  that  unsophisticated  jx'ople  are  apt  to 
give  |>hysieian.s  a  wide  b«Tth,  and  to  have;  nothing  to  do  with  them, 
unless  i»*-^*>.s.sity  eoin|)els.  Tict  doctors  .strip  off  their  reserve,  and 
while  th«^y  remain  genilenien,  become  likewise  companions,  impart- 
ing their  knowledge  frrtdy  and  familiarly  to  all,  and  the  public  eon- 
fidence,  now  '/>nsiderubiy  shaken,  will  be  frankly  restored  to  the  pro- 
fession. 

It  should  be  *hv  obj<  ct  of  a  good  physician  to  know  all  he  can,  and 
to  irnptrt  his  knowledge  to  as  many  as  |K>ssible.     Knowledge  is  not 


H' 


m 


merely  power ;  it  is  happiness,  it  is  wisdom,  it  is  health,  it  is  virtue ; 
yes,  it  is  always  virtue,  except  in  some  rare  instancf^s,  where  the  worst 
natures  pervert  it.  No  physicians  are  so  much  loved  as  those  who 
are  frank,  and  have  no  concealments.  The  day  for  mysterious  nods 
of  the  head,  and  rollings  of  the  eyes,  and  shrugs  of  the  shoulder,  has 
gone  by.  Men,  and  women  too,  (or  those  of  them  who  are  wise), 
wish  to  know  distinctly  what  their  diseases  are,  and  what  ia  ueoe&> 
sary,  not  to  palliate  and  prolong,  but  to  cure  them. 

Time  wlipu  Female  Diiiea.se8  Begfin.  —  Female  complaints  begin  to 
make  their  api>earance  at  the  period  of  life  called  puberty,  —  the  time 
when  the  girl  passes  from  childhood  to  womanhood.  This  is  the 
period  when  menstruation  is  established,  which  consists  of  a  discharge 
from  the  genital  organs,  com|M)sed  of  blood  and  mucus,  and  which 
occurs,  when  regular,  every  four  weeks.  Up  to  this  period,  the  system 
of  reproduction  has  remained  dormant-  By  the  intervention  of  thb 
mysterious  function,  the  young  female  becomes  a  new  being.  The 
heart  unfolds  itself  to  new  emotions ;  the  mind  assumes  a  solidity 
before  unknown,  and  even  the  body  acquires  btsauty  from  a  sudden 
rotundity  of  form. 

This  is  the  jMiriod  when  the  great  question  of  fiMuale  health  is  very 
apt  to  be  settled  once  for  all,  and  for  life.  The  girl  who  is  well 
trained  at  this  time,  generally  has  a  foundation  laid  for  health  and 
character,  which  is  worth  more  to  her  than  riches.  At  no  time  does 
the  mother  need  so  much  wisdom  and  knowledge  as  now.  To  es- 
tablish the  health  and  develop  the  aflfections  of  tlie  daughter  at  this 
ciitical  period,  is  a  sacn-id  trust  which  she  can  devolve  upon  no  other 
being;  nor  can  she  meet  her  responsibilities  at  this  time, unless  better 
informed  than  most  mothers  are.  ,  The  general  apathy  in  regard  to 
this  maternal  duty  is  deplorable. 

4  

False  Delicacy.  —  The  refined  delicacy  which  withdraws  these  sub- 
jects from  the  public  gaze,  is  commendable,  for  it  casts  a  beautiful 
chann  over  s#x;iety ;  but  when  carried  so  far  as  to  spread  a  veil  even 
over  the  eyes  of  mothers,  it  is  quite  unnatural,  and  leads  to  the  wont 
results ;'  for  in  the  bad  management  of  girls  at  this  critical  period  is 
l:iid  the  foundation  of  many  of  the  disea.ses  which  shatter  the  consti- 
tution  of  so  many  women.  For  this  bad  management,  it  is  not 
mothers  alone  who  are  t«  be  blamed.  The  neglect  of  the  medical 
profession  t^i  furnish  the  neoassary  information  should  come  in  for  its 
full  shan;  of  reproaci'. 

Tlie  liNtalilislinieiit  of  the  Heiuifit.  —  Nature  always  comes  slowly 
and  by  degrees  to  the  inauguration  or  establishment  of  any  of  her  great 
functions.  It  is  «>  in  regard  to  meustruaisHi,  or,  as  it  is  variously 
called,  "the  menses.*  "the  courses,"  "tli*»  «*vMige,"  "the  flowers, 
"  nature,"  etc.  Fur  ?*>me  time  before  tiw  ik^  be;gins,  there  are  cer- 
tain symptoms,  or  p»f  monitions,  whick  t©  tiie  eve  of  the  physician, 
plainly  enough  f'lretelt  the  i.npendNi|(  eliny.  To  the  laothi^r  the«e 
signs  would  be  equally  intiilligibii^  'iwwe  slie  as  well  infoniHxl  as  she 
■bould  be.     It  is  plainly  her  dut*  «o  be  intelligent  enough  to  assist 


virtue ; 
le  worst 
ose  who 
)us  noda 
dcr,  has 
e  wise), 
a  neoe»> 


begin  to 
the  time 
a  is  the 
idchargc 
d  which 
i  system 
II  of  thb 
ig.  The 
solidity 
\  sudden 

h  is  very 
)  is  well 
alth  and 
iiie  docs 
Toes- 
r  at  this 
no  other 
!ss  better 
regard  to 

lese  sub- 
jeautiful 
veil  ev«n 

le  wont 
period  is 
e  consti- 
it  is  not 

medical 
in  for  its 


IS  slowly 
her  great 
variously 
JUnvers, 
are  oer- 
hysician, 
Wt  the«»e 
I  vi  as  she 
to  assist 


f^ 


FKMALE  DISEASES. 


341 


natnre  in  the  establishment  of  this  important  function.  Rut  how 
often,  either  from  ignorance,  or  from  false  ideas  of  delicacy,  does  she 
fail  to  interfere,  and  allow  the  daughter  to  be  taken  by  surprise,  and 
perhaps  frightened  and  thrown  into  convulsions! 

From  inquiries  made  of  about  one  thousand  women,  a  distin- 
guished English  physician  found  that  about  one  quarter  were  unpre- 
pared for  the  appearance  of  the  menses.  Some  of  the  girls  were 
frightened  and  went  into  hysterical  fits ;  others  thought  they  were 
wounded,  and  washed  with  cold  water.  The  flow  was  stopped  in 
several  cases ;  and  in  some,  never  restored ;  while  the  health  of  all 
in  whom  it  was  interrupted,  was  seriously  impaired. 

Symptoms  of  the  First  Menstmation.  —  A  variety  of  symptoms  pre> 
cede  and  foretell  the  first  menstruation.  Headache,  dizziness,  slug>- 
gishness  of  thought,  and  disposition  to  sleep;  —  these,  occurring  in  a 
girl,  may  be  taken  as  hints  that  the  "  change  "  is  at  hand.  If  to  these 
be  added  pains  in  the  back  and  lower  limbs,  the  intimations  will  be 
still  more  significant 

At  this  time  a  girl  loses  a  relish  for  the  society  of  children  ;  she  is 
apt  to  acquire  a  taste  for  solitude  ;  her  temper  becomes  wayward  and 
fretful ;  her  eyes  acxjuire  a  peculiar  lustre ;  she  becomes  a  sort  of 
mystery  to  her  friends  and  herself, —  not  her  physical  frame  only;  her 
whole  character  is  changed.  She  is  about  stepping  into  a  new  life. 
Her  emotions,  thoughts,  anticipations,  retrospections,  are  all  new  to 
her,  and  her  outward  manifestations  are  new  to  her  fr>*-tids.  An  in- 
telligent mother  will  not  fail  now  to  prepare  her  mind  for  the  impor- 
tant event  close  at  hand. 

Tlio  Hfpe  nt  Which  tliis  chanfff  ttikes  pltice,  depends  very  rrmch  upon 
a  variety  of  cirenm^faiuvs^  It  occurs  much  earlier  in  warm  than  in 
cold  climates.  It  is  hastened  by  high  livinjif;  b)  the  whir!,  and  bustle, 
and  exciteiiietit  of  city  life  ;  by  reading  novels  which  are  full  of  love 
incidents;  by  attending  l)alls,  \heutres.  and  parties;  and  by  mingling 
much  in  the  society  of  gentlemen. 

Early  UleiistnDititHi  not  Hesirxhle. —  It  is  a  law  both  in  animal  and 
VI  ^j^table  lil'e,  that  the  later  th»'  periml  at  which  marurity  is  warhed, 
the  greater  th«'  st)li(lity  i  tlu'  body,  and  the  longer  it  livj's.  liiris 
who  menstruate  early,  tlo  so  becaus<»  the  body  if<  weakened  l)\  clmnate 
or  luxury,  and  the  nervous  system  ufiduly  «ievelop<?d  by  'X' rfement ; 
while  those  wlio  come  late  to  \\>>miiiihtKKl.  hav«-  tinner  constitutions, 
enjoy  better  health,  and  live  lonpT.  Those  riiothcrs,  t her  lore,  com- 
mit great  errors,  who  an'  anxious  and  A«lminister 'M'oreing  i.ediemes,'* 
becaus(>  their  daughters  do  not  menstruate  at  foorteeu  or  'itieen.  If 
girls  are  sutlering  tVom  no  special  ill  health,  no  a:  i  *  need  be  felt  if 
"the  custom  of  women"  tlo  not  cohk;  to  tti'-r'  \\  ,iX''  <»f  eighteen, 

or  even  twenty.  The  delay  should  r\i\  lai  ulness  rather  than 
regret.  It  shows  that  the  constitution  ha^  not  in  it  the  seeds  of  eartv 
dissolution  ;  that  it  is  lortifyinir  itself  againsi  future  disease. 

Girls  who  ctime  thus  tardily  to  maturity,  are  much  nu*re  "fr^ukir" 
in  after  life.     They  bear  children  with  fewer  accidents,  and  are  af- 


*^ 


^ 


*^'- 

mi: 

m^ 


a42 


FEMALE  DISEASES. 


flicted  much  leas  with  female  diseases.  The  duty  of  mothers  is  plain; 
it  is  to  bring  their  daughters  forward  as  late  as  possible,  by  refusing 
their  early  aamission  to  society,  by  withdrawing  from  them  all  excit- 
ing reading,  by  prohibiting  their  early  attendance  at  concerts  and 
theatrical  entertainments,  by  prescribing  for  them  the  most  unstimu- 
lating  diet,  and  by  requiring  a  large  amount  of  exercise  in  the  open 
air. 

A  wide  investigation  has  shown  that  the  first  menstruation  occurs, 
in  hot  climates,  at  the  average  age  of  thirteen  years  and  nineteen 
hundredths ;  in  temperate  regions,  at  fourteen  years  and  seventy-four 
hundri^dths ;  in  cold  latitudes,  at  sixtc?en  years  and  fifty-three  hun- 
dredths. Und(?r  the  hot-house  culture  of  modern  society,  and  espec- 
ially among  the  wealthy  classes,  where  indolence,  luxury,  and  excite- 
ment, unite  to  weaken  the  constitution,  this  change  is  constantly 
occurring  at  a  more  tender  age. 

How  Femtile  Diseases  are  Induced.  —  AH  living  things  have  their 
origin  in  fferms.  The  germ  from  which  the  higher  animals  spring, 
man  included,  is  an  ovum,  or  eg-g:  Every  animal  and  every  vegetable 
is  provided  with  an  organ  for  the  production  of  germs.  In  woman, 
this  organ  is  called  ovary.  There  are  two  ovaries,  about  half  an  inch 
in  length,  —  one  lying  on  each  side  of  the  womb,  to  which  they  are 
attached  by  ligaments,  or  cords.  The  ovarian  btKlies  contain  vast 
numbers  of  vesicles,  or  cells,  or  eggs,  whii^h  are  the  true  germs  of 
human  life,  and  the  only  sources  from  which  it  can  spring. 

Between  the  ages  of  fourteen  and  forty-five  (s^ieaking  in  general 
terms),  every  healthy  woman  matures  and  dejMisits  an  ovum  once  in 
twenty-eight  days.  This  vesicle,  some  time  bt^fore  the  monthly  flow, 
begins  to  germinate  and  swell,  and  after  a  time,  like  a  grain  of  wheat 
in  the  eartli,  it  bursts  its  covering,  and  springs  forth.  It  then  passes 
through  what  is  called  the  fallopian  tube  into  the  womb,  whence  it  is 
cast  o^. 

During  the  swelling  and  bursting  of  this  vesicle  or  germ,  the  ves- 
sels «f  the  ovaries,  and  womb,  and,  particularly,  of  the  membrane 
lining  the  womb  and  its  neck,  are  so  crowded  with  blood  as  to  pro- 
duce in  th«'  parts  a  state  of  congestion.  If  the  parts  be  examined 
with  a  Mp<'culuin  at  this  time,  they  will  be  found  red,  sensitive,  and 
almost  indaiiu'd.  So  great  is  this  congestion,  that  the  woman  often 
compliiiiis  of  pain  in  the  ovaries  and  the  womb,  —  and  a  general 
sens*'  of  liciit,  aching,  and  dragging  down  in  the  lower  part  of  the 
bowels.  The  pain  often*  extends  to  the  back,  the  groins,  and  the 
thighs. 

This  ronditioii  llepented  Everj'  .fioiitli.  —  When  we  consider  that 
thifc  stati^  of  things  is  n'pcated  every  four  weeks,  and  that  the  con- 
gested or  c'-owded  state  of  the  vessi^ls  begins  some  days  before  the 
monthly  How,  and  lasts,  in  all,  some  ten  days,  making  about  one  third 
part  of  every  month,  we  need  not  wonder  that  inHammation  so  often 
supervenes,  with  all  its  attendant  ill  health  and  suHerings. 

Iiirreased  hy  Various  faiises.  —  If  we  reflect,  further,  that  this  con- 


>.  't' 


m 

la 


■\ 


FEMALE  DISEASES. 


^43 


g(>i<tion  is  increased,  among  the  wealthy,  by  high  living,  and  among 
all  classes,  by  over-stimulation  of  the  nervous  system,  and  by  the  las- 
civious  morals  of  the  age,  we  see  stronger  reasons  for  expecting, — 
whiit  is  really  occurring?,  —  a  contiimally  increasing  amount  of  suffer- 
iiiij;  from  female  diseases. 

And  when  we  know,  still  further,  that  American  females  are  care- 
less of  their  lieallh  ;  that  they  often  attend  balls  and  theatres  at  the 
\'<'ry  time  of  suffering  from  this  monthly  aflliction ;  that  they  fre- 
(|U<!ntly  wet  th<Mr  fert,  and  otherwise  expose  themselves  to  colds,  we 
cannot  feel  surprise,  even  when  we  learn  that  from  one-half  to  three- 
fourths  of  all  women  in  cities,  and  quite  a  large  pro|Hirtion  of  them 
in  the  country,  have  inllammution  of  the  ovaries,  or  of  the  womb,  or 
of  the  neck  of  the  womb,  or  suffer  some  of  the  forms  of  displace- 
ment of  this  latter  organ. 

Chilli  Betiriiis:.  —  The  inflammatory  state  of  the  uterine  organs  is 
often  induced  by  injuries  received  in  child-bearing,  and  by  excessive 
indulgence  in  sexual  pleasures. 

Weakness  of  the  Sexutil  System.  —  The  womb,  moreover,  like  any 
other  organ,  may  be  naturally  frail,  and  easily  affected  by  disease. 
This  weakness  of  the  sexual  system  is  indicated  by  the  difficulty 
with  which  menstruation  is  established,  and  the  presence  of  the 
whites,  both  before  and  after  each  monthly  flow.  Women  in  whom 
the  generative  organs  are  weak,  are  much  more  liable  to  inflamma^ 
lion  of  the  womb,  and  to  all  the  complaints  peculiar  to  the  sex. 

F'O.  IM 


Jl 


Description  of  tlie  Sexnal  Onrnns.  —  Before  describing  th«^  partien- 
lar  diseases  to  which  the  female  generative  organs  are  liaole,  it  is 
proper  to  give  the  reader  a  brief  description  of  the  ch  ef  of  theae 
organs. 

Tlie  Womb  itJwlf,  in  its  healthy,  natural  state,  is  about  two  inches 
long,  and  one  inch  broad,  —  weighing  a  little  more  than  an  ounce; 
and  is  in  shape  like  a  pear.  It  is  lined  with  a  mere  rudimentary 
mucous  membrane. 

The  Xeck  of  the  Womb  has  a  cavity  distinct  from  that  of  the  b<»dy 
of  the  organ,  and  is  lined  with  a  mucous  membrane  well  suppUed 
with  follicles  or  glanda. 


344 


FEMALE  DISEASES. 


Tlie  Fallopian  T'obes  open,  one  from  each  side  of  the  base,  or  largest 
end  of  the  womb,  and  extend  outward  to  the  ovaries. 

Tlie  Ovaries  are  a  bundle  of  eggs  lying  one  on  each  side  of  the 
base  of  the  womb.  They  are  more  particularly  explained  else^ 
where. 

Fig.  134  gives  some  idea  of  these  organs.  A,  is  the  body  of  the 
womb;  B,  the  neck  of  the  womb;  C,  C,  the  vagina;  D,  one  of  the 
ovaries ;  F,  F,  the  fallopian  tubes ;  E,  E,  the  fimbriated  extremi- 
ties ;  G,  the  small  ligament  attaching  the  fimbriated  extremity  to  the 
ovary. 

Inflammation  of  tlie  Neck  of  the  Womb.  —  Inflammation  of  the 
body  of  the  womb  is  a  comparatively  rare  disease,  but  inflammation 
of  the  neck  of  this  organ  is  so  common  that  in  nearly  nineteen  out 
of  twenty  cases,  when  females  seek  relief  for  whites,  for  painful  men- 
struation, for  stoppage  of  the  menses,  or  even  for  what  they  suppose  to 
be  falling  of  the  womb,  a  careful  examination  will  show  that  this 
pendent  portion  of  the  womb  is  in  a  state  of  marked  inflammation, 
or  of  absolute  ulceration.  The  whites,  if  they  "ontinue,  without  in- 
termission, from  one  menstrual  flow  to  another,  are  almost  always  the 
result  of  one  of  these  conditions  of  the  uterine  neck. 

It  would  surprise  most  persons,  out  of  the  medical  profession,  and 
many  physicians,  to  know  how  large  a  proportion  of  the  more  grave 
diseases  which  inflict  such  terrible  sufiering  upon  woman,  and  so 
completely  shatter  her  constitution,  are  dependent  for  their  exist- 
ence u|)on  a  simple  local  inflammation,  cither  in  ihc  neck  of  the 
uterus,  or  in  one  or  both  of  the  ovaries.  Many  a  female  has  for 
years  sufTered  agonies  greater  than  those  of  death  itseJf,  arising,  as 
she  supposed,  from  a  complication  of  ills  which  invade  every  part  of 
the  system,  while  the  whole  of  her*  troubles  arose,  in  fac-i,  from  an 
inflamed  spot  which  could  be  covered  by  the  ball  of  the  finger. 

Difficulties  of  Studyinjj^  Uterine  Diseases.  —  The  facts  stated  above 

have  been  but  a  short  time  known  to  medical  men  ;  and  to  large 

numbers  of  the  pvofession,  are  still  unknown.     The  reason  is,  that 

very  serious  obstacles  have  stood  in  the  way  of  studying  the  diseases 

■  of  women. 

The  social  relations  of  the  sexes,  and  the  great  delicacy  of  the 
matters  to  be  investigated,  were  long  the  cause  of  inquiries  and  ex- 
aminations so  indirect  that  little  knowledge  was  gained,  and  as  little 
benefit  conferred. 

Woman,  always  distinguished  for  her  modesty,  could  not  be  ex- 
pected to  invite  investigations  which  were  not  proflered,  whatever  the 
extremity  of  her  sufferings ;  and  man,  scrupulously  sensitive  lest  he 
should  make  himself  an  intruder  by  stepping  within  delicate  inclos- 
ures,  have  both,  in  times  past,  mistaken  their  duty  by  misinterpreting 
the  demands  of  tiie  highest  delicacy. 

Needful  FAaniinatiouH  not  Indelicate.  —  Rightly  viewed,  no  inqui- 
ries or  examinations  are  indelicate  which  are  necessary  to  a  full  un- 
derstanding of  the  nature  of  disease,  and  which  are  made  with  the 


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TW  f  (Hopi^i'it;  T'rtH's  Of)?!!,  on    fy.m  t"!)  .h  •Idt?  oi'  tlv  I  'We  or  laf|t'»n 

Tat  ll'vitrV.  liT',  a  buitdie  of  » j^j^Ji  ',v«nj<  «>iio  <.r»  rach  si^Ic  of  tW 

Pig.  \'M  givfir  weiy    (iK-a  «»i  i,|if:.o,  or^iUU-       A,]i«  ihf!  Ixxly  of  tli 
pvor  ^r ,  iJ,  tir^  neck  '■<(  the    •.'■uiit!    (.',  t\  £h<:   voci;;  i  :   !'),*»»(    of  th» 
«.>vrtr"'# ;  J'\  F,  tht    lalkipia.]    tuix-H ;  K,   li,  jIm*  HtahriattMi   <  \ir«(n^ 
liPH     G,  111  •  8m»JI  iigiijiio'H  a(tiu:hini?  tbo  ;iinl»natt'<i  tsxininity  to  lli- 
'»vary. 

In(i)4iitnvifion  t-'  the  \i«*fc  «r  tlit'  V^V,tiil».  —  fnHacn  riHt;<*M  of  thf 
i'o<(.!y  >f  tlic  woiat'  i«4  u  '  Mni|/;iii  .i\»,  Iv  :>n  di!»<M\«'.  bnt  imianimatjou 
/(  f)l'  ?h<'  n^r/c  of  ti'iih  >.>r  .niri  i?  ««'  <!:«)U'.n.i<'n  that  in  nearly  nmeto  u  •»,  t 
of  twt'iuy  f  •i«>,  •..vh»-iJ  feiii.»ii'-  sifk  r*  hrf  for  Mliifea,  for  painful  ir>eii- 
aiTrujitJ<>ii,  tiif  HiopjUi^'  of '.bi.  MH-nf«€!»,  *»r  I'V^n  .  >r  vha  ''I'y  nup;>o!*i'  i<^ 
he  ftt!litig^'.>f  th«  v»o«i'.  J.  ■••af'"fu)  jwf)!'  ij(rtti<in  v»ill  uuw  thai.  r;'»?'a 
IwikKmiI  vt'i'li'^i*  "f  I*  vviit  il>  i  iji  K<  i-'d.v  itf  fwi'keU  'irdamniaitjiiiiit 
i«t  of  ni).'..(lu(r  uli:<'r«'i  ?  The  wfutf. ,  «i  h'>y  t'otihnnc,  ^vitluuil  i»i- 
U':nni»wK)i».  f  •>!!■{  ■■'■{  •  MK-auti'tm}  i'ow  lo  aii'ulu')  tn-  ninoHi  Hlw;»yH  \w 
'iMiit  of  ot«.  o''  l^K"^'«.•  coiKli-ioi.'f-  'jf  ♦!v  uteiuu''  itt*<'k- 

il  vouli!    'iumfO  itiOr>  p»  f*'..t(»   4  rj»  of  i\\i    mi^riivil  profes'siiJn.  'tw! 

.-...iiy  pnvi'i*  tail-,  'v«  !  i»<',u    iio«,v  )ari»''  a  p<>|K>r<ioii  oi'  rhe  motv-  g'w.  •." 

-.;.»<:*»  wfp'h  uUjs  I  ^u<;:h   t!   ribl*    vu(}(.^iiti:.r   njH'ir 'v<>rnau,  an-l   ^.• 

f)lcti'!y   Khnttti-   her  •.*o:i:"^ii!itioi),   arc   'I'lu-mli'i't   U»r   Anh    «:>!;«'- 

i      <;  (tJpKiii  a  (-itoplf   lot.-,)'    jiiHcii!iniati'iij,  ciihir   i.i    ilii?   luci:  of  *.k<' 

»v    -us,  nr  in  one  or  bufh  of  l!.."  ov.iries.     M'  liy  ;i   fei\in!e  h,iH    Uf 

yf.    «  HUKeml  agorii«s  pfrrater  iliaii  tho'-.*  of  tlcatli  lU-tOf,  ari.<'  (•?,   •» 

«h<!     ippoiu'il,  from  ti  ooir'plicuno'i  of  itV<  wh'u.'i  lui. ^idf  I'very  j  u*  t  * 

tho       hIi'm,  vvi/i;     do   Aiiolf  of  tier  Trouhi'  .  »«■-<,  i!»  fiu-v.  fr(.>iii  *:« 

iu(la»    hI  f[M>t    ■^liicb  .rnnild  J>e  covon-d  by  th*"  ir.fll  u''  tho  liiigtrr. 

iH'^\  I'iifo  of  S>urlUiMr  tU-rmt  DisttwM.  -  -  T!»<^  tn<-t;<  xtatHd  ai>i>» 
liavt)   \h  'n  hot.  a  xhirt     ii.';**  lut'.nvii   l.o  iukSu  ivi  ini  ii  :   aiKl  to  kr?i>; 
{iU!Jit?«"rK  of  ^he  ori,>ir^«Kion,  nrv  r.jti!l  unkdowo.     Tin-  rnueion  Is,  thh' 
v<-ry  ••*ru  w  abmtJuU^  ■lavf,  «,totHl  irr  th«  ■?:\\'  of  ^'•.  »i!}iug  the  di.sr';t.v*. 

of  V.'«>.  ('•'^ 

Tb«>  iJ'<k''  «.  rel;ition;:i  of  i  le  s«:xf8,  aail  tltf   gr  at  d*  licacy  of  IV 
;,'n**r:r*  'r  1,  '  in.pstigHtiul,  w-^re  long  lln    «;j.'uo.      ;  iiupiirieH  aixl  t  . 
■  iiidircit  J[,ar  liiiU'  kfiv>wl<Migo  war  gitjnrd.  and  uh  liU*': 
j,     'I   !  ■■.'(1  o.d. 

''         V-    .  i\\  vay.-*  <iis4iiii»ia.^h'fl  for  Ijt  r  ii\udesiy«  could  not  be  ct 

fHtot^"-!  «•*»  ljt»itA  invrisfi;r>tions  which  wcrr.  not  pr(>fi«re<l,  wUotevcr  ti 
^f  ftp\  ^uH!;^H^g^  ;  unci  tuui>,  tiw-rupBtoiiiily  senftitlvc  lo!*t  it' 
k<.-  'vid  H«ll  ail  intrn<U.'r  by  >'tf'ppir.g  ■"/•I'l'm  delicute  incio*^ 
Iwr*'   ('   timfc;*  past.  jni-takfJi  ili*  t  o  ■    '•  bv  iiii«iutfrnr<-^ti*>. 
iC  i)*«ii'-st  dtniciu-y. 

V,        >« !  0  t/>f»niiiiUniv  »ot  linl<'licatet- -  Bii,l4ly  vW-ved,  no  i-Kp 

,u  UP'  indrlicatt'  whiiMi  a  J"'  t:r-Hf«r.5*ary  to  a  fall  n  ' 

'i^,  li'       '  ,       ,,vfur<^  of  clitoii-*',  nci   ^.^bicin  An:  nrjtidc.  with  'ivj 


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•m 


FEMALE  DISEASES. 


345 


sole  purpose  of  rendering  its  cure  possible.  I  agree  with  Dr.  Meigs^ 
the  eider,  that  the  delicacy  or  indelicacy  of  examining  the  persons  of 
females  for  the  purpose  of  exploring  disease,  depends  on  the  motive 
with  which  it  is  done.  To  pure-minded  persons,  it  is  never,  I  think,  a 
source  of  impurity.  On  the  contrary,  the  self-restraint,  the  honorable 
feeling,  and  the  nice  sense  of  delicacy  which  it  calls  into  exercise^ 
oflen  heighten  the  tone  of  a  man's  virtue,  and  certainly  increase  a  true 
woman's  respect  for  it.  Unfortunately  there  is  now  and  then  a  gross- 
minded  man  in  the  profession,  who,  in  these  investigations,  will  vio- 
late the  most  sacred  of  all  trusts  committed  to  his  hands ;  but  such 
monsters,  —  few  in  number,  —  soon  find  their  level,  and  are  shunned 
as  the  most  vile  of  the  race. 

It  is  now  so  well  understood  that  these  investigations  do  not  lead 
to  imr^oralities,  that  the  most  highly  ec'acated,  intelligent,  refined, 
and  virtuous  females,  almost  invariably  raise  the  fewest  objections  to 
such  examinations  as  a  physician  of  character  may  propose. 

Hethods  of  Investi^tln^  Female  Diseases.  —  The  symptoms  of 
these  complaints  will  be  spoken  of  in  their  proper  place,  as  the 
several  diseases  come  under  a  brief  review.  I  merely  wish  to  allude 
here  to  the  methods  of  physical  exploration  which  modern  practice 
has  called  to  its  aid. 

The  Toncli.  —  These  methods  consist,  first,  of  what  is  called  the 
touch,  which  is  made  either  externally  upon  the  bowels,  or  inter- 
nally, with  the  index  finger,  through  the  vagina,  or  passage  from  the 
external  genital  organs  to  the  neck  of  the  womb. 

The  Speculum.  —  In  the  second  place,  of  ocular  inspection  of  the 
vagina  and  neck  of  the  uterus,  through  an  instrument  called  the  spec- 
ulum. By  this  instrument,  the  eye,  as  well  as  the  finger,  is  made  to 
assist  in  learning  the  real  condition  of  the  parts. 

The  finger  informs  us  whether  there  is  any  deviation  from  nature 
in  the  bulk,  the  firmness,  the  smoothness,  or  the  sensibility  of  the 
parts ;  while  the  siffht,  through  the  speculum,  affords  absolute  cer- 
tainty as  to  whether  the  parts  are  suflfering  from  inflammation,  ulcer- 
ation, abrasion,  or  eruption.  The  following  is  the  best  form  of  spec- 
ulum yet  used. 

» 

Fio.  185 


The  end  is  so  shaped  as  to  catch  the  neck  of  the  womb,  and  then 
by  drawing  the  instrument  forward  slightly,  the  diseased  surface  is 
ptesented  for  as  perfect  inspection  as  if  located  externally. 


:s^ 


11 


h « 


f; 


■.IH- 


?.. 


IT 


r 


846 


FEMALE  DISEASES. 


Inflammation,  Ulceration,  and   Enlargement  of  the 

Neck  of  the  Womb. 

Inflammation  of  the  neck  of  the  uterus  is  very  common ;  ulcera- 
tion and  permanent  enlargement  (technically  called  hypertrophy),  are 
its  results,  when  it  is  not  arrested  in  due  time.  These  affections,  in 
fact,  and  the  same  troubles  rm  they  affect  the  ovaries,  make  up  the 
bulk  of  female  diseases,  —  being  the  real  causes  of  the  most  of  thoee 
symptoms  which  have  passed  under  the  name  of  whites,  suppression, 
painful  menstruation,  sterility,  general  debility,  etc. 

The  neck  of  the  womb,  when  healthy,  is  soft  and  smooth.  No 
hardness  or  condensation  of  tissue  can  be  felt  by  the  finger,  on  press- 
ing over  it.  It  is  elastic,  too,  and  feels  unctuous  to  the  touch.  This 
latter  sensation  is  communicated  by  the  layer  of  mucus  which  covers 
it.  Pressure  upon  it  produces  no  pain.  Platk  VII.,  Fig.  1,  is  a 
fine  specimen  of  the  size,  shape,  color,  and  appearance  of  a  healthy 
womb. 

Inffammation,  when  found  in  this  part,  may  begin  in  the  mucous 
membrane  which  covers  the  neck,  or  in  that  which  lines  its  cavity,  or 
in  the  small  glands  in  the  body  of  the  organ. 

Symptoms.  —  Inflammation  of  the  mucous  membrane  covering  the 
neck  of  the  uterus,  destroys  the  unctuous  feel  which  it  has  in  health. 
It  also  causes  the  neck  to  swell,  its  vessels  being  crowded  full  of 
blood.  If  the  body  of  the  organ,  as  well  as  the  surface,  be.  reachcAi 
6y  the  inflammation,  it  will  be  hardened,  as  well  as  enlarged;  and  in 
consequence  of  its  increased  weight,  it  is  apt  to  drop  down  somewhat 
into  the  cavity  of  the  vagina.  In  married  ladies,  it  is  often,  by  physi- 
cal prcvssure,  pushed  a  littk;  backward,  or  retroverted.  Examination 
with  the  speculum,  shows  the  inflamed  neck  to  be  of  a  vivid  red, 
instead  of  a  pale  rose-color.  It  may  be  covered  with  red  or  white 
pimples,  which  are  glands  enlarged  with  muco-pus. 

In  the  healthy  state,  the  mouth  of  the  womb  is  so  much  closed  as 
to  be  just  perceptible  when  the  finger  passes  over  it.  Inflammation 
causes  it  to  be  more  or  less  open,  and  its  lips  to  be  parted. 

Inflammation  Followed  by  Ulceration.  —  In  a  majority  of  cases,  in- 
flammation of  the  neck  of  the  womb  and  of  its  cavity,  is  soon  fol- 
lowed by  ulceration,  which  generally  appears  first  around  the  mouth, 
and  just  within  the  cavity  of  the  neck.  From  thence  it  spreads  both 
inward  and  outward.  Plate  VII.,  Fig.  3,  furnishes  a  good  speci- 
men. 

Various  Deg^rees  of  Ulceration,  etc.  —  Of  course  ^  these  inflamma- 
tions and  ulcerations  mix  and  run  into  each  other  in  all  possible 
forms, — presenting  excoriations,  or  raw  places  ;  granulations,  or  pim- 
ply surfaces ;  ai.d  indurations,  or  hardened  parts.  Sometimes  these 
pimply  patches  will  be  red  and  hard,  and  again  the  whole  surface  will 
be  spongy,  and  will  bleed  upon  the  slightest  touch. 

In  many  cases,  these  ulcerations  make  wretched  work  with  the 


of  the 


;  ulcera- 
phy),  are 
ctions,  in 
e  up  the 
;  of  those 
jpressioti, 

•oth.  No 
on  press- 
ch.  Thia 
ich  covers 
g.  1,  is  a 
a  healthy 

B  mucous 
cavity,  or 

• 
irering  the 

in  health, 
pd  full  of 
e.  reache-d 
d;  and  in 
somewhat 

by  physi- 
amiiiation 

vivid  red, 
or  white 

closed  as 
ammation 


cases,  m- 

soon  fol- 

he  mouth, 

reads  botli 

ood  speci- 

inflamma- 
II  possible 
IS,  or  pim- 
mes  these 
arface  will 

:  with  the 


FEMALE  DISEASES. 


347 


mouth  of  the  womb,  eating  deeply  into  the  cavity,  and  giving  it  a 
ragged  and  unsightly  appearance.  Plate  VIL,  Fig.  4,  may  be  talen 
as  a  sample. 

Velvety  Feel  from  IJlceriitioii.  —  Ulceration  generally  gives  to  the 
surface  on  which  it  exists,  a  soft,  velvety  feel,  which  the  finger  gener- 
ally recognizes.  This  velvety  sensation,  with  the  open  state  of  the 
mouth,  are  the  most  important  evidences  we  can  derive  from  the 
touch,  of  this  form  of  disease. 

The  Disehiir^e  from  these  Ulcers  is  always  Pus,  or,  in  common 
language,  matter.  It  is  sometimes  poured  out  scantily,  at  other  times, 
very  freely.  It  may  be  thick  and  yellow,  or  thin,  and  of  a  lighter 
color. 

The  inflammatory  and  ulcerated  condition  of  the  neck  of  the 
womb,  often  gives  rise  to  pain  ;  and  when  the  seat  of  the  disease  has 
not  been  examined,  as  it  should  be,  this  pain  has  frequently  been 
called  neuralgia.  In  this  way,  ignorance  has  compelled  neuralgia  to 
stand  sponsor  for  a  great  many  pains  with  which  it  has  had  nothing 
to  do. 

These  Ulcers  Disturb  Menstniation.  —  Menstruation  is  generally 
changed,  more  or  less,  in  its  character,  by  the  presence  of  inflamma- 
tion or  ulceration  in  the  neck  of  the  womb.  It  usually  becomes  more 
painful.  In  some  cases  it  is  made  more  profuse,  in  others  more  scanty. 
It  may  come  on  more  frequently,  or  it  may  be  postponed,  protracted, 
or  abridged  in  its  continuance.  There  is  generally  pain  of  a  dull, 
aching  kind,  low  down  in  the  back.  There  is  often  a  feeling  of  fui- 
ness,  pain,  and  a  sense  of  bearing  down  in  the  lower  part  of  the 
bowels ;  sometimes  the  pain  extends  to  the  groins  and  thighs. 

Eitensive  Disturbances  from  the^^n^  Inflammatious,  etc. — The  nerves, 
with  which  the  womb  is  liberally  supplied,  belong  to  those  of  the 
sympathetic  system.  Hence,  the  condition  of  the  uterus  influences  a 
wide  circle  of  sympathies.  By  these  nerves  this  organ  is  brought  into 
close  relationship  with  the  organs  of  animal  life.  If  the  former  suf- 
fer, the  latter  suffers  also.  The  stomach,  being  intimately  connected 
with  the  womb,  physically,  feels  keenly  these  inflammations  and 
ulcerations  of  the  uterine  neck.  At  times,  the  pain,  debility,  general 
disturbance,  and  dyspeptic  state  of  the  stomach  are  such  as  to  cheat 
both  the  doctor  and  the  patient  into  the  belief  that  this  organ  is  the 
seat  of  the  disease.  But  in  such  cases,  the  symptoms  of  stomach 
disease  will  all  disappear  the  moment  the  local  affection  is  removed 
from  the  neck  of  the  womb. 

The  liver,  too,  often  participates  in  these  troubles,  and  becomes 
sadly  deranged.  It  is  sometimes  even  greatly  enlarged  and  congested, 
and  patients  frequently  have  the  various  symptoms  of  what  are  called 
liver  complaints. 

Severe  pains  are  sometimes  felt  under  the  breast  bone,  and  over 
the  chest  generally,  making  the  patient  apprehensive  of  disease  of 
the  lungs ;  and  indeed  consumption  is  not  a  very  unfrequent  result  of 
uterine  diseases. 


i. : 


; 


Pains  are  often  felt  in  the  region  of  the  heart,  which  organ  is  often 
harassed  with  palpitations. 

The  flesh  is  apt  to  waste  under  the  symptoms  excited  by  these  in- 
flammatory and  ulcerative  processes  in  the  uterine  neck  ;  and  even 
the  brain,  though  lying  in  some  measure  beyond  the  circle  of  influ- 
ences set  in  motion  by  the  organic  nerves,  suffers  dis^turbance  ami 
pain. 

Even  the  special  senses  of  sight  and  hearing  may  oe  drawn  into 
this  general  vortex,  and  both  be  much  impaired.  And  to  crown  this 
catalogue  of  ills,  it  may  be  mentioned  that  those  distressing  things 
called  hysterical  fits,  proceed  from  the  same  local  disorders. 

In  brief,  there  is  scarce  a  point  in  the  hunmn  body  to  which  these 
inflammatory  and  ulcerative  conditions  of  the  uterine  neck  may  not 
send  their  sympathetic  pains  and  aches,  and  where  they  may  not  in 
time  induce  real  disease.  This  is  the  reason  why  so  many  women 
Buflering  from  these  local  complaints,  tell  the  phyif  cian,  when  consult- 
ing him,  that  they  are  "  diseased  all  over."  If  asked  where  the  com- 
plaint is  located,  thoy  will  answer  —  "  It  is  everywhere."  In  the  most 
<;arnest  manner  the  assurance  will  be  given — ^^ Doctor,  there  isn't  any 
well  part  about  me." 


\f  ^ 


Treatment.  —  It  is  just  as  unreasonable  and  useless  to  treat  these 
inflammations  and  ulcerations  through  the  stomach,  as  it  is  an  in- 
flamed or  ulcerated  throat.  Thei/  are  local  diseases,  affecting-  a  par- 
ticular  part,  and  the  remedy  must  be  local. 

Like  all  other  affections,  these  can  only  be  managed  intelligently 
after  their  nature  is  well  understood.  Nothing  can  really  be  done  to- 
wards a  cure,  until  it  is  known  what  the  matter  is ;  and  no  competent 
physician  will  move  a  single  step  in  jthe  treatment  of  one  of  these 
cases,  until  he  has  made  a  thorough  examination.  He  owes  this  to 
himself  and  to  his  patient,  —  the  more  so  as  the  neck  of  the  womb 
may  be  as  easily  examined  as  the  upper  part  of  the  throat,  and  the 
local  remedy  may  be  almost  as  readily  applied  in  the  former  case  as 
in  the  latter. 

< 

If,  upon  the  introduction  of  the  speculum,  the  uterine  neck  be  found 
simply  inflamed  and  enlarged,  the  application  of  a  strong  solution  of 
nitrate  of  silver,  once  in  five  or  six  days,  will  often  prove  sufficient  to 
reduce  both  the  inflammation  and  the  swelling.  If  it  should  not,  tho 
Bolid  stick  should  be  lightly  applied.  IJf  thif*  should  not  succeed 
(though  it  will  in  most  cases)  then  introduce  a  speculum,  and  when 
tiie  neck  of  the  womb  is  fairly  lodged  in  its  extremity,  drop  in  two  or 
three  leeches  and  allow  the  m  to  fill. 

If  ulceration  be  present,  the  solid  nitrate  of  silver  must  be  applied  to 
the  ulcer  once  in  five  days.  One  who  is  not  accustomed  to  treat  these 
affections  in  this  simple  way,  will  at  first  be  surprised  at  the  rapidity 
with  which  the  local  trouble  will  disappear,  and  with  it,  the  thousanu 
and  one  aches  and  pains  which  torment  the  whole  body.  As  the 
terrible  pains  in  the  whole  face  and  head,  which  are  produced  by  a 
single  tooth,  all  instantly  come  to  an  end  when  the  tooth  is  extracted, 
80  oo  the  bad  feelings  all  over  the  body  subside  as  fast  as  the  local 


;an  is  often 

>y  these  in- 
;  and  even 
jle  of  influ- 
rbance  and 

drawn  into 
crown  this 
sing  things 

vhich  these 
■ck  may  not 
may  not  in 
any  women 
len  consult- 
•e  the  com- 
In  the  most 
re  is  n't  any 


treat  these 
it  is  an  in- 
;ting-  a  par- 

intelligently 
be  done  to- 
)  competent 
me  of  these 
)wes  this  to 
f  the  womb 
jat,  and  the 
■mer  case  as 

• 

ck  be  found 
solution  of 
sufficient  to 
>uld  not,  the 
not  succeed 
t,  and  when 
jp  in  two  or 

le  applied  to 
o  treat  these 
the  rapidity 
le  thousanu 
dy.  As  the 
jduced  by  a 
is  extracted, 
as  the  local 


ailments  of  the  uterine  neck  are  cured.  There  is  no  exception  to  this 
rule,  except  wher^  the  sympathetic  affection  has  become  fixed  by  long 
neglect  of  the  primary  uterine  disease.  It  is,  therefore,  surprising 
that  so  many  excellent  women,  whose  lives  are  of  the  greatest  value 
to  themselves  anij  friends,  should  be  permitted  to  perish  of  these  ail- 
ments, when  the  cure  is  so  simple,  and  many  times  so  entirely  within 
the  reach  of  the  most  ordinary  skill.  It  is  a  reproach  to  the  profes- 
sion which  should  be  wiped  away. 

If  there  are  a  hundred  motives  for  gaining  the  mastery  over  other 
diseases,  there  are  a  thousand  for  learning  to  control  these.  More 
than  any  other  disease,  or  all  others,  they  make  the  homes  of  men 
desolate,  by  robbing  them  of  woman,  their  ornament  and  solace.  The 
physician  who  neglects  to  make  himself  acquainted  with  all  there  is 
to  be  known  of  these  complaints,  shows  himself  not  only  unfit  for  his 
profession,  but  deficient  in  some  of  the  prime  elements  which  combine 
to  make  a  true  man. 

Ilardeninjc  of  the  Uterine  Neck. —  In  many  cases  the  uterine  neck 
is  not  only  inflamed  and  enlarged,  it  is  indurated  and  hardened.  At 
times,  it  is  enlarged  and  hardened  on  one  side,  and  not  much  on  the 
other.  In  still  other  cases,  there  are  enlarged  spots,  or  nodes,  giving 
the  whole  neck  a  knotty  feel  under  the  finger. 

These  hardened  conditions  of  the  uterine  neck  proceed  from  vari- 
ous causes,  and  are  more  difficult  to  cure  than  the  ordinary  inflam- 
mation, or  even  tilceration.  They  sometimes  indicate  cancerous  dis- 
ease, and  then,  of  course,  involve  the  most  serious  considerations.  In 
nany  of  these  cases,  nitrate  of  silver  fails  to  produce  its  usual  effects. 
We  then  have  to  resort  to  the  acid  nitrate  of  mercury,  or,  as  it  is 
often  called,  Bennet's  Caustic.  No  definite  rules  can  be  given  as  to 
the  extent  to  which  this  article  should  be  reduced.  It  is  sometimes 
applied  very  strong,  and  immediately  neutralized  by  the  application 
of  water. 

Uterine  Syrlnj^.  —  For  applying  the  several  remedies  to  the  inter- 
nal cavity  of  the  uterine  neck,  I  have  contrived  a  silver  syringe,  which 
ia  bent  a  little  at  the  extremity,  and  pierced  with  fine  holes  all  round. 
With  this  instrument,  the  remedy  is  carried  directly  to  the  di&sased 
part»  and  applied  instantaneously  to  every  side  of  the  cavity. 

Beside  these  local  applications,  it  is  frequently  necessary  to  resort 
to  soothing  or  astringent  injections  into  the.  vagina,  hip  baths,  and 
injections  into  the  bowels,  some  mild  physic,  and  rest  in  a  horizontal* 
position.     These  matters  will  all  be  judiciously  regulated  by  the  at- 
tending physician,  if  he  is  master  of  his  business. 

Case  I.  —  Mrs.  F.  applied  for  relief  from  incessant  bearing  down, 
pains  ir  the  back  and  hips;  pressure  upon  the  top  of  the  head,  palpi- 
tation of  the  heart,  bad  appetite,  the  whites,  and  a  brick-colored  de- 
posit in  the  urine,  after  standing  a  time. 

I  made  an  examination,  lind  found  the  neck  of  the  womb  enlarged 
and  ulcerated,  as  in  Plats  VIL,  Fig.  4. 

There  was  no  doubt  as  to  the  treatn*ent  required.     I  applied  the 


1 

1 

1 

i 

"f: 

I    ".'■■ 


l>. 


solid  nitrate  of  silver  to  the  ulcerated  surface  once  in  five  days,  for 
three  montlis,  —  at  the  same  time,  building  up  the  health,  which  was 
much  broken,  by  iron  and  other  tonics  (75)  (63),  by  a  generous  diet, 
and  by  gentle  exercise  in  a  carriage. 

The  appetite  and  general  health  came  back,  the  whites  and  pains 
all  disappeared,  and  the  patient  felt,  as  she  said,  "  like  a  new  being." 

Case  II. —  Mrs.  C,  the  mother  of  two  children,  had  t^utl'cred,  sir/,e 
the  birth  of  the  second  child,  great  pain  low  down  in  the  bsick,  with 
bearing  down,  and  a  distressing  desire,  a  good  part  of  the  time,  to 
pass  water.  She  had  a  continual  discharge  from  th(^  vagina,  of  fi 
cream-like  matter,  which  very  much  reduced  her  strength.  Besidn 
these  symptoms  she  had  pains  everywhere,  particularly  in  the  head. 

An  examination  revealed  that  the  neck  of  the  womb  was  much 
enlarged  and  hardened,  and  badly  ulcerated  about  the  mouth. ,  (See 
Plate  VII.,  Fig.  3.) 

Once  in  six  days,  the  solid  nitrate  of  silver  was  applied  to  the 
ulcerated  surface.  This  was  dene  fire  times,  which  caused  the  ulcer 
to  heal,  but  did  not  reduce  the  size  of  the  neck,  or  diminish  its  hard- 
ness. 

To  effect  these  objects,  I  touched  'the  whole  hardened  surface  with 
acid  nitrate  of  mercury,  and  immediately  pressed  upon  the  cauterized 
surface  a  sponge  saturated  with  water.  I  re|}eated  this  twice,  that 
the  acid  might  not  penetrate  too  deep.  These  operations  were  re- 
peated once  a  week,  for  six  weeks,  —  thirty-drop  doses  of  syrup  of 
iodide  of  iron  being  given,  in  the  mean  time,  three  times  a  day,  with 
a  vegetable  bitter  and  mineral  acid  (63).  At  the  end  of  this  time,  the 
hardness  had  given  way,  and  the  uterine  neck  was  brought  down  to 
near  its  ordinary  size.  The  other  symptoms  disappeared,  and  the 
patient  has  had  no  return  of  her  sufferir>gs. 

Inflammation,  etc.,  of  the  Ovaries. —  Ovaritis. 

The  inflamed  condition  of  the  ovaries  is  indicated  by  increased 
heat,  and  pain  upon  pressure.  The  pain  in  the  ovarian  region  is 
sometimes  intermittent,  sometimes  constant,  and  occasionally  passes 
down  to  the  loins  and  thighs. 

There  are  acute  and  chronic  inflammations  of  the  organs ;  but  it 
will  be  sufficiently  accurate,  in  a  work  of  this  kind,  to  treat  of  them 
as  essentially  one. 

The  effects  of  inflammation  upon  the  ovaries,  as  upon  other  bodies, 
are  various,  sometimes  enlarging  and  hardening,  at  other  times,  col- 
lapsing and  blasting  them.  This  last  effect,  it  is  hardly  necessary  to 
s^y,  cuts  off*  all  hope  of  bearing  children. 

The  Causes  of  ovarian  inflammation  are  numerous.  One  of  the 
most  important  causes  has  already  been  noticed,  namely,  the  conges- 
tion of  the  parts,  for  several*  days,  at  every  menslVual  period.  This, 
amounting  as  it  does  almost  to  inflammation,  is  often  intensified  by 
other  causes,  such  as  wetting  the  feet,  taking  sudden  colds,  excessive 
fatigab  from  dancing,  and  exuting  drinks. 


days,  for 
/hich  was 
!rous  diet, 

ind  pains 
T  being." 

•rt'd,  sir/.e 
)!ifk,  with 
L>  time,  to 
gina,  of  a 
Besidi' 
le  head, 
vas  much 
ith..   (See 

ed  to  the 

the  ulcer 

h  its  hard- 

irface  with 
cauterized 
twice,  that 
s  were  re- 
■  syrup  of 
day,  with 
3  time,  the 
t  down  to 
i,  and  the 


ritis. 

increased 

region  is 

illy  passes 

ins ;  but  it 
t  of  them 

ler  bodies, 
times,  col- 
cessary  to 

)ne  of  the 
he  conges- 
od.  This, 
insified  by 


Sexual  indulgence  oftjn  proves  a  cause  of  inflammation  in  the  i 
bodies.     It  is  particularly  apt  to  have  this  efll'ct  in  the  uewly-marrK  I 
female,  with  whom  it  is  a  novel  stimulus,  and  often  applied  with  in 
moderate  excess.     In  late  marriages,  when  the  stimulus  to  the  ovarii 
has  long  been  denied,  its  sudden  presentation  is  liabU;  to  make  an  in 
flammatory  impression.     Its  entire  absence,  too,  in  persons  of  stror  . 
passions,  may  result  in  ovarian  disease. 

This  inflammation  may  be  produced  by  the  new  state  of  thing? 
existing  at  the  critical  period  called  the  turn  of  life,  when  it  reacts  o  . 
the  womb,  pu^Jucing  the  floodings  which  often  bring  menstruatio 
to  a  close.  The  congestion,  too,  which  has  been  present  every  monti 
for  many  years,  does  not  immediately  cease  at  this  change  ;  and  nc 
finding  relief  by  the  accustomed  flow,  the  ovarian  bodies  are  expose  ! 
to  inflammation. 

In  all  large  cities,  the  pest-houses  of  civilization,  where  the  womcfy 
are  more  numerous  than  the  men,  there  are  many  females  whose  vir« 
ginity  is  a  burden,  and  numerous  others  who  give  themselves  up  to 
sexual  excesses  ;  —  to  both  these  classes,  the  turn  of  life  is  very  liabl 
to  promote  these  ovarian  disorders. 

There  is  another  class  of  cau  ^es,  which,  though  not  so  easily  re- 
cognized, are  equally  cogent  in  exciting  this  form  of  disease.  I  mear< 
all  those  excitements  which  arise  from  unbridled  thoughts,  from  books; 
of  questionable  character,  from  music,  social  intercourse,  and  stimu- 
lating food  and  drinks,  —  all  which  promote  and  intensify  burning 
desires,  which,  though  natural  and  proper  in  themsislves,  cannot  law- 
fully be  ^ratified  in  a  community  where  the  female  sex  greatly  pre- 
ponderates, numerically,  over  the  male.  When  we  consider  how 
powerful  within  a  woman's  breast  the  conflict  often  is  between  the 
impulse  of  passion  and  the  dictates  of  duty,  and  how  strongly  this 
conflict  must  react  upon  the  sexual  organs,  and  especially  upon  the 
ovaries,  the  centre  of  the  sexual  system,  we  can  easily  see  in  how 
many  cases  they  may  becc"ie  inflamed. 

Another  cause  of  this  disease  is  suppression  of  the  menses.  The 
engorged  and  crowded  state  of  the  vessels  of  the  womb,  of  the  ute- 
rine neck,  and  of  the  ovaries,  not  finding  vent  in  the  accustomed  flow, 
inflammation  in  any  one  of  these  organs  is  a  very  natural  result. 

The  inflammation  of  these  ovarian  bodies  is  a  frequent  result,  too, 
of  a  similar  condition,  previously  existing  in  the  neck  of  the  womb. 
In  passing  from  the  uterine  neck  to  the  ovarian  bodies,  the  infla:Tin.a- 
tory  condition  often  fastens  itself  upon  the  broad  ligament,  the  fallo- 
pian tubes,  and  their  fimbriated  extremities.  (See  Plate  VIII.,  Figs. 
1  and  2.)  The  whole,  it  will  be  seen,  presents  an  amount  of  disease 
which  it  is  painful  to  contemplate. 

'  The  womb  being  turned  over,  and  pressing  against  one  of  the 
ovaries,  may  cause  it  to  inflame  by  mechanical  irritation.  Pessaries, 
injudiciously  used,  may  do  the  same  thing. 

Symptoms. —  The  first  and  most  obvious  symptom  is  a  pain  a  little 
to  ^e  right  or  left  of  the  womb.  This  pain  is  almost  always  increased 
by  walking,  riding,  or  by  external  pressure.    It  is  especially  augmented 


I! 


Ff 


f,R 


!■  *s«&*U 


ny  straightening  the  thigh,  by  which  the  parts  over  the  inflamma- 
tio?i  are  put  upon  the  stretch.  When  standing  up,  ladies  suffering 
fr'»in  this  disease,  are  generally  compelled  to  rei»t  the  foot  on  a  stool, 
8(.  as  to  bend  the  thigh,  and  relax  the  muscle; .  Th'J  pains  radiate 
iroin  the  ovaries,  and  go  down  to  the  loins  and  thighs,  and  sometimes 
'•  the  fundament.     They  are  of  a  dull,  dragging:,  heavy  nature. 

Sometimes  the  ovarian  bodies  become  vere  much  enlarged,  and 
d  )pping  down,  somewhat,  press  upon  the  lower  bowel,  causing  con- 
■    pation,  or  upon  the  neck  of  the  bladder,  creating  a  frequent  desire 

urinate,  and  an  inability  to  pass  the  water  freely 

Treatment. —  As  inflammation  of  the  ovaries  is  always  increased 
during  the  menstrual  flow,  it  is  not  proper  to  meddle  with  it  at  these 
nionthly  periotls,  lest  the  trouble  be  aggravated.  Immediately  after 
one  of  the  turns  has  passed,  from  six  to  eight  leeches  should  be  ap- 
plied over  the  diseased  ovary.  When  the  bites  are  healed,  a  blister 
may  be  used  in  the  same  place.  The  scarf-skin  should  not  be  re- 
moved, and  the  irritated  surface  must  be  healed  as  soon  as  possible. 
The  blister  should  Le  camphorated  to  prevent  strangulation.  The 
purt  should  next  be  rubbed  for  a  few  minutes,  night  and  morning, 
with  an  alterative  and  amxlyne  ointment  (169). 

After  the  next  menstruation,  the  same  things  should  be  repeated, 
and  again  after  the  next,  and  so  on,  for  five  or  six  months,  or  even 
longer,  if  need  be.  The  already  bloodless  condition  of  the  patient 
may  require,  however,  that  the  leeches  should  not  be  applied  more 
than  once,  or,  at  most,  twice. 

The  bowels  should  occasionally  be  opened  by  some  simple  cathartic, 
for  the  purpose  of  removing  all  hard  substances  which  may  press 
against  and  fret  the  inflamed  ovaries.  The  purgatives  employed 
should  be  of  the  most  cooling  kind,  such  as  salts  or  oil ;  while  aloes> 
and  all  harsh  cathartics  must  be  avoided. 

Injections  of  tincture  of  belladonna  and  hyoscyamus  are  useful  for 
quieting  neighboring  parts,  and  warding  off  external  disturbances. 
They  act  like  soft  substances  thrown  upon  the  pavement  in  front  of  a 
Mck  man's  house. 

The  patient  should  be  kept,  as  much  as  possible,  in  the  recumbent 
position,  lying  upon  the  bed  or  the  lounge,  and  should  only  be  per> 
rnitted  to  ihove  about  to  such  extent  as  will  not  irritate  the  inflamed 
parts. 

Case. —  Miss  R.  M.  B.  suffered  a  great  deal  of  pain  every  month 
while  menstruating.  She  had  also  a  great  tenderness  upon  pressure 
just  at  the  left  of  the  upper  part  of  the  womb,  and  at  times  a  severe 
(ain  in  the  same  region,  which  often  extended  down  into  the  grpin 
uad  thigh. 

The  left  ovarium  was  so  much  enlarged  that  it  could  be  distinctly 
felt  through  the  walls  of  the  bowels. 

Immediately  after  the  next  monthly  period,  I  applied  six  leeches 
over  the  inflamed  ovarium,  and  when  the  bites  were  healed,  put  a 
blister  over  the  same  region.  After  this  healed,  the  same  space  was 
riibbed,  twice  a  day,  with  an  ointment  (169).     Immediately  after  the 


J... 


e  inflamma- 
ie»  Huffering 
)t  on  a  stool, 
tains  radiate 
d  sometimes 
lature. 

nlarged,  and 
causing  con- 
quent  desire 

ys  increased 
th  it  at  these 
;diately  after 
lould  be  ap- 
iled,  a  blister 
[1  not  be  re- 
1  as  possible, 
lation.  The 
nd  morning, 

be  repeated, 

nths,  or  even 

the   patient 

ppliecl  more 

pie  cathartic, 

may  press 

!S  employed 

while  aloes, 

ire  useful  for 
disturbances, 
in  front  of  a 

;  recumbent 
only  be  per* 
the  inflamed 

jvery  month 
pon  pressure 
[Ties  a  severe 
to  the  gipin 

be  distinctly 

six  leeches 
ealed,  put  a 
le  space  was 
ely  after  the 


FEMALE  DISEASES. 


353 


oouraes,  the  same  thing  was  repeated  for  four  months,  —  the  patient, 
each  time,  being  kept  quiet  for  a  few  days,  and  then  permitted  to  take 
gentle  exercise  out  of  doers.     The  diet  was  generally  nourishing. 

I'he  patient  was  well  at  the  end  of  four  months,  and  has  had  no 
return  of  the  inflammation. 

This  was  a  simple  case,  requiring  only  the  most  simple  course  of 
treatment ;  but  it  furnishes  the  general  outline  to  be  pursued  in  all 
cases  of  inflamed  ovaries. 

Whites. — Leucorrhoea. — Fluor  Albus. 

Lbucorrh(ka  is  from  two  Greek  words,  Xev^o^  and  ^o),  and  fluor 
albus  from  two  Latin  words,  albus  and  fluo,  having  precisely  the 
same  meaning  as  the  Greek,  namely,  a  white  discharge.  Hence,  in 
popular  language,  the  disease  is  called  the  ^^  whites;"  it  is  also  called 
*^ female  weakness^ 

These  terms  are  well  enough,  perhaps,  if  we  have  in  mind  that 
they  convey  to  us  only  the  idea  of  a  symptom  of  disease.  They  all 
mean,  with  the  exception  of  the  last,  a  white  discharge  from  the 
female  genital  organs.  They  are  slightly  inaccurate,  as  the  discharge 
is  sometimes  yellow,  or  green,  or  otherwise  variant  from  white.  Any 
discharge  from  the  female  genital  or^ns  which  is  not  bloody,  comes 
under  the  term  "  whites." 

k  Symptom  Only.  —  As  the  name  of  a  disease,  the  term  whites  has 
no  specific  meaning.  It  does  not  designate  any  particular  complaint. 
It  is  a  symptom,  just  as  the  matter  expectorated  and  raised  in  lung 
diseases  is  a  symptom  ;  and  as  such  only  should  it  be  regarded. 
When  persons  cough  and  raise  a  great  deal,  they  do  not,  on  consult- 
ing a  physician,  say  they  have  got  the  expectoration ;  but  they  say 
they  fear  they  have  some  disease  of  the  lungs,  because  they  expecto- 
rate. They  look  upon  the  expectoration  as  the  sign  or  symptom  of 
disease. 

So  females,  and  physicians  too,  must  learn  to  look  upon  the  whites, 
not  as  a  disease,  but  as  the  sign  or  symptom  of  disease,  which  sign 
they  should  become  skilled  in  interpreting. 

There  is  no  reason  why  the  discharge  from  the  genital  organs 
should  not  be  as  well  interpreted  as  the  expectoration  or  discharge 
from  the  throat.  The  parts  from  which  it  comes,  may  be  about  as 
easily  and  as  well  inspected. 

Ko  Female  Ailments  so  Common. —  There  are  no  female  troubles  to 
which  the  attention  of  the  physician  is  so  often  called  as  these  aimoy- 
ing  and  debilitating  symptoms  called  whites  ;  and  th(!re  is  no  depart- 
ment of  medical  practice,  in  which  the  really  able,  as  well  as  conscien- 
tious and  j)ainstaliing  phyt^ician,  is  so  well  tested.  If,  regarding  these 
discharges  as  they  are,  simply  as  signs,  he  searches  faithfully  for  their 
cause,  he  will  be  led  to  a  treatment  which  in  a  great  majority  of 
cases  will  be  successful.  And  surely  no  success  in  life  can  be  more 
prized  by  a  right-minded  phvsician.     It  procures  health,  the  highest 

45 


ii.. 


354 


FEMALK  DISEASKS. 


earthly  boon,  for  snflbring  womnn,  and  gratitude,  the  most  prized  of 
all  rewards,  for  himself. 

Tliere  nre  Four  KIikIh  of  DiscliiirpTPH  from  the  female  genital  or- 
gans,—  inucua,  pus,  mucus  and  pus  eonibined,  and  the  watery.  The 
first,  muuus,  does  not,  in  itself,  im|)ly  disease  ;  but  when  pus  is  dis- 
charged, we  know  that  inflammation  exists,  because  such  a  cause 
sdone  can  produce  it. 

Seat  of  the  INsense.  —  The  cause  which  produces  the  whites  may 
have  its  seat  either  in  the  vagina,  or  in  the  neck  of  the  womb;  and 
in  practice,  it  is  of  course  quite  important  to  know  where  its  location 
is.  The  charaettir  of  the  discharge  generally  scuttles  this  |x)int.  If  it 
be  thin  and  watery,  or  thick  and  cream-like,  it  is  from  the  vagina  or 
passage  which  lea(ls  to  the  womb ;  if  ropy,  gluey  or  albuminous,  like 
w^hite  of  cgrt,  it  is  from  the  cavity  of  the  uterine  neck. 

Treatment.  —  Some  physicians  always  prescribe  the  same  remedy 
for  the  whitt^s.  They  might  as  well  have  but  one  prescription  for 
expectoration.  The  remedy  must  have  reference  to  the  cause  of  the 
discharge  ;  until  the  cause  be  searched  out,  every  prescription  is  a 
mere  trial  at  guessing,  —  a  sort  of  practice  well  enough  adapted  to 
quarks,  but  not  becoming  scientific  men. 

When  a  ci'su  of  whites  is  brought  before  a  physician  who  under- 
stands his  business,  he  makes  no  prescription  until  he  hiis  discovered 
what  the  diseases  !?••,  Having  determined  this  point,  his  remedies  have 
an  intelligent  beariuf^  upon  the  case.  This  being  so,  I  have  no  reme- 
dies to  set  dowji  for  whites,  simply  as  such.  1  shall  proceed,  there- 
fore, to  speak  of  several  other  complaints  which  bear  more  or  less 
upon  this.    For  trcatmoiit,  see  page  390. 

Absence  of  the  Menses. — Amenorrhcea. 

The  absence  of  the  menses  is  divided  into  two  kinds, — retention 
and  suppression.  It  is  retention  when  the  monthly  flow  has  never 
appeared,  —  suppression,  when,  having  been  established,  it  is,  by  one 
cause  or  another,  stopped. 

Retention  Explained. —  The  ovaries,  as  we  have  before  said,  are 
the  centre  of  the  female  sexual  system.  It  is  the  swelling  or  ripening 
of  an  ovum  or  egg,  every  four  weeks,  which  causes  the  large  now  of 
blood  to  the  parts,  and  the  consequent  menstrual  discharge. 

But  it  sometimes  happens  that  ihe  ovaries  are  not  developed  at  the 
ttsual  time  of  life.  The  monthly  evacuation  does  not  then  appear. 
There  is  retention.  There  may  be  retention,  too,  from  other  causes, 
after  the  ovaries  are  matured.  Costiveness  may  sometimes  occasion 
it, —  so  may  a  degenerated  and  low  state  of  the  blood. 

There  may  be  mechanical  causes  of  retention.  The  mouth  of  the 
womb  may  be  entirely  closed,  or  the  neck  may  be  so  constricted  aa 
to  close  the  passage  through  it,  leaving  no  outlet  for  the  monthly  accu- 
mulatioa    The  hymen,  also,  may  have  no  opening  through  it    When 


prized  of 


'enital  or- 
ery.  The 
)us  Ih  dis- 
h  a  cause 


hitcs  may 
oinb ;  and 
t3  location 
)int.  If  it 
i  vagina  or 
linous,  lilte 

ne  remedy 
•ription  for 
luse  of  the 
iption  is  a 
adapted  io 

vho  under- 
discovered 
pedies  have 
e  no  reme- 
ceed,  there- 
ore  or  less 


—  retention 
has  never 
is,  by  one 

e  said,  are 
or  ripening 
rge  now  of 

oped  at  the 
len  appear, 
her  causes, 
es  occasion 

outh  of  the 
istricted  as 
mthly  accu- 
it    When 


FEM.VLE  DISEASES. 


3;5o 


these  mechanical  obstructions  exist,  there  are  sometimes  large  collec- 
tions of  fluid  in  the  womb,  which  cause  enlargement  of  the  body,  and 
in  some  instances,  painful  suspicious  that  the  sutt'erer  has  committed 
imprudences,  and  is  in  the  family  way.  Physicians  should  be  on  their 
guard  lagainst  falling  into  such  errors,  and  lending  the  sanction  of  their 
name  to  these  blasting  mistakes. 

Suppression  Expliliiieii.  —  Suppression,  —  a  stoppage  after  flow  has 
been  once  established,  —  may  be  caused  by  itilhinnriation  of  the  ova- 
ries,—  the  bloofi,  in  this  diseased  condition,  being  drawn  so  entirely 
to  these  swelling  and  germinating  bcxlies,  that  the  accustomed  flow 
from  the  womb  does  not  take  place. 

Inflammation  in  the  neck  of  the  womb  may  also  cause  a  stoppage. 
So  may  a  fright,  as  from  a  fire  occurring  in  the  neighborhood,  or  a 
cold  taken  by  being  caugiit  in  a  shower.  Girls  sometimes,  in  their 
utter  thoughtlessness  or  ignorance,  dip  their  feet  in  cold  water,  wher. 
their  courses  are  u|)on  them,  and  briif'  on  a  suppression  of  a  most 
dangerous  character.  The  most  lovely  ,1.1)  innocent  girls  have  done 
this  for  the  purpose  of  attending  a  party ;  and,  in  some  instances,  the 
stoppage  induced  has  ended  in  den^h  witliin  a  few  hours.  The  pro- 
found ignorance  of  their  own  mecl  ism,  and  of  the  laws  which  gov- 
ern it,  in  which  girls  are  kept  who  are  just  budding  into  life,  is  a  seri- 
(lus  reproach  both  to  parents  and  physiriaii.s. 

Suppression  may  be  induced  by  whatever  reduces  the  quantity  or 
quality  of  the  blood,  as  consumption,  or  by  great  depression  of  spirits. 
With  some  rare  exceptions,  women  have  not  their  turns  w^hile  in  the 
family  way. 

Treatment. — Before  anything  can  be  done  in  the  way  of  treatment, 
the  case  must  be  thoroughly  investigated,  and  the  specific  cause  of 
the  disease  searched  out. 

If  it  prove  to  be  retention,  and  arises  from  a  bloodless  condition, 
and  an  undeveloped  state  of  the  ovaries,  iron  is  the  proper  remedy, 
(61)  (73)  (74)  (75),  with  a  generous  diet  and  exercist  ^^  of  doors. 
If  caused  by  an  inflammatory  state  of  the  uterine  neck  or  ovaries, 
the  proper  treatment  has  been  already  indicated.  If  from  costiveness, 
relief  may  generally  be  found  from  prescriptions  (5)  (9).  The  me- 
chanical causes  alluded  to  above,  when  found  to  exist,  must  be  removed 
by  gently  dilating  the  mouth  of  the  womb  or  the  uterine  neck,  with 
bougies,  beginning  With  the  smallest,  and  increasing  the  size,  or  by 
puncturing  the  hymen,  as  the  case  may  require. 

In  Treating  Suppression,  it  should  be  borne  in  mind  that  at  a  cer- 
tain time  each  month,  nature  makes  an  attempt  to  restore  the  lost 
function.  Even  when  she  is  not  successful,  probably  an  ovum  is  ma- 
tured and  in  some  way  disposed  of.  The  intelligent  physician  will  of 
cpurse  avail  himself  of  this  favorable  moment  to  try  his  skill  in  bring- 
ing about  the  desired  regularity.  When  this  time  arrives,  he  should 
order  three  or  four  leeches  applied  to  each  groin  at  night.  The  next 
night,  he  should  direct  the  use  of  a  pungent  foot  bath  (242) ;  also  (1 6) 
as  a  cathartic 


1   ■  1  ii 


!■■    ',! 


W: 


m  «" 


ill 


356 


FEMALE  DISEASES. 


When  suppression  exists,  it  is  not  always  proper  to  try  in  this 
direct  way  to  bring  on  the  turns.  There  may  be  no  blood  to  spare ; 
an(<  this  may  be  the  sole  reason  why  the  courses  do  not  appear. 
When  this  is  the  case,  nothing  is  to  be  done  but  to  build  up  the 
health  as  rapidly  as  possible,  and  when  this  is  sufficiently  established, 
the  courses  will  be  all  right. 

Profuse  Menstruation. — Menorrhagia. 

Menstruation  may  continue  too  lonff,  or  occur  too  often,  or  be  too 
jrofuse  while  it  lasts;  or  all  these  irregularities  may  be  experienced  by 
the  same  person.  Any  one  of  them  will  prove  a  serious  irritation, 
and  a  drain  upon  the  constitution ;  the  whole  together,  if  not  arrested, 
will  undermine  and  destroy  it. 

The  Cause  of  this,  like  the  sourse  of  all  other  female  diseases,  is, 
in  a  great  majority  of  cases,  overlooked. 

It  is  not  to  be  attributed,  as  so  many  suppose,  to  a  congested  state 
of  the  womb ;  but  is  rather  the  result,  in  a  great  many  instances,  of 
the  inflammatory  or  ulcerated  condition  of  the  uterine  neck. 

In  still  another  large  number  of  cases,  it  arises  from  a  succession 
of  ovarian  abortions.  When  the  blood  has  run  low,  and  imtrition  is 
defective,  as  in  the  consumptive  habit,  the  ovarian  vesicles  fail  to 
reach  maturity.  Like  other  products  of  the  economy,  they  become 
blighted,  and  abort  And  as  these  blights  occur  often,  nature  is  busy 
every  two  or  th  -^e  weeks  in  casting  them  off.  Hence,  the  menses 
ap|)ear  often,  luty  come  and  go  without  order,  because  they  "spring 
from  a  process  which  is  a  contraversion  of  nature's  laws. 

Explanation.  —  It  is  not  easy  to  explain  how  inflammation  and 
ulceration  of  the  uterine  neck  should  in  one  case  produce  suppression, 
and  in  another  profuse  menstruation.  Yet  it  is  a  settled  truth,  that 
such  opposite  results  do  come  from  one  and  the  same  apparent  cause. 
Probably  the  explanation  is  to  be  found  in  the  difl'erent  degrees  of 
inflammatory  action,  in  the  varieties  of  constitution,  and  in  the  vari- 
ant degrees  of  tenacity  with  which  the  vessels  hold  the  blood. 

Bleeding  from  the  female  genital  organs  may  be  produced  by  a 
•variety  of  causes  which  have  nothing  to  no.  136. 

do  with  menstruation.  Such  bleedings 
are  propmly  uterine  or  vaginal  hemor- 
rhages^ and  not  profuse  menstruation. 
Tliey  ure  the  result  of  inflammations, 
or  tuniDrs  within  tiie  uterine  neck  (Fig. 
136),  or  wt"ciknoss.  The  wonjb  may 
bleed  for  days,  or  even  for  months,  from 
pure  debility. 

Treatment. —  As  profuse  menstruation 
and  uterine  hemorrhage  spring  from  a 
variety  of  causes,  so  the  remedies  are  various.     Here  again  we  are 
confronted  with  the  same  absolute  necessity  to  investigate  accurately 


try  in  thU 
I  to  spare; 
not  api^ar. 
dikl  up  the 
established, 


en,  or  be  too 
terienced  by 
[s  irritatiorv 
lot  arrested, 

diseases,  is, 

jested  state 
nstances,  of 

a  succession 

nutrition  is 

icles  fiiil  to 

hey  become 

^ture  is  busy 

the  menses 

they  "spring 

mation  and 
suppression, 

truth,  that 
arent  cause. 

degrees  of 
in  the  vari- 
o<h1. 
)duced  by  a 


TWf 


gam  we  are 
2  accurately 


; 


the  true  nature  of  the  complaint,  before  we  venture  a  single  prescrip- 
tion. All  the  cases  present  one  general  feature.  There  is  too  great 
a  loss  of  blood ;  and  the  first  thought  is  that  astringent  medicines  are 
necessary  to  arrest  it.  But  if  the  bleeding  be  occasioned  by  a  poly- 
pus, or  by  inflammatory  ulceration,  astringents  would  not  arrest  it, 
and  might  do  great  mischief. 

When  the  immoderate  flowing  is  caused  by  a  general  breakdown 
of  the  nutritive  powers,  and  by  ovarian  abortions,  the  great  aim  must 
be  to  rally  the  vital  powers  by  iron,  quinine,  porter,  wine,  a  generous 
diet,  exejcise  on  horseback  and  on  foot,  and  warm  and  cold  bathing. 
When  produced  by  local  diseases  of  the  ovaries  and  neck  of  the 
womb,  the  treatment  is  to  be  local,  —  such  as  has  been  described.  If 
a  polypus,  or  other  tumor,  be  the  cause,  the  remedy  must  be  sought 
for  under  the  appropriate  head.  If  the  womb  has  become  relaxed, 
and  bleeds  from  pure  debility,  —  as  it  may,  —  something  must  be 
found,  if  possible,  which  will  condense  it^s  substance,  —  making  it 
harder,  smaller,  and  more  solid.  For  this  purpose,  cold  bathing,  as- 
tringent injections  into  the  front  passage,  and  acid  drinks,  are  useful. 
But  one  of  the  best  remedies  is  the  wine  of  spurred  rye  (267).  One 
teaspoonful  should  be  taken  three  times  a  day.  This  article,  by  caus- 
ing the  womb  to  contract,  solidifies  and  condenses  it,  —  thus  arresting 
the  blood' which  oozes  from  its  relaxed  tissues. 

Case.  —  Miss  S.  F.  was  treated,  in  1855,  for  great  loss  of  blood  by 
too  frequent  and  too  profuse  menstruation.  She  had  suffered  for  a 
number  of  years, —  her  courses  coming  on  every  three  weeks,  some- 
times every  two  weeks,  and  lasting  from  a  week  to  ten  days.  She 
had  become  very  pale,  and  much  debilitated ;  and,  as  she  had  a  slight 
cough,  her  friends  feared  that,  if  not  relieved,  she  would  soon  sink  in 
consumption. 

Having  made  an  examination,  and  learned  that  there  was  no  or- 
ganic disease,  but  that  the  exhaustive  bleeding  was  caused  entirely 
by  debility,  I  prescribed  sulphuric  acid  (60)  three  times  a  day,  with 
half  a  pint  of  cold  water  injected  into  the  bowel  once  a  day,  and  qui- 
nine (67)  three  times  a  day. 

The  patient  was  required  to  take  a  very  generous  diet  of  juicy 
meats,  broths,  etc.,  and  to  be  in  the  open  air  to  a  reasonable  extent. 

The  case  began  immediately  to  improve,  and  in  a  few  weeks  the 
courses  were  restored  to  a  healthy  state.  No  other  treatment  was 
UMcd,  except  to  drop  the  sul|)huric  acid  in  two  instances,  for  a  few 
days,  usii\g  in  place  of  it,  tannin  in  one  case,  and  alum  in  the  other. 

Painful  Menstruation. — Dt/smcnorrhoea. 

D>-.»t'.NORRHa?A  is  from  three  Greek  words  Bvt,  fir)v,  and  ^ew,  which 
tnean,  literally,  a  difficult  monthly  Jloio.  These  words  do  not  precisely 
descritvc  the  complaint ;  for  it  consists  not  so  much  in  a  difficult,  as  in 
b  /irtunful  flow. 

Hymptoms. —  This  affection  is  always  marked  by  more  or  less  pain 


I 


iw 


358 


FEMALE  DISEASES. 


while  the  courses  are  on,  —  especially  during  i.ie  first  day  or  two. 
The  pain  sometimes  begins  two  or  three  days  in  advance  of  the  evac- 
uation. It  extends  over  the  whole  lower  part  of  the  belly,  —  running 
down,  at  times,  to  the  thighs,  and  causing  great  distress  in  the  back. 
it  is  frequently  so  violent  as  to  resemble  the  pains  of  labor,  compell- 
ing the  sufferer  to  take  the  bed,  and  drawing  from  her  tears  and 
groans,  and  occasionally  throwing  her  into  spasms  most  painful  to 
witness.  So  terrible  are  the  monthly  sufferings  which  some  women 
experience  from  this  cause,  that  the  anticipation  of  it  destroys  much 
of  their  peace,  even  during  the  intervals  of  respite. 

The  Causes  of  this  complaint  are  very  numerous.  There  is,  doubt- 
less, such  a  thing  as  pain  in  the  womb  from  rheumatism,  and  espec- 
ially from  neuralgia,  though  these  are  much  rarer  forms  of  the  com- 
plaint than  many  suppose. 

Pains  at  the  monthly  periods  are  often  induced  by  a  displacement 
of  the  womb.  If  the  organ  fall  over  backward  or  forward,  its  nerves 
are  pressed  upon  in  an  unnatural  way,  ai;d  when  the  parts  are 
crowded  with  blood,  :t  is  very  natural  for  painful  sensations  to  be 
excited.  In  these  caset,  the  neck  of  the  organ  is  bent  at  right  angles, 
and  the  canal  which  piisses  through  it  is  of  course  strictured,  so  that 
the  evacuations  are  necessarily  made  with  difficulty. 

And  this  leads  me  to  remark,  that  the  passage  through  the  uterine 
neck,  becomes,  occasionally,  from  inflammation  or  other  cause,  almost 
closed.  The  result  is,  much  difficulty  and  great  pain  in  passing  the 
monthly  secretion. 

There  are  no  causes  which  excite  painful  menstruation  more  often 
than  inflammation  in  the  uterine  neck  and  the  ovaries.  An  increased 
flow  of  blood  .o  an  inflamed  part  always  causes  pain.  An  inflamed 
foot  or  leg  has  to  be  laid  up  in  a  chair,  because  it  aches  when  put 
down.  The  reason  is,  that  when  hanging  down,  it  is  more  full  of 
blood,  and  the  sensitive  nerves  are  painfully  compressed.  When  the 
finger  is  hot  with  inflammation,  we  assuage  the  pain  by  holding  it  up 
for  the  blood  to  run  down.  For  the  same  reason,  the  infiamed  ovaries 
and  uterine  neck  ache  when  the  blood  flows  to  them,  in  large  quan- 
tities, at  the  menstrual  period. 

Congestion  of  the  lining  membrane  of  the  womb  itself  is  a  frequent 
cause  of  painful  menses.  It  is  a  condition  of  the  membrane  of  the 
womb,  similar  to  that  of  the  larynx  in  membranous  croup.  There  is  the 
same  pouring  out  of  what  physicians  call  coagulable  lymph,  which 
forms  itself  into  a  membrane.  This  membrane  the  womb  strives  by 
strenuous  contractions  to  throw  off,  and  finally  succeeds  in  expelling 
it,  not  whole  and  entire,  but  in  shreds  and  patches.  These  shreds, 
which  women  sometimes  call  skinny  substances,  are  characteristic  of 
the  disease.  The  efforts  to  expel  them  cause  pains  very  much  like 
those  of  natural  labor,  and  sometimes  almost  as  severe. 

Treatment.  —  Painful  menstruation,  excited  by  the  falling  over  of 
the  womb,  backward  or  forward,  is  cured,  of  course,  by  putting  the 
organ  back  into  its  proper  position. 

Pains  caused  by  stricture  of  the  canal  through  the  iiterine  neck,  are 


day  or  two. 
of  the  evac- 
i'^,  —  running 
iu  the  back. 
)or,  compell- 
;r  tears  and 
t  painful  to 
ome  women 
stroys  much 

re  is,  doubt- 
,  and  espec- 
of  the  com- 

isplacement 
d,  its  nerves 
e  parts  are 
itions  to  be 
•ight  angles, 
ired,  so  that 

the  uterine 
luse,  almost 
passing  the 

more  often 
n  increased 
in  inflamed 

when  put 
lore  full  of 

When  the 
olding  it  vp 
ned  ovaries 
quan- 


large 


1  a  frequent 
''ane  of  the 
?here  is  the 
nph,  which 
)  strives  by 
1  expelling 
ese  shreds, 
cteristic  of 
much  like 


ing  over  of 
(utting  the 

e  neck,  are 


cured  only  by  enlarging  the  passage.  This  is  effected  by  introducing 
at  first  a  very  small  bongw,  and  then  a  larger  and  a  larger,  until  the 
passa^  is  of  the  usual  size.  It  is  a  delicate  operation,  quite  success- 
ful in  careful  and  skilful  hands,  but  liable  to  produce  mischief  when 
improperly  conducted. 

In  all  the  forms  of  this  disease,  the  treatment  should  aim,  not 
merely  at  palliation,  but  at  a  cure.  And  generally,  1  am  happy  to 
say,  a  cure  is  attainable.  Yet  how  many  women  suffer  for  years, 
until  health  has  fled,  and  life  has  become  a  burden,  —  receiving  from 
their  medical  attendant  the  assurance  that  .palliation  only  is  pos- 
sible! 

It  is  necessary  at  each  monthly  turn,  to  do  something,  in  these 
cases,  to  quiet  the  pain.  For  this  purpose,  twenty  drops  of  lauda- 
num, in  a  wine  glass  of  tepid  water,  throv^n  into  the  bowel,  will  be 
highly  serviceable.  For  a  like  purpose,  one  pill  (116)  may  be  taken 
twice  a  day,  beginning  one  day  before  the  menstrual  flow.  A  bella- 
donna ointment  (170)  may  be  rubbed  upon  the  neck  of  the  womb 
with  great  advantage. 

In  the  congestive  form  of  this  disease,  —  that  in  which  the  membrane 
is  formed  on  the  internal  surface  of  the  womb,  and  thrown  off  in  frag- 
ments,—  the  liquid  acetate  of  ammonia,  or  spirits  of  Mindererus,  is  a 
very  valuable  remedy  taken  in  two  teaspoonful  doses,  in  a  table- 
spoonful  of  cold  water,  three  or  four  times  a  day,  while  the  pain  lasts. 

Case  I.  —  Miss  E.  S.  of  B.,  aged  twenty-two  years,  applied,  in 
1856,  for  relief  from  great  suffering  at  her  monthly  periods.  Her 
menses  had  been  disturbed  some  time  before  by  taking  cold,  since 
which  time,  her  mother  stated,  her  pains,  for  a  short  time  before  the 
flow  began,  and  during  the  first  day,  had  been  terrible,  not  much  less 
severe,  indeed,  than  those  of  natural  labor,  or  child-bearing.  The 
pains,  at  these  times,  had  been  of  a  terribly  bearing-down  kind ;  had 
frequently  been  preceded  and  accompanied  by  sickness,  vomiting,  and 
fever ;  and  finally,  what  came  from  her  at  first  was  not  so  much 
blood,  as  a  kind  of  skinny  svbstance,  in  shreds  and  patches. 

It  was  immediately  evident  that  this  was  a  case  of  painful  men- 
struation (dysmenorrhoea)  of  the  congestive  kind.  The  womb  was 
every  month  too  full  of  blood,  —  its  internal  surface,  in  fact,  if  not  its 
whole  substance,  inflamed.  Hence,  a  false  membrane  like  that  of 
croup,  was  formed,  which  the  womb  contracted  and  struggled  hard  to 
throw  off',  and  finally  tore  to  pieces,  and  expelled  in  shreds. 

Of  course  this  local  inflammation  was  to  be  reduced,  which  wai« 
done  by  first  giving  a  brisk  purge  (31),  which  was  followed  by  apply- 
ing half  a  dozen  leeches  directly  over  the  womb.  On  the  following 
day,  a  blister  was  raised  in  the  same  place.  In  two  weeks,  three 
leeches  were  applied,  and  again  followed  by  a  blister.  These  appli- 
cations were  repeated  every  fortnight,  for  three  months,  being  careful 
not  to  use  them  within  three  days  of  the  monthly  turns,  either  before 
or  after. 

The  pain,  at  each  turn,  was  assuaged,  by"  injecting  into  the  bowel 
twenty  drops  of  laudanum  in  a  gill  of  tepid  water,  by  rubbing  upoii 


360 


FEMALE  DISEASES. 


the  mouth  of  the  womb  some  of  the  ointment  (170),  and  by  giving 
two  teaspoonful  doses,  in  a  little  cold  water,  of  the  liquor  of  acetate 
of  ammonia,  three  times  a  day. 

The  patient  was  cured  in  three  months,  and  has  since  had  easy  and 
natural  menstruation. 

Case  11.  —  Mrs.  L.  C.  was  treated  for  a  case  of  painful  menstrua- 
tion, in  1857. 

The  lady  also  had  terrible  pains,  attended  by  forcing  down  as  if 
her  bowels  were  all  coming  out  of  her.  Yet  she  had  but  a  very 
scanty  discharge.  Every  month  she  was  made  literally  sick,  and 
was  obliged  to  take  to  her  bed. 

On  examination,  it  was  found  that  the  great  difRculty  in  passing 
the  menstrual  fluid,  as  well  as  the  scantiness  of  the  quantity,  was 
owing  to  the  smallness  of  the  passage  through  the  neck  of  the  womb  ^ 
this  passage  was  nearly  closed  up ;  it  was  strictured. 

There  could  be  no  doubt  as  to  the  treatment  required.  Medicines 
could  do  no  good.  This  passage  must  be  gradually  opened.  To  do 
this,  I  introduced  a  small  metallic  male  catheter  into  the  strictured 
passage,  and,  gently  turning  it  once  or  twice  round,  withdrew  it 
This  was  done  once  in  three  days,  for  three  months, — using  each 
time  a  slightly  larger  instrument.  Thenceforward,  her  menstruation 
was  natural  and  easy.     She  was  well. 

Chlorosis.  —  Green  Sickness. 

Before  the  age  of  puberty,  the  girl  is  only  a  child.  She  has  withia 
her  only  the  elements  of  a  woman.  The  change  to  which  she  is  des- 
tined, brings  with  it  a  wonderful  development  both  of  body  and 
mind. 

To  effect  this  development,  and  bring  out  the  new  being  in  the 
perfection  designed  by  the  Creator,  a  large  amount  of  hidden  nerve 
power  is  required.  She  requires  o  have  been  born  with  a  well-vital- 
ized constitution,  and  to  have  been  physically  trained  in  a  way  to 
harden  and  energize  it.  Without  these  antecedents,  her  develop- 
ments at  puberty  will  be  feebly  and  imperfectly  made.  Her  devel- 
opment and  evolution  of  germs  will  be  ao  defective  as  to  cause  her 
' .  enstruation  to  be  only  partially  established,  or  to  fail  altogether. 

Symptoms.  —  Where  the  inherent  powers  of  the  system  are  just 
sufficient  to  bring  about  a  first  menstruation,  it  often  happens  that 
they  seem  to  be  spent  by  the  effort,  and  that  the  evacuation  fails  to 
appear  again  for  several  months.  Indeed,  the  whole  organization  may 
break  down  at  this  point,  and  become  blasted,  as  it  were,  like  a  blade 
of  wheat  which  has  grown  well  for  a  time,  but  which  fails  to  develop 
the  kernel. 

The  blood  at  this  period,  may  become  impoverished,  and  fail  to 
distribute  adequate  nourishment  and  development  to  the  various  tis- 
sues. When  this  occurs,  it  loses  a  part  of  its  red  globules,  and  in- 
creases its  watery  portion.     As  a  result,  the  skin  becomes  pale,  and 


m 


FEMALE  DISEASES. 


361 


'  giving 
acetate 

asy  and 


enstrua- 

ivn  aa  if 

a  very 

ick,  and 

passing 
ity,  was 
;  womb ; 

[edicine» 
To  do 
trictured 
idrew  it. 
ing  each 
struation 


IS  within 
e  is  des- 
ody  and 

ig  in  the 
en  nerve 
^rell-vital- 
1  way  to 
develop- 
er devel* 
;au8e  her 
sther. 

are  just 
jens  that 
fails  to 
ition  may 
e  a  blade 
0  develop 

id  fail  to 
irious  tis- 
i,  and  in- 
pale,  and 


sometimes  of  a  yellowish  hue;  the  bowels  become  torpid  and  con- 
fined ;  the  nervous  system  sensitive  and  weak ;  the  digestion  is  im- 
paired ;  the  appetite  is  either  lost,  or  perverted,  —  longing  for  unnatu- 
ral food ;  the  tongue  is  white ;  the  heart  palpitates ;  the  spirits  are 
depressed ;  the  temples  and  ears  throb ;  the  head  occasionally  aches 
and  whirls  with  dizziness ;  the  sleep  is  disturbed  and  abbreviated ; 
and  hysterics  are  now  and  then  superadded  to  close  the  catalogue 
of  ills. 

This  is  Chlorosis,  briefly  depicted  in  its  origin  and  its  symptoms. 
The  word  is  from  the  Greek  ;^\a>/309,  which  means  green  and  pale. 
By  ifUrses  it  is  called  the  "  green  sickness." 

Its  €aii!iies  are  quite  numerous,  among  which  may  be  reckoned  im- 
poverished diet,  damp  atmosphere,  sedentary  habits,  long  confine- 
ment indoors,  overworking  the  mind  in  childhood,  constipation  of  the 
bowels,  and  an  inherited  feeble  constitution.  - 

Treatment.  —  Chlorosis,  as  a  general  thing,  is  connected  either  with 
retention  or  suppression  of  the  menses ;  and  in  treating  it,  physicians 
are  too  much  in  the  habit  of  resorting  indiscriminately  to  forcing 
medicines,  called  emmenagogues.  From  such  practice,  great  injury 
often  results. 

It  is  not  always  sufficiently  considered  that  a  woman  fails  to  men- 
struate, or  ceases  to  do  so,  becau^se  she  is  sick ;  and  if  we  would  cause 
her  courses  to  return,  we  must  restore  her  health.  To  do  this  should 
generally  be  the  great  object  of  treatment.  Let  the  health  be  restored, 
and  the  menses  will  come  back.  The  only  philosophical  treatment  is 
that  which  will  invigorate  the  system. 

In  chlorosis,  the  vital  powers  are  in  a  state  of  dilapidation.  How 
can  they  be  roused  ?  By  exercise  on  horseback  and  on  foot ;  by  wear- 
ing clothing  enough  to  keep  warm ;  by  a  tepid  bath  two  or  three  times 
a  week,  and  brisk  rubbing  with  a  coarse  towel ;  and  by  a  generous 
diet,  composed  of  tender  meats,  animal  broths,  etc. 

This  treatment,  however,  should  be  preceded  by  unloading  the 
Dowels  with  prescription  (35)  or  (40),  according  to  choice.  One  pill 
should  be  taken  at  night.  When  the  liver  is  considerably  deranged, 
prescription  (40)  will  be  particularly  serviceable.  Half  a  pint  of 
tepid  water  thrown  into  the  bowel,  night  and  morning,  will  help 
relieve  costiveness. 

The  bowels  having  been  well  opened,  give  a  tablespoonful  of  pre- 
scription (59),  two  or  three  times  a  day ;  or,  of  prescription  (60),  a 
teaspconful,  the  same  number  of  times,  each  day. 

In  the  treatment  of  this  disease,  iron,  in  some  form,  is  almost  al- 
ways needed.  Prescriptions  (61)  (71)  (73)  (74)  (75)  (80)  and  (316) 
are  suitable  preparations. 

A  girl  suffering  from  this  disease  should  always  be  tak6n  out  of 
■chool.     The  mind  should  be  divided  between  rest  and  recreation. 

Case. —  Miss  J.  T.,  aged  nineteen,  was  treated  by  me  for  this  como 
plaint  in  1858. 

She  had  always  been  delicate.     Her  first  menstruation  was  at  the 


III- 


Ii 


■fi.^'l 


I* 


ii'l-. 


age  of  fourteen ;  but  it  was  quit«  defective  in  quantity,  and  was 
imperfectly  repeated  two  or  three  times,  at  irregular  periods,  when  it 
stopped  altogether,  and  had  not  again  appeared  up  to  the  time  of  her 
being  brought  to  me. 

She  was  very  pale,  and  a  little  yellowish,  —  her  lips  being  nearly 
white.  She  was  very  costive,  —  habitually  so,  —  was  without  appe- 
tite, and  her  tongue  was  coated  white.  She  had  dizziness,  palpita- 
tion of  the  heart,  neuralgic  pains  in  various  parts,  and  was  extremely 
nervous  and  irritable.  Having,  in  addition  to  the  above  symptoms,  a 
pretty  constant  cough,  her  friends  feared  consumption,  and  brought 
her  to  me  from  some  distance  for  that  reason. 

I  found  no  physical  signs  of  lung  disease,  and  had  no  difHcuIty, 
therefore,  in  making  it  out  to  be  a  case  of  chlorosis,  —  particularly  as 
there  was  no  expectoration  attending"  the  cough. 

The  parents  were  chiefly  anxious  to  have  the  menses  brought  on. 
With  me,  this  was  of  minor  consequence ;  the  main  thing  was  to  rally 
the  prostrate  powers  of  life,  and  restore  the  blood  to  health. 

To  do  this,  it  was  necessary  to  rouse  the  liver,  for  which  I  gave 
leptandrin,  etc.  (34),  which  I  ordered  to  be  taken  once  a  day,  namely, 
at  bed-time.  This  not  only  caused  a  flow  of  bile,  but  the  scutelarine 
calmed  and  strengthened  the  nervous  system. 

It  was  necessary,  too,  to  correct  the  habit  of  costiveness.  To 
effect  this,  she  was  ordered  to  take  two  teaspoonfuls  of  Mettauer's 
aperient,  after  breakfast  and  dinner. 

To  restore  the  blood,  iron  was  ordered,  particularly  the  citrate  of 
iron  and  strychnine  (316).  This  had  a  fine  effect  to  raise  the  blood 
and  support  the  nervous  system. 

She  was  ordered  a  generous  diet  of  tender  meats,  broths,  etc.,  and 
to  take  unrestrained  and  free  exercise  out  of  doors. 

Her  improvement  was  immediate  and  visible,  and  was  not  inter- 
rupted during  the  three  months  of  her  stay  in  Boston.  Soon  after 
her  return  home,  her  menses  appeared,  and  she  has  since  enjoyed 
pretty  good  health. 

Cessation  of  the  Menses.— Turn  of  Life. 

There  is  probably  no  period  in  woman's  earthly  existence  which 
she  approaches  with  so  much  anxiety  as  that  which  she  is  in  the 
habit  of  calling  "  the  turn  of  life."  The  anxiety  is  not  without  some 
reasonable-  ground  for  its  existence.  She  has  been  accustomed,  for 
thirty  years  or  more,  to  lose,  every  four  weeks,  a  certain  amount  of 
blood.  When  this  evacuation  stops,  disturbances  of  the  system  may 
well  be  expected.  So  well  is  this  understood,  that  this  climacteric 
has  come,  by  general  consent,  to  be  called  the  "  critical  period "  in 
female  life. 

If  it  be  well  and  safely  passed,  the  health  is  generally  better  than 
before,  and  a  "  green  old  age "  is  likely  to  follow.  But  if  the  seeds 
of  disease  are  in  the  system,  —  if  there  be  a  tendency  to  cancer  or 
other  malignant  disease,  which  has  been  held  in  check  by  the  monthly 
flow,  it  now  takes  up  its  destructive  work,  and  shows  itself;  or,  if 


'iu 


and  was 
s,  when  it 
me  of  her 

ing  nearly 
lout  appe- 
is,  palpita- 
extremely 
mptoms,  a 
d  brought 

difficulty, 
icularly  as 

•ought  on. 
aa  to  rally 

ch  I  gave 
y,  namely, 
scutelarine 

tiess.  To 
Mettauer's 

citrate  of 
the  blood 

3,  etc.,  and 

not  inter- 
Soon  after 
se  enjoyed 


e. 

nee  which 
is  in  the 
iiout  some 
tomed,  for 
mount  of 
stem  may 
limacteric 
period^^  in 

etter  than 
the  seeds 
cancer  or 
e  monthly 
jelf ;  or,  if 


there  be  a  predisposition  to  apoplexy  or  congestion  of  any  organ,  it 
is  more  likely  to  become  active,  now  that  the  accustomed  waste-gate 
is  closed.  A  distinguished  writer  has  said  that  about  half  the  deaths 
among  women,  about  the  age  of  forty-four,  are  from  cancer. 

]Vervous  Coiiiplicatioiis.  —  It  is  the  duty  of  the  physician  to  look 
carefully  after  those  females  who  come  under  his  care  at  this  critical 
time.  For,  in  addition  to  the  organic  and  malignant  diseases  which 
attack  her  at  this  time,  she  is  exposed  to  a  host  of  nervous  irritations, 
which,  if  neglected  or  badly  managed,  make  her  life  a  cross  and  a 
burden.     The  symptoms  of  these  irritations  are  in  number,  legion. 

A^e  at  which  tlie  turn  of  life  comes.  —  As  a  general  rule,  the  turn 
of  life  comes  between  the  ages  of  forty  and  fifty  ;  but  occasionally 
occurs  at  other  periods,  varying  from  thirty  to  seventy.  If  the  menses 
appear  early  in  life,  they  terminate  early.      .    . 

Symptoms. — When  there  is  a  tendency  to  corpulency  at  this  period, 
the  symptoms  are  headache,  dizziness,  and  a  sense  of  suffocation.  It 
is  common,  when  the  period  of  cessation  approaches,  for  deviations 
from  regularity  to  occur.  At  one  time  the  menstrual  discharge  will 
be  profuse ;  at  another,  scanty.  It  will  now  disappear  for  a  time, 
and  be  replaced  by  the  whites.  Then  it  will  appear  for  a  few  times 
with  considerable  regularity.  Next  will  come  a  suspension  for  sev- 
eral months,  to  be  followed  by  a  flow  of  such  profusion  as  to  amount 
almost  to  flooding. 

Mixed  up  with  these  irregularities,  will  be  palpitations  of  the 
heart,  constipation  of  the  bowels,  a  variable  appetite,  and  broken 
sleep,  weakness  and  inquietude,  timidity,  a  dread  of  impending  evil, 
irritability  of  temper,  hysterical  attacks,  bad  feelings  in  the  head,  with 
sounds  in  the  ears,  as  of  the  rolling  of  carriages,  sparks  before  the 
eyes,  and  an  unsteady  gait. 

Treatment  —  If  there  be  at  this'  period,  fulness  of  habit,  with  diz- 
ziness, headache,  sparks  before  the  eyes,  a  sense  of  suflbcation,  etc., 
there  is  a  plain  indication  that  the  brain  is  oppressed  with  too  much 
blood.  I  am  not  much  in  favor  of  bleeding,  but  this  is  a  case  in 
which  from  a  gill  to  a  half  pint  of  blood  may,  if  ever,  be  drawn  from 
the  arm  with  }K)sitive  advantage.  Cups  applied  to  the  back  of  the 
neck  will  also  be  useful.  Give  at  night,  also,  three  of  the  compound 
cathartic  pills,  and  then  keep  the  bowels  regular  with  prescription 
(18),  —  a  wine-glassful  to  be  taken  occasionally.  The  diet  should  be 
spare,  and  strictly  vegetable :  —  to  which  should  be  added  much  daily 
exercise. 

Purging  should  not,  in  any  case,  be  carried  too  far.  If  nervous 
affections  show  themselves,  with  disturbance  of  the  digestion,  and 
general  debility,  even  leeches  would  be  improper,  and  physic  should 
be  swallowed  very  sparingly. 

When  serious  organic  disease  is  suspected,  —  as  cancer,  —  it  is  the 
duty  of  the  physician  to  investigate  the  case  very  thoroughly,  and  to 
give  the  patient  the  advantage  of  the  most  prompt  ancf  decided 
treatment.     That  treatment  is  six>ken  of  in  the  ]>roi)er  place. 


364 


FEMALE  DISEASES. 


Hysterics. — Hysteria. 

The  name  of  this  complaint  is  from  a  Greek  word,  signifying  the 
womb.  It  took  this  name  from  the  belief  that  this  organ  is  the  seat 
of  the  irritation  which  produces  the  hysteric  disturbance. 

This  belief  is  correct,  if  we  include  with  the  womb,  t  le  ovaries, 
and  the  other  sexual  organs.  The  sexual  system  is  doubtless  ths 
centre  of  the  reflex  nervous  derangement,  called  hysteria. 

It  has  been  sufficiently  demonstrated  that  hysterics  are  dependent 
for  their  existence  either  upon  organic  disease,  or  upon  simple  irrita- 
tion of  the  sexual  organs.  Sir  Benjamin  Brodie  mentions  cases  of 
the  hysteric  paroxysm,  produced  by  pressing  upon  an  inflamed  and 
tender  ovary. 

Symptoms.  —  An  attack  of  hysterics  is  generally  preceded  by  de- 
pression of  spirits,  restlessness,  and  a  frequent  desire  to  pass  water. 
It  is  sometimes  marked  by  convulsions,  or  fits ;  at  other  times,  it  is 
not.  At  times,  the  attacks  are  local,  and  are  manifested  by  spasms 
of  the  throat  at  the  top  of  the  windpipe,  or  in  the  bronchial  tubes  *, 
the  patient  feels  a  ball  rise  up  in  her  throat  (globus  hystericus),  her 
heart  beats  violently,  and  she  laughs  and  cries  by  turns. 

When  the  disease  is  more  general,  the  muscles  of  the  limbs  are 
thrown  into  spasms;  the  patient  struggles  violently;  rising  up  in  a 
sitting  posture,  and  then  throwing  herself  back;  twisting  the  body 
from  side  to  side,  clenching  the  hands,  and  throwing  the  arms  about, 
so  that  she  is  with  difficulty  held  by  persons  much  stronger  than  her- 
self. Soon  after  these  paroxysms,  the  patient  generally  passes  a  large 
quantity  of  very  pale  urine. 

The  Causes  of  this  complaint  are  as  numerous  as  the  causes  of 
female  diseases,  for  in  truth  there  is  no  female  complaint  which  may 
not  produce  it.  Whatever  develops  and  excites  the  sexual  system, 
and  at  the  same  time  weakens  the  constitution,  lays  the  foundation 
of  this  malady.  Nervous  women  are  much  inclined  to  it.  In  large 
cities  there  is  more  of  it  than  in  the  country,  because  there  is  more 
excitement  and  luxury,  and  more  of  their  consequences,  —  nervous 
and  female  diseases. 

Treatment.  —  To  treat  this  complaint  successfully,  it  is  necessary  to 
search  out  its  cause,  and  remove  that.  Like  the  whites,  it  is  not  so 
much  a  disease  in  itself,  as  a  symptom. 

The  first  inquiry  to  be  made  should  have  reference  to  the  iea\ 
origin  of  the  complaint  Is  it  dependent  upon  inflammation  of  the 
ovaries  or  the  womb,  or  to  displacement  of  this  latter  organ ;  or  does 
it  arise  from  the  low  state  of  the  blood,  and  the  weakened  condition 
of  the  nerves,  acted  upon  by  some  irritation  or  heightened  sensibility 
of  the  sexual  organs. 

If  dependent  upon  inflammatory  disease,  that  is  to  be  treated  ac- 
cording to  directions  elsewhere ;  if  upon  falling  of  the  womb,  no 
remedies  will  avail,  until  that  is  put  in  its  proper  place.    If  diluted 


pfiifying  the 
is  the  seat 

t'.ie  ovaries, 
iibtler^s  the 

dependent 
mple  irrita- 
)s  cases  of 
flamed  and 

ded  by  de- 
pass  water, 
times,  it  is 
by  spasms 
hial  tubes; 
ericus),  her 

'.  limbs  are 
ng  up  in  a 
;  the  body 
irms  about, 
r  than  her- 
jses  a  large 

causes  of 
wrhich  may 
iial  system, 
foundation 
:,  In  large 
re  is  more 
—  nervous 


ecessary  to 
it  is  not  so 

to  the  leai 
tioii  of  the 
m ;  or  does 
i  condition 
sensibility 

treated  ac- 
womb,  no 
If  diluted 


i 


•'m 


R0. 2. 


<S<P^' 


*?■'"■■    3f;,- 


iM''^ 


;■!■'  ,t'- 


M  ^.  %  'I 


»»: 


'■4m 


F?:*' 


A%' 


l'^^:^:v'' 


'i^' 


4 


III 


11/^  i- 


Ii 


am 


►  w 


i 


■  ^l«t»        Wm^wh 


;m;4.  fh^mau:  DisfiASKR. 


f 


rs»:T?tc  of  thift  complpitr;  i/^  frtiin  n  'Imn^'  word,  'ip^nifying  the 
.-„■',:      U  I'Xi-k  tbis  iia'Jif  f«xuA  the  b<-li'*f  ii  U  thi'»  orgnu  is  t!)'^  ;rai  _ 
of  ihft  itrif4it:on  whicii  jmxiufios  xh<-  hvfc«<<*««<'  di»t'.aHMHt'-e. 

Chic  fwlii-i  is  conect,  if  we  iiioind.'  wiiJj  the  vvonjb,  thr-  oviri",', 
ai.d  th-  othf  r  ecHiiii]  organ?.  T>ic  m'^ohI  hy.-ttfisi  i-  'loi/btii ■»*  ths 
ewitff^  of  tlv  rcik'x  iu'.rvcn'.««  •l«mngeii."Mir,  chIM  h)*Unn. 

Jt  hfiji  btH-i)  siiOk hntly  d?n)OMsfn\T«..»  thiit  h/sterifH  ar«>  di  |»«-iuici «. 
for  tlK'ir  ixistcmx    eiiheV  upon  org:in»'.  dii+<'a.'<-,  or  iipun  simplt-  irrifa- 

ihf.  hysteric  puro\yHra,  prcxiufed  ;y  pr<"Hs«iMg  ihh'H  'I'l  indaiicJ  uiiU 
teiuier  ovary. 

;^yju]if^itiiif4. An  iU(«t*k  of  hyul.rirw  if  gfnrtR'.li^  jm'Cf'dfd  hy  tlr- 

,4rphiUij;  ••t'  jHTitj-.  h.'eik-'vi'at'M,  ai)d  a  fmjuenv  U'-'k'  to  puoii  wntcr 
fc  ui  »i>iti'-iffiiet>  nmrkc'l  oy  tonviilsioi;s  <>r  fite ;  at  otlur  timfs^  ii.  k 
not.  At  tirncH,  the  oft«<'Kiii  are  i'.i;al,  ttud  3.ro  rnaiiitVsUHl  by  siiupius 
of  the  t;;rout  nl  iiw  h>|>  of  '^t-  \i?i'H»;.»jiJH.  .^  m  ih>'  biiMicl>iiil  uv«'*''h; 
'l/iir  fyUicfd  /nn/  l*  I'vi//  r».^i'  'if  i»  ^-t  iArm/i  (.f  U-Uns  hystrriouH).  vrt 
heart  j^wH?/!  via^flwth,  isjicJ  »l>'  i**J^««  «»Ki  <■"«*•»  tjv  iurnf>. 

\V>it«ic  ilw  i;U-«<-*^*  i«  v.'^r.  gciwrai,  <liO  miiK-lfs  of  Ihc  Juvjlw  ;;ire 
throxvu  inS»  Hpaums;  the  patio-it  btrug.iilfA  violtutly ;  t'lMm  up  i<i  a 
sitting  jxwtun".  and  ilvn  thm'.ving  h.;rHHir  JWik;  twiitiiig  th«!  ««  dy 
from  Viidft  Ui  sMde,  r;l«'iiciiing'  tl-;  ha-id-s,  and  chvowjuf.'  the  arm;-  nJxnr. 
«o  thai:  rlio  is  v/i;.h  d^llK!ulty  Iickl  by  iHn-;«>ui? -inu'  h  stTon^^'r  'h:ia  j'-^t 
wlf.  S<)«.ti  {iftx  r  th.i:^c  pan)xy:-inr,  the  patient  generally  p:^s«e^  -a  iarg«i% 
(luant'iy  ut'  vt^ry  pale  tumc.  ,  ^ 

# 

Tlif  CijsiNi'H  of  tiiif  ':'pmr.i]aint  are  ai^  n\im«'rous  fis  the  ciiujV":"  of 
li-nirtb  di5»^as*v,  for  iit  J-.tilli  ^acre  is  jk>  !>m;i.l»!  cnnjplaiut  which  nuv, 
not  produce  i(,  Whattiver  ri<*v«dop^  f^nd  oxcitcs  lh<  s^isuai  .<y^t.nin, 
ant' at  (hi- sanw  tjiiio  wenkfus'  th"  mnstitiraou,  lays  the  fouiulutiou 
of  this  m;dn<!y.  Nt-rvou^  Winr:t:ri  wni  rnuih  indirKd  to  li.  Iii  hrg* 
c'dics  there  is 'ijiort'.  o!  it  than  in  the  coni:!;ry,  bwauso  ilier.'  id  t>]<^ri' 
c:vcitv;rtn-nt  aiul  liixitry,  and  more  of  ihcir  couse.qa<:i)cfs,  —  jarvou- 
mid  feiuaK*  diveases. 

TstatiitK'Ui.  -  To  irv.iit  this  <x<mplaint  sun^^^s  fully  sit  is  nece3»aTy»w 
lytAKh  out  it«  cteuse,  and  remove  tlvit.  Uk^  the  whites,  it  io  not  M> 
•  . .    ■  -4  dJi'Pase^  in  Jtwlf,  as  a  symptom. 

.  :•  firiil   inquiry  "to  he  mldc  should  htivc  referrnce  to  the  re«d 

it  t:>f  the  (XM'n[)lat,'»t.     h  it  dep^-ndorit  npcui  iuiiairjmatJon  of  ftn' 

;)»  o,'  lhf»  vvoinb.  vr  io  dispiaficin^jiit  uf  thin  lart^-.r  orgrm  ;  or  ikw**- 

.  •:••*  from  tlie  low  ytaie  of  tbf  bioiKJ,  And  the  >veakfrj'>d  c<mditw>*^ 

!'.!}  nerves,  ftitcxi  upon  by  iome  irrii«?it>n  or  if-K i{|?ht4»ned  8<'nsibJhSj 

:fi   ilt>.c  &sbXvt;tl  organ.*. 

l!  dvjW'rdeju   ',i\K>n  inllainmatoi-y  di»tn»ej  that  is  to  1:>e  treaUd  n'•• 
l;;<■>rdin^  : "'  dirr^e»?(»m  elsewnere;  if  U]>Ott  ftUSkg  of  the  womb. 
w;>.m<-d*«-:      :       .-ii„uiitii  ihat.  i;-!  put  jo  il*  j>fa|>f"r  place.     If  'HhiU' 


.11 


ifying  tht      ' 

i 

MfAi    tl>£5        ! 

i; 

iljUMUlfl;'.         I 

ipl«-  jrrifa-     , 


I'd  hy  ci<- 

iiMf's.  I).  IS 

iiU  Uift^*:*: 
rioiw),  vKT 

iirubft  art;? 

fj  up  iii  a 

tlie  f.«  viy 

hi  eh  ittttv 

M'  !■  tut  ion 
lit  l:ii'g' 
id  mon* 
•    rvou" 


.jie  refd 
■  of  th\- 

aud  Ski* 
If  'Mhitt"! 


PL8 


Fig.  3. 


•«l^:-.^«»^^ 


.',  «if.^ 


iii 


V  . 


ii-.^; 


i  I .  I  ■ 


I 


1    • 

i 

mk 


blood  and  weakened  nervea  be  the  cause,  iron  and  quinine  are  the 
remedies.  When  the  complaint  arises  from  deficient  menstruation, 
iron  and  aloes  (47)  will  be  serviceable.  The  nervous  spasm  can 
sometimes  be  broken  up  by  pouring  cold  water  upon  the  head,  ot 
face,  or  limbs  of  the  patient. 

Tlie  Hyfienlc  and  Nortil  Treatment  are  of  great  consequence.  The 
complaint  is  very  much  under  the  control  of  the  will.  Whatever 
tones  the  moral  nature,  and  strengthens  the  will,  tends  to  subject  this 
disorder  to  the  control  of  the  patient.  Plain  wholesome  diet,  exercise, 
bathing,  and  the  enforcing,  as  far  as  possible,  of  a  rugged,  self*reliant 
habit,  generally  go  far  towards  breaking  its  force. 


Polypus  of  the  Womb. 

This  is  simply  a  foreign  body,  or  tumor,  growing  either  within  the 
womb,  or  in  the  vagina,  and  attached  to  the  uterine  neck.  It  is  rather 
a  serious  affection. 

These  tumors  vary  in  weight  from  half  an  ounce  and  less,  to  many 
pounds.  They  are,  in  color,  whitish,  re<',  brown,  and  even  black. 
They  have  almost  every  consistence,  —  being  soft,  spongy,  gristly, 
and  hard. 

The  Syni;)tonis  of  polypus  are  vr  ions,  lesembling  those  of  almost 
every  other  womb  complaint.  It  is  c.ften  mistaken  for  displacement 
of  the  womb,  for  dropsy  of  this  organ,  and  for  pregnancy. 

These  tumors  are  apt  to  give  rise  to  dangerous  bleeding  from  the 
womb,  and  other  discharges  which  greatly  weaken  and  derange  the 
system.  They  are  liable  to  terminate  in  cancer.  In  pregnancy,  they 
may  produce  miscarriage.  When  they  are  suspected,  therefore,  the 
utmost  scrutiny  should  be  employed  to  search  them  out.  This  is 
especially  desirable,  since  the  fallen  or  inverted  womb  may  carelessly 
be  taken  for  a  polypus,  and  be  operated  on  as  such. 

Treatment. —  This  is  of  two  kinds,  medical  and  surgical.  The 
first  consists  in  means  of  supporting  the  strength  of  the  patient,  and 
checking  the  discharges  by  means  of  injections,  rest,  etc.,  and  in  en- 
deavoring to  cause  the  removal  of  the  tumor  by  absorption. 

This  last  object  is  sometime  efTected  by  an  unstimulating  diet; 
and  by  the  use  of  iodine  (101)  for  some  time.  This  treatment  does 
not  often  succeed,  however,  and  cannot  be  relied  upon. 

If  the  polypus  be  within  the  womb,  of  courrtc  it  cannot  be  reached. 
The  only  thing  to  be  done,  in  such  case,  is  to  cause  its  expulsion. 
This  is  sometimes  eifected  by  causing  the  woinb  to  contract  by  the . 
use  of  spurred  rye  (267),  or  by  the  use  of  the  electro-magnetic 
machine.  Tins  latter  remedy  can  do  no  harm,  and  had  better  be 
tried  first. 

When  the  oolypus  is  outside  the  womb,  the  methods  of  removing 
it  are  various  It  is  sometimes  done  by  cauterization,  or  burning  it 
off  by  hot  iroi  or  caustic.  This  is  a  harsh  method,  and  not  resorted 
to  by  skilful  g  urgeons.    Another  method  is  that  of  crushing  the  tumor 


ill 


I'f  \ 


■<  w ' 


366 


FEMALE  DISEASES. 


with  an  instrument-  Another  still  is  that  of  torsion,  or  twisting  it 
off.  And  still  anothear,  that  of  applying  a  ligature,  or  tying  .a  string 
around  the  neck  of  the  tumor,  and  strangling  it  by  preventing  the 
blood  from  going  to  it.  By  this  means  it  falls  off  in  a  few  days. 
There  is  one  other  method,  that  of  cutting  the  tumor  away  with  a 
knife,  or  with  a  pair  of  curved  sci:,.iors.  These  three  last  methods 
are  the  chief  ones  now  used  by  skilful  surgeons. 

Case  I. —  Mrs.  J.  W.  H.,  from  one  of  the  cities  in  New  England, 
applied  for  treatment  for  an  affection  of  the  lungs,  from  which  she 
had  suffered  for  several  months.  She  was  thin  in  flesh,  feeble,  and 
pale  from  loss  of  blood ;  for  she  informed  me  that  her  courses  had 
been  upon  her  a  large  part  of  the  time  for  several  months.  1  tried 
the  usual  remedies  for  profuse  menstruation  (for  she  at  first  declined 
an  examination),  but  without  effect.  The  hemorrhage  was  unabated, 
and  she  rather  lost  ground.  I  again  proposed  an  examination,  and 
apprized  her  that  upon  it  hung  the  only  hope  of  my  being  able  to  do 
anything  for  her.     She  assented  without  further  hesitation. 

Upon  introducing  the  speculum,  a  pendulous  tumor,  hanging  from 
the  mouth  of  the  womb,  immediarely  dropped  into  it,  precisely  like 
that  in  Plate  VIII.,  Fig.  3.  I  immediately  put  a  ligature  around  its 
neck,  and  in  a  few  days  it  came  away.  Upon  being  apprized  of  this, 
I  applied  to  the  root  a  small  amount  of  acid  nitrate  of  mercury,  with 
a  camel's  hair  pencil,  and  immediately  after  pressed  upon  the  cauter- 
ized surface  a  small  velvet  sponge,  thoroughly  wet  with  soap  suds. 
By  this  last  application,  the  acid  was  decomposed,  and  prevented 
from  spreading.  The  bleeding  stopped  at  once.  Under  the  use  of 
iron,  and  a  thoroughly  rallying  treatment,  the  lady  began  to  come  up. 
The  affection  of  the  lungs,  no  longer  encouraged  by  the  drain  upon 
the  system,  gradually  yielded,  and  she  recovered. 

Case  II. —  An  unmarried  lady,  from  an  interior  town  in  another 
state,  sought  relief  for  a  throat  disease,  complicated  with  a  sUght 
affection  of  the  lungs.  As  my  custom  is,  I  inquired  respecting  her 
menses,  and  learned  that  her  "  turns,"  as  she  said,  came  upon  her 
every  tw6  weeks,  or  oftener,  —  indeed,  that  she  was  seldom  entirely 
free  from  some  flow.  Upon  making  an  examination,  —  to  which, 
like  a  sensible  woman,  she  assented  without  hesitation,  —  I  found 
about  the  mouth  of  the  womb,  as  in  Plate  VIIL,  Fig.  2,  several 
small  projecting  tumors,  looking  like  ripe,  red  currants.  With  the 
fcrceps,  1  took  hold  of  them,  and  in  a  few  moments,  without  pain  to 
the  patient,  I  twisted  them  all  off;  and  then  made  il.'i  same  apphca- 
tions  as  in  the  preceding  case.  The  bleeding  was  ended  at  once;  and 
the  patient  got  well,  not  only  of  the  hemorrhage,  but  of  the  throat  and 
lung  complaints. 

Uterine  Hydatids. 

This  name  is  given  to  a  bladder-like  substance,  occasionally  found 
growing  in  the  womb.     It  is  filled  with  a  white  or  yellowish  fluid. 


i 


Hi' 


FEMALE  DISEASES. 


36/ 


Sometimes  a  bundle  of  them  grow  together,  like  a  bunch  of  grapes. 
Some  are  elongated,  like  a  bean,  and  have  a  sort  of  claw,  by  which 
they  are  attached ;  others  are  shaped  like  an  egg. 

Those  with  a  claw  are  generally  supposed  to  be  living  beings,  like 
worms,  in  the  bowels.  When  expelled  from  the  womb,  they  move 
about  if  placed  in  warm  water. 

The  Causes  which  produce  these  singular  growths,  are  obscure. 
Probably  whatever  improperly  excites  or  irritates  the  uterine  organs 
may  produce  these  vesicular  bodies. 

The  Syiiiptonis  may  be  easily  mistaken  for  those  either  of  preg- 
nancy, or  of  water  or  inflammation  in  the  womb. 

From  the  growth  of  these  bodies,  the  bowels  may  enlarge,  the 
breasts  swell,  and  the  menses  stop.  If  to  these  symptoms  be  added 
sickness  at  the  stomach,  the  woman,  if  married,  feels  confident  she  is 
in  the  family  way.  There  is  no  certain  method  of  correcting  this 
mistake,  until  the  collection  of  bladder-like  bodies  is  expelled  from 
the  womb. 

It  is  rare  that  these  bodies  appear  in  the  virgin  woman.  They  are 
supposed  to  be  connected,  ir  some  way,  with  imperfect  conception. 

Treatment.  —  No  very  exact  directions  can  be  given  in  regard  to 
treatment,  because  we  can  seldom  say  absolutely  that  hydatids  exist, 
until  we  see  them  expelled.  Whatever  will  produce  contractions  of 
the  womb,  will  cause  their  expulsion  ;  but  it  will  not  do  to  give  these 
remedies  indiscreetly,  lest  the  caub^  be  one  of  real  pregnancy  instead 
of  hydatids. 

Inflammation  of  Womb. — Metritis. 


This  disease  very  often  follows  delivery,  and  is  connected  with 
child-bed  fever. 

Various  Causes  also  produce  it  in  the  unimpregnated  state.  The 
inflammations  of  the  ovaries,  or  of  the  uterine  neck,  may  extend  to 
the  womb.  Falling  of  the  womb  may  cause  it  to  be  irritated  by 
being  placed  in  a  new  position,  and  thus  bring  on  inflammation.  In 
some  temperaments,  marriage  may  produce  this  disease  ;  in  others, 
singleness.  It  may  also  be  brought  on  by  painful  menstruation,  by 
forcing  medicines,  by  constipation,  by  tight  corsets,  by  solitary  vices, 
and  by  excited  sexual  feelings. 

Symptoms.  —  When  the  membrane  lining  the  womb  is  involved  in 
the  inflammation,  the  symptotns  are  dull,  constant  pain  in  the  region 
of  th6  womb  and  in  the  loins.  The  passage  of  water  or  feces  causes 
pain.  There  is  a  sense  of  weight  which  causes  the  patient  to  bear 
down  and  strain,  as  in  labor.  The  belly  swells,  and  is  painful  and 
tender,  not  bearing  even  the  weight  of  the  clothes.  There  are  chills, 
fever,  and  sometimes  even  delirium. 

Treatment —  In  this,  the  aim  must  be  to  reduce  the  inflammatioa 


..'  I' 


■J  ^* 


' 


I  ^.? 


I 


368 


FEMALE  DISEASES. 


The  bowels  must  be  opened  with  some  saline  medicine  (18^,  perapi. 
ration  must  be  induced,  and  the  hands  and  feet  must  be  made  wami. 
A  large  meal  poultice  should  be  put  upon  the  belly,  and  leeches  or 
cups  on  the  inside  of  the  thighs.  The  patient  should  lie  upon  the 
back  with  her  knees  raised  so  as  to  keep  the  clothes  from  pressing  on 
her.  If  the  purgative  medicine  does  not  operate,  an  injection  (349) 
should  be  used. 

The  food  nmst  be  reduced  almost  to  entire  abstinence,  and  no  stim- 
ulants whatever  should  be  taken.  The  room  must  be  well  ventilated, 
and  kept  still. 

Falling^  of  the  Womb. — Prolapsus  Uteri. 

The  womb  is  often  found  out  of  its  natural  and  proper  place. 
There  are  certain  ligaments  and  muscles  intended  to  act  as  stays, 
and  hold  it  up  in  its  position.  These,  from  various  causes,  become 
rlaxed.  It  then,  losing  its  support,  drops  down  into  the  vagina,  be- 
tween the  bladder  in  front  and  the  large  bowel  called  rectum,  behind. 
It  is  then  said  to  he  fallen,  ox  prolapsed. 

The  womb  of  married  women  is  more  apt  to  become  prolapsed 
than  that  of  the  unmarried,  because  it  is  more  liable  to  have  its  weight 
increased  by  congestions. 

The  Symptoms  are  dull  pain  in  the  small  of  the  back,  a  dragging 
sensation  in  the  groin,  and  a  feeling  of  fulness  around  the  funda- 
ment. 

Treatment.  —  The  complaint  is  easily  cured  if  the  remedies  be 
applied  early.  If  the  falling  be  o«  asioned  by  a  relaxed  and  weak- 
ened condition  of  the  parts,  a  very  effectual  relief  may  sometimes  be 
derived  from  simple  injections  of  cold  water  into  the  front  passage, 
■  alternating  them  sometimes  by  an  infusion  of  white  oak  bark,  or  of 
nut  galls,  or  a  solution  of  tannin. 

If  the  womb  have  been  long  down,  these  simple  remedies  will  not 
be  sufficient  to  restore  it.     It  is  then  necessary  to  put  it  back  in  its 

1>lace,  and  employ  some  mechanical  means  to  keep  it  there,  until  the 
igaments  and  muscles  recover  their  strength  so  far  as  to  hold  it.    For 
this  purpose,  passaries,  of  various  styles  and  materials,  are  employed. 

Palling  Over  of  the  Womb. 

Anteversion.  —  The  womb  sometimes  falls  over  forward  upon  the 
bladder,  towards  the  pubes.  This  is  called  anteversion.  The  top  is 
turned  forward  to  the  bladder ;  the  mouth,  back  towards  the  large 
bowel.     (Fig.  137,  b.) 

Retroversion.  —  When  the  womb  falls  over  backward,  between  the 
rectum  and  the  vagina,  it  is  said  to  be  retroverted,  d.  This  is  just 
the  opposite  of  being  anteverted.  In  this  displacement,  the  mouth  is 
turned  forward,  the  top  backward. 

This  displacement  may  occur  suddenly  or  gradually.    If  the  former, 


•iiiii 


FEMALE  DISEASES. 


m9 


thexe  is  generally  great  distress,  and  the  organ  should  be  immediateljr 
put  back  in  its  place ;  if  the  latter,  the  pain  will  be  less  intense,  land 
the  replacement  must  be  efTected  by  pessaries,  —  particularly  with  the 
ring  pesi^ary,  made  from  India  rubber. 

tio.  137. 


Anteflexion  and  Retroflexion.  —  When  these  occur,  the  womb  is 
doubled  upon  itself,  the  mouth  of  the  organ  not  being  tilted  up  before 
or  behind,  but  retaining  its  natural  position.  These  flexions  are  rep- 
resented by  a,  c,  and  e. 

Beside  these  more  common  displacements  of  the  womb,  there  are 
several  slighter  deviations  which  it  is  scarcely  necessary  to  describe. 
There  is  the  obliquity  of  the  womb,  which  is  simply  a  leaning  of  the 
organ  backward  or  forward,  or  to  one  side. 

There  are  still  other  more  serious  troubles,  which  are  so  very  rare 
as  not  to  require  me  to  dwell  upon  them,  such  as  the  inversion  of 
the  womb,  or  turning  it  wrong  side  out,  like  the  finger  of  a  glove ; 
and  the  hernia  of  the  womb  (hysterocele),  which  is  like  that  of  the 
bowel.  '  .    • 

Inflammation  of  the  Vagina. 

This  may  be  produced  by  many  of  the  same  causes  which  induce 
inflammation  of  the  uterine  nock.  It  may  follow  tedious  child-bear- 
ing,—  especially  if  instruments  have  been  ustvl.  Marriage  is  not 
an  infrequent  cause  of  it,  —  so  may  a  pessary  be,  if  an  improper 
one. 

Tlie  Symptoms  are  pain  in  the  groins,  a  feeling  of  heat  and  tight- 
ness in  the  passage,  and  a  difliculty  in  passing  water.  In  a  few  days 
a  discharge,  like  gum  water,  begins  to  flow,  v/hich  gradually  becomes 
thicker,  like  cream,  and  is  green  or  yellow.  Sometimes  the  disease 
gets  well  in  a  few  days;  at  other  times,  it  degenerates  into  the  chronic 
torrasi  and  lasts  a  long  time.     It  should  be  cured  as  soon  as  possible, 

47 


ri-      i 


^1 


I- 


r  \ 


.b> 


n^ 


370 


FEMALE  DISEASES. 


lest  the  inflammation  cause  the  walk  of  the  passage  t-o  grow  together, 
and  make  a  stricture,  as  in  Fig.  138. 

In  this  Figure,  b,  represents  the  mouth  fio.  iss. 

of  the  womb  ;  a,  is  the  lower  entrance  to  a 
narrow  passage  in  the  vagina,  called  a 
stricture.  It  is  caused  by  inflammation, 
which  so  thickens  the  walls  of  the  vagina 
as  to  bring  their  inner  surfaces  near  to- 
gether. In  examining  a  case  of  this  sort, 
a  practitioner  needs  to  be  on  his  guard  lest 
he  mistake  the  entrance  to  the  stricture,  a, 
for  the  mouth  of  the  womb,  b,  —  a  mistake 
which  might  lead  to  evil  consequences  as 
well  as  seriously  damage  his  professional 
character. 

Treatment — The  diet  should  be  light 
and  unirritating.  The  bowels  should  be 
kept  open.  A  cooling  wash  (207)  (218) 
should  be  used  several  times  a  day,  until 
the  discharge  becomes  thick, — then  employ 
injections  (232)  (202)  (244)  (243)  of  a  more 
astringent  nature.  Let  the  marriage  bed 
be  abandoned  till  the  recovery  is  complete. 

When  the  discharge  arises  from  small 
granular  elevations  upon  the  inner  surface 
of  the  vagina,  the  whole  diseased  surface 
should  be  painted  over  with  a  solution  of 
nitrate  of  silver,  twenty  grains  to  the  ounce 
of  water,  —  the  disease  being  brought  to 
view  by  the  use  of  a  speculum.  This  may 
be  done  every  other  day. 


Itching  of  the  External  Parts. — Prurigo  of  the  Vulva. 

This  complaint  is  apt  to  attack  females  abojit  the  cessation  of  the 
menses,  though  they  are  liable  to  it  at  other  jjeriods.  It  is  a  most 
annoying  and  distressing  aftection.  So  terrible  and  tormenting  at 
times,  is  the  itching  of  the  external  genitals,  that  the  woman  is  una- 
ble to  avoid  rubbing  and  scratching,  and  she  is  occasionally  compelled 
to  absent  herself  from  all  society.  She  feels,  as  she  says,  as  though 
she  should  tear  herself  to  pieces. 

Sometimes  this  irritation  of  the  sexual  organs  excites  venereal 
thoughts  so  dominant  and  controlling  as  to  constitute  a  real  mania, 
called  nympho-mania,  from  the  name  of  a  part  involved. 

This  complaint  generally  indicates  some  disease  of  the  womb,  or 
its  appendages,  or  of  the  bladder.  When  this  is  the  case,  of  course 
it  cannot  be  cured  without  seeking  out  and  removing  the  disease,  of 
which  it  is  a  symptom. 


gether, 


Vulva. 

>n  of  the 
a  most 

inting  at 
is  una- 

)i:npelled 
though 

venereal 
1  mania, 

iromb,  or 
if  course 
Isease,  of 


Treatment.  —  To  alleviate  the  local  Buffering,  the  lotion  (223),  or 
the  ointment  (171),  may  be  applied  to  the  parts  several  times  a  day. 
I  prefer  the  lotion.  A  weak  solution  of  nitrate  of  silver  (211)  will 
sometimes  do  well. 

When  the  disease  is  brought  on  by  masturbation,  as  it  sometimes  is, 
this  habit  must  of  course  be  broken  off  before  a  cure  can  be  effected. 
In  this  case,  also,  cold  water  must  be  applied  to  the  parts  several 
times  a  day ;  some  of  the  preparations  of  iron  should  be  taken,  and 
some  active  employment  be  engaged  in,  which  shall  absorb  the  ener- 
gies of  mind  and  body. 

Sterility  or  Barrenness. 

It  has  doubtless  occurred  to  every  person  who  nas  thought  upon 
the  subject,  that  there  must  be  some  special  reasons  why  so  many 
women  do  not  and  cannot  bear  children.  These  reasons  I  propose 
now  to  explain  as  simply  and  as  plainly  as  the  nature  of  the  subject 
admits.  To  this  explanation,  I  shall  add  some  remarks  upon  treat- 
ment ;  for,  in  nine  cases  out  of  ten,  barrenness  is  completely  curable. 

Reproduction.  —  Throughout  nature,  life  is  perpetuated  by  repro- 
duction. Tlie  vegetable  and  the  animal  die ;  but  before  death  comes, 
they  reproduce  the  g-erm  of  a  new  thing  or  being,  which  lives  after 
them.  The  law  of  reproduction,  throughout  the  realm  of  nature,  is 
one,  and  but  one.  All  living  things  have  male  and  female  structures. 
Every  new  being  is  evolved  from  an  egg,  the  product  of  an  antece- 
dent parent. 

Reproduction  consists  in  the  growth  of  an  egg  or  germ  in  connec- 
tion with  some  living  part,  until  it  is  capable  of  independent  exist- 
ence. This  germ  or  egg  is  the  product  of  the  female  parent,  and  will 
abort  or  perish  unless  brought  in  connection  with  a  fructifying  fluid 
from  the  male.  Thus,  two  palm  trees,  growing  about  forty  miles 
from  each  other,  the  one  without  stamens  (the  male  organs),  the  other 
without  pistils  (the  female  organs),  bore  no  seed  for  many  years;  but 
when  they  had  risen  in  height  above  all  intervening  and  obstructing 
objects,  the  winds  bore  the  pollen  from  the  stamens  of  one  to  the 
pistillate  *  flowers  of  the  other,  which  immediately  began  to  produce 
fruit.  A  knowledge  of  this  great  law,  as  applicable  to  all  living 
things,  enables  horticulturists  to  raise  such  varieties  of  fruit  as  they 
wish,  Ijy  shaking  the  blooming  male  branch,  which  has  stamens,  over 
the  female  flowers,  supplied  with  pistils.  Sometimes  the  male  and 
female  flowers  are  upon  the  same  plant, — at  other  times,  upon  differ- 
ent ones.  The  strawberry  is  of  the  latter  kind,  —  the  pollen  being 
found  only  on  the  plants  which  have  the  largest  flowers,  —  the  pistil- 
lated  flowers  being  only  on  the  smaller  plants.  The  pollen,  or  dust, 
is  carried  from  the  male  to  the  female  plant  on  the  feet  of  honey-bees, 
as  they  fly  from  flower  to  flower.  It  has  been  recently  discovered 
that  the  reason  why  many  beds  are  unfruitful  (strawberry  beds,  I 
mean)  is  that  the  large  male  plants  are  allowed  to  monopolize  the 
beds  to  the  exclusion  of  the  smaller  female  plants.    The  plants  with 


MiiiJi 


liii 


\[     ' 


3-^ 


FEMALE  DISEASES. 


laise  flowers  should  be  thinned  out,  leaving  only  a  few  to  furnish 
pollen  for  the  females,  which  are  the  real  bearers. 

A  New  Branch  of  Industry. —  It  is  only  quite  recently  that* this 
law  has  been  understood  in  its  wide  applicability.  How  wise  and 
nu;rciful  an  arrangement  of  Providence  that  an  unseen  hand  should 
turn  for  man  the  mystic  leaves  of  knowledge  at  the  very  time  when 
he  is  most  in  need  of  the  instruction  imparted !  At  this  very  moment^ 
the  more  complete  knowledge  of  this  great  law  is  opening  a  new 
branch  of  industry  and  a  new  suppiy  of  food,  and  is  thus  helping  the 
solution  of  the  great  problem  of  how  the  increasing  inhabitants  of 
civilized  countries  are  to  be  worked  and  fed.  I  refer  to  the  propaga- 
tion and  culture  of  fish. 

A  committee  appointed  by  the  legislature  of  Massachusetts,  in  1855, 
reported  very  ably  upon  this  subject.  It  appears  that  the  eggs  of  the 
fish  may  be  fecundated  almost  as  easily  as  the  pistillate  flowers  of  the 
plant.  It  is  only  necessary,  when  the  eggs  of  the  female  are  mature, 
to  hold  her  over  a  basin  of  water,  and  make  gentle  pressure  upon  the 
belJy,  when  the  eggs  will  pass  freely  into  the  water ;  then  to  pass  the 
milt  of  the  male  into  the  same  water,  and  shake  them  thoroughly 
together.  By  this  means,  the  eggs  are  impregnated,  and  fish  may  be 
raised  to  any  extent. 

The  egg  of  the  higher  animals  is  inore  difficult  to  fecundate,  and 
that  of  the  human  female,  most  difficult  of  all ;  for  in  nature  as  in  art, 
the  more  perfect  structures  are  begun  and  reared  with  less  ease. 

Propriety  of  Imparting  this  Knowledge.  —  Men  are  naturally  curi- 
ous, and  love  to  understand  the  mystery  of  their  own  origin  ;  and  yet 
there  is  scarcely  any  subject  upon  which  they  have  so  little  reliabl* 
information.  It  has  been  held  that  this  is  a  kind  of  information 
which  it  is  not  proper  to  impart  to  the  multitude ;  that  the  curiosity 
which  seeks  this  knowledge  is  based  upon  improper  feelings ;  and 
that  to  gratify  it  by  imparting  what  is  sought,  would  lead  to  immor- 
ality. 

I  do  not  believe  it.     Such  ideas  are  based  upon  a  shallow  philoso- 

f)hy.  They  overlook  the  fact  that  nothing  excites  the  imagination 
Ike  that  which  is  covered  with  mystery.  It  is  because  the  immensely 
important  subject  of  the  procreation  of  the  race  is  so  carefully  hidden 
from  the  public  eye  ;  because  it  is  purposely  buried  so  deep  in  obscu- 
rity, that  any  allusion  to  it, excites  improper  thoughts.  If  the  subject 
be  properly  viewed,  it  is  no  more  indelicate  to  explain  the  mode  of 
reproducing  a  human  being,  than  to  explain  that  of  propagating  a 
plant  or  a  lish.  Both  are  effected  in  the  same  way,  under  precisely 
the  same  natural  law. 

True,  the  propagation  of  the  human  being  involves  moral  laws 
likewise  ;  but  these  relate  only  to  the  social  relations  in  which  it  may 
take  place,  and  do  not  affect  in  any  way  the  propriety  of  making  u 
Understood  by  the  people. 

•The  Germ  Famished  only  at  Certain  Periods.  —  These  general  re- 
Qiatrks  bring  me  to  the  immediate  subject  in  hand.      Throughout 


ii'lilll 


•ill;:': 

!    III!!! 


I  few  to  furnish 

icently  that 'this 

How  wise  and 

en  hand  should 

very  time  when 

lis  very  moment^ 

opening  a  ne\r 

thus  helping  the 

y  inhabitants  of 

'  to  the  propaga- 

;husetts,  in  1855, 
;  the  eggs  of  the 
te  flowers  of  the 
lale  are  mature, 
ressure  upon  the 
then  to  pass  the 
hem  thoroughly 
and  fish  may  be 

3  fecundate,  and 
nature  as  in  art, 
I  less  ease. 

^  naturally  curi- 
origin  ;  and  yet 
90  little  reliable 

of  information 
at  the  curiosity 
feelings ;  and 

ead  to  immor- 


r 


shallow  philoso- 
le  imagination 

the  immensely 
arefully  hidden 

deep  in  obscu- 

If  the  subject 

n  the  mode  of 

propagating  a 
under  precisely 

'es  moral  laws 
II  which  it  may 
,y  of  making  in 

ese  general  re- 
Throughout 


FEMALE  DISEASES. 


8T>J 


riQ.iaa. 


animated  nature,  the  female  furnishes  the  mature  germ  or  egg^  only 
at  certain  periods.     The  healthy  human  female,  —  as  I  have  already 

explained,  —  matures  a  g^rm 
once  in  four  weeks.  The.se 
germs  or  eggs  are  constantly 
advancing,  in  succession,  from 
the  rudest  beginning,  to  a  state 
of  ripeness,  or  maturity.  Every 
person  must  have  seen  the  eggs 
taken  from  the  hen  when  killed 
in  the  laying  season.  Fig.  139 
furnishes  a  good  illustration. 
They  are  in  all  stages  of  pro- 
gress, from  the  invisible  germ, 
up  to  the  nearly  mature  egg. 

Such  is  the  progress  of  the 
human  egg,  —  only  that  it  does 
not  attain  to  any  such  size. 
So  far  as  the  maturing  is  con- 
cerned, it  occurs  in  the  same 
gradual  way. 

CcMiceptioii  or  Impreg;nntioii  can  take  place  only  when  a  germ  or 
egg  is  ripe ;  and  as  an  egg  ripens,  bursts,  and  passes  into  the  fallopian 
tubes  leading  to  the  womb,  only  at  the  time  of  menstruation,  it  is 
plain  that  conception  must  happen  somewhere  in  the  neighborhood 
of  this  period.  Intercourse  with  the  male  may  take  place  at  interme- 
diate times ;  but,  except  in  some  rare  instances,  conception  will  not 
occur,  because  there  is  no  mature  egg  to  be  impregnated. 

Now,  as  every  healthy  woman  T)rings  to  maturity  a  germ  or  egg  at 
the  time  of  every  monthly  flow,  and  as  every  ripened  egg  is  capable, 
under  favorable  circumstances,  of  being  fecundated,  it  follows  that 
every  woman  who  menstruates,  and  is  well,  can,  under  certain  cir- 
cumstances, be  impregnated.  To  eflect  it,  it  is  only  necessary  that 
the  vivifying  portion  of  the  male  semen,  called  spermatozoa,  come 
into  union  with  the  ripened  egg. 

This  union  (for,  that  men  and  women  may 
have  a  chance  to  know  as  much  about  them- 
selves as  they  do  about  fishes  and  plants,  I 
propose  to  make  the  whole  subject  plain)  takes 
place  in  the  following  way.  In  the  act  of 
copulation,  the  male  organ  penetrates  the  va- 
gina, and  deposits  the  sperm,  spermatic  fluid, 
semen,  or,  as  the  scriptures  call  it,  the  "  seed," 
directly  at  the  mouth  of  the  uterine  neck. 
Some  suppose  that  when  the  sensation  of  the 
female  is  at  its  height,  the  womb  opens  to 
receive  the  injected  semen.     But  this  is  uncertain. 

This  spermatic  fluid  is  composed,  in  a  large  part,  of  mucus.  A 
smaller  portion  of  it  is  secreted  by  the  testicles,  and  is  the  true  semen,  | 


Fig.  140. 


III' 

■il 


'fr 


'I  > 


t 


;>1 
ft-*' 


IV' 


.^: 


'ii 


IS 


374 


FEMALE  DISEASES. 


or  life-giving  principle.  This  last  portion  is  composed,  almost  en- 
tirely, of  fertilizing  filaments  or  vesicles,  which  look  like  small  ani- 
mals (Fig.  140),  and  for  a  long  time,  were  supposed  to  be  animalcules. 
They  are  generally  called  spermatozoa.  By  some  mysterious  law  of  , 
their  nature,  they  are  endowed  with  the  power  of  motion  ;  and  when 
deposited  near  the  mouth  of  the  womb,  they  immediately  begin  to 
move,  as  if  by  instinct,  in  search  of  Km  ui 

a  ripened  egg.  Passing  through  the 
uterine  neck,  they  enter  the  womb, 
and  thence  glide  onward  into  the  right 
and  left  fallopian  tubes,  and  through 
these  to  the  ovaries.  If  an  egg  be 
found,  in  its  ripened  condition,  either 
in  the  womb,  or  the  tubes,  or  about 
leaving  the  ovarian  bundle,  they  im- 
mediately embrace  it,  and,  in  some 
mysterious  way,  mingling  their  own 
fluid  contents  with  the  contents  of  the 
egg,  they  impregnate  or  fertilize  it 
Fig.  141  shows  the  womb  divided 
lengthwise.  A,  is  the  internal  nunUh 
(os  internum),  or  point  where  the 
canal  through  the  uterine  neck  enters 
the  body  of  the  womb ;  B,  is  the  ex- 
temal  mouth  (  os  externum) ;  the  space 
between  A  and  B,  the  passage  through 
the  neck ;  and  C,  C,  the  points  where 
the  fallopian  tubes  begin.  By  looking 
back  now,  and  examining  Fig.  134, 
the  whole  thing  wHl  be  understood.  * 

This  is  a  very  brief  and  simple  account  of  impregnation.  It  ia 
supposed  to  be  capable  of  taking  place  either  a  little  before  or  a  little 
after  the  monthly  flow,  and  not  at  int«rtnediat«  times,  for  the  reason 
already  stated.  There  are  some  reasoiio  for  believing  that  the  same 
egg  or  germ,  if  fertilized  just  before  the  courses,  will  grow  to  be  a 
male,  while,  if  fecundated  after  the  turns,  it  will  be  a  female.  One 
reason  for  this  supposition  is,  that  plants  may  be  made  to  bear  male 
or  female  flowers  by  simply  subjecting  them  to  different  degrees  of 
heat.  If  there  be  more  heat  than  light,  male  flowers  are  produced ; 
If  more  light  than  heat,  female  flowers  are  the  result.  The  heat  of 
the  female  generative  organs  is  raised  to  its  highest  degree  about  the 
time  the  egg  bursts  its  covering,  which  is  just  before  the  beginning  of 
the  flow. 

It  has  been  thought  that  the  right  ovary  produces  males,  and  the 
left  ovary  females ;  but  this  theory  is  not  supported  by  any  facts,  and 
is  probably  not  true. 

Causes  of  .  terility.  —  From  what  has  been  said,  it  would  appear 
that  to  ensure  childbearing,  it  is  only  necessary  that  semen  or  seed, 
containing  spernoatozoa,  come  in  contact  with  a  germ  vesicle  or  egg, 


^^^■-r-^^^ 

\ 

r^ >^ 

-    |p  1^    3 

^^^^   yi     .^^- 

i 

~      "~  ^I/^                  y 

L         .       -        .?K                       / 

V          1  / 

\ 1  -            / 

\       i 

7 

\ — fl 

—  fl 

k—  j[b— -^ 

FEMALE  DISEASES. 


375 


at  the  right  time ;  that  there  be  no  hindering  disease ;  and  that  the 
parties  cohabiting  be  adapted  to  each  other. 

It  is  evident  enough  that  a  want  of  adaptation  between  the  parties, 
physical  or  moral,  or  both,  is  often  an  absolute  bar  to  conception. 
A  lack  of  moral  adaptation  was  probably  the  obstacle  in  the  case  of 
Napolnon  and  Josephine,  —  her  marriage  with  a  previous  husband, 
and  his  with  a  subsequent  wife  having  both  been  fruitful. 

It  is  certain  that  indifference  on  the  part  of  the  wife  towards  the 
husband,  and  especially  repugnauoe,  may.  prove  an  obstacle.  A  mere 
lack  of  sexuiil  feeling  does  not  necessarily  prove  a  bar,  though  it 
probably  lessens  the  chances  of  a  fruitful  union. 

Conception  may  fail  to  take  place  from  the  diminutiveness  of  the 
male  organ,  —  the  semen  not  being  deposited  in  the  right  place;  or, 
from  its  excessive  largeness,  —  penetration  of  the  vagina  bring  impos- 
sible. In  some  rare  cases,  the  womb  is  absent.  The  inflammation 
of  the  ovaries  often  prevents  the  ripening  of  eggs.  The  fallopian 
tubes  occasionally  get  diseased  and  plugged  up,  so  that  no  egg  can 
pass  to  the  womb.  Inflammation  in  the  cavity  of  the  uterine  neck 
is  probably  the  most  frequent  of  all  the  causes  of  sterility.  The 
viscid,  gluey  matter  which  is  secreted  in  inflammatory  conditions  of 
this  part,  plugs  up  the  passage,  so  that  no  spermatozoa  can  pass  up 
in  search  of  the  egg.  The  acrid  discharges  in  most  of  the  cases  of 
whites  destroy  the  fertilizing  spermatozoa,  and  render  conception  im- 
possible. All  the, displacements  of  the  womb  may  act  as  bars  to 
impregnation.  If  it  fall  over  backward  or  forward,  the  mouth  is 
tilted  up  before,  or  down  behind,  and  is  not  in  the  right  position  to 
receive  the  semen 


es,  and  the 


Treatment.  —  Judicious  treatment  will,  in  most  cases,  remore  ster- 
ility, and  open  that  "well-spring  of  pleasure,"  which  the  poet  has  so 
felicitously  described  as  —  "a  baby  in  the  house." 

The  obstacles  to  conception,  stated  above,  are  chiefly  those  diseases 
which  had  been  previously  described.  To  cure  those  diseases,  is  to 
remove  the  obstacles.  When  it  is  dependent  on  the  causes  which 
produce  painful  menstruation,  or  profuse  menstruation,  or  a  suppres- 
sion of  menstruation,  the  remedies  are  the  same  as  are  pointed  out 
for  those  complaints.  If  inflammation  of  the  ovaries  be  the  cause,  a 
cure  may  be  effected,  provided  the  inflamed  condition  be  removed 
before  the  bundle  of  eggs  be  destroyed.  If  inflammation  or  ulcera- 
tion of  the  neck  of  the  womb  be  the  obstacle,  the  remedy  may  be 
found  in  the  treatment  recommended  for  those  affections. 

Sterility  depending  on  the  causes  just  mentioned,  I  have  had  the 
pleasure  of  curing  many  times.  When  dependent  on  a  lack  of  phys- 
ical or  moral  adaptation  between  the  parties,  it  does  not,  of  course, 
admit  of  relief.  It  is  a  misfortune  to  be  borne  in  silence.  It  has 
happened,  perhaps,  through  a  lack  of  judgment  or  care  in  selecting 
a  partner,  and  is  one  of  the  mistakes  of  a  lifetime  which  a  lifetime 
cannot  repair.  When  this  want  of  adaptation  is  not  complete,  a  rem- 
edy may  frequently  be  found. 

Unfortunately,  many  females  do  not  regard  sterility  as  an  evil  to 


f;!iiii 


i\ 


376 


FEMALE  DISEASES. 


be  deplored,  but  rather  as  a  blessing  to  be  Uesired.  Life,  to  them, 
has  no  high  aims  or  duties,  —  it  is  a  round  of  fashion  and  pleasure. 
To  bear  and  rear  children  interrupts  their  frivolities,  and  they  seek  to 
escape  such  abridgment  of  their  pleasures.  This  is  wrong.  Life  is 
a  great  theatre,  in  which  all  should  strive  to  act  some  worthy  part, 
and  feel  that,  upon  retiring,  it  would  be  wrong  to  leave  their  garments 
upon  the  vacant  stage,  with  none  to  put  them  on,  and  continue  the 
drama. 

Case.  —  In  1854,  a  lady,  twenty-five  years  of  age,  was  brought  to 
me  by  her  husband,  in  the  hope  that  some  relief  might  be  obtained 
for  some  female  complaints,  from  which  she  had  suffered  for  a  num- 
ber of  years,  and  which  threatened  to  make  a  wreck  of  her  health,  if 
not  to  destroy  her  life. 

Having  come  with  the  full  purpose  of  having  the  case  properly  in- 
vestigated, both  herself  and  husband  readily  assented  to  an  examina- 
tion, which  revealed  a  highly  inflamed  and  swollen  condition  of  the 
neck  of  the  womb,  with  a  small  ulcerated  patch  immediately  around, 
and  extending  some  half  inch  within  the  cavity.  She  had  for  a  long 
time  suffered  severe  pain  at  her  ntonthly  turns,  with  great  and  dis- 
tressing bearing  down  both  before  and  after  her  menstrual  flow ;  her 
back  was  weak  and  painful,  making  it  impossible  to  walk  out  of 
duors,  or  to  stand  much  upon  her  feet.  She  had  become  nervous 
and  much  debilitated,  and  had  pains  at  times  in  her  chest,  her  liver, 
her  head,  and  limbs ;  was  distressed  by  all  sorts  of  disturbances  of 
the  stomach ;  and  had  become,  as  she  said,  about  as  thoroughly  un- 
fitted for  all  the  useful  purposes  for  which  human  beings  are  made, 
as  she  well  could  be. 

She  had  been  married  five  years ;  but,  as  might  be  expected  from 
the  condition  of  the  uterine  neck,  she  had  no  children. 

Introducing  a  glass  speculum,  I  took  a  caustic  holder,  with  a  piece 
of  stick  nitrate  of  silver  in  it,  and  touched  the  whole  surface  of  the 
ulcer  in  the  mouth  of  the  womb  as  far  as  it  could  be  reached.  I  di- 
rected her  to  take  one  to  two  teaspoonful  doses  of  the  tincture  of 
scuUcap  every  night,  to  quiet  the  nerves  and  promote  sleep,  and  re- 
quested her  to  come  to  me  again  in  a  week. 

At  the  next  visit  I  reached  the  upper  part  of  the  ulcer  in  the  uterine 
neck  with  a  delicate  silver  syringe,  and  threw  a  fine  shower  of  a 
strong  solution  of  nitrate  of  silver  upon  all  sides  of  the  ulcer,  and 
prescribed,  in  addition  to  the  scuUcap,  pills  of  iron,  etc.  (75),  to  be 
taken  three  times  a  day. 

I  directed  her  to  see  me  once  a  week,  which  she  did  for  four 
months.  The  improvement,  after  the  second  week,  was  gradual  and 
steady,  —  so  much  so,  that  little  variation  was  required  in  the  treat- 
ment. At  the  end  of  four  months,  the  inflammation  and  ulceration 
had  both  disappeared ;  her  pains  and  aches  had  all  silently  with- 
drawn ;  she  could  walk,  ride,  and  stand  upon  her  feet ;  and,  in  brief, 
she  has  since,  to  the  delight  of  herself  and  husband,  borne  two  chil- 
dren, and  enjoyed  tolerably  good  health. 


I' I. 


'M' 


Midwifery. 

A  STOPPAGE  of  her  courses  is  most  commonly  the  first  notice  a 
woman  has  of  her  being  in  the  family  way.  This  is  perceived  two 
or  three  weeks  after  conception,  when  she  begins  to  experience  other 
feelings  peculiar  to  the  situation.  These  feelings  are  nausea  and  vam- 
t/tng',  or  a  decided  languor,  in  the  morning;  swelled  and  sometimes 
painful  breasts ;  the  areoloB,  or  colored  rings  around  the  nipples  darker 
than  usual ;  pain  in  the  lower  part  of  the  back ;  and,  occasionally,  a 
good  deal  of  spitting  of  a  frothy,  cotton-like  substance. 

These  symptoms  are  more  or  less  severe  in  difterent  cases,  and 
under  different  circumstances,  according  to  the  state  of  the  patient's 
bowels,  and  her  habits  of  exercise.  Ordinarily,  she  suffers  most 
during  the  second  and  third  months,  on  account  of  the 

Sinkiuf  Down  of  the  Womb,  which,  from  soon  after  the  period  of 
conception,  is  gradually  increasing  in  size  and  weight  As  it  grows 
larger  and  heavier,  it  sinks  lower  in  the  cavity  of  the  pelvis,  until 
about  the  fourth  month,  when,  becoming  so  large  that  it  cannot  longer 
be  accommodated  within  the  narrow  limits  of  this  unyielding  box  of 
bones,  it  is  obliged  to  mount  higher  to  find  room  in  the  ampler  and 
more  distensible  belly.  This  low  position  of  the  womb  in  the  early 
months  of  pregnancy,  occasions  many  disagreeable  sensations,  —  as 
pain  in  the  lower  part  of  the  back,  and  sickness  at  the  stomach. 

The  Costiveness,  too,  from  which  women  suffer  so  much  at  this 
time,  is  often  caused,  in  part  at  least,  by  the  pressure  of  the  enlarged 
womb  upon  the  lower  bowel.  Costiveness,  thus  induced,  at  length 
becomes  itself  a  cause  of  serious  mischief.  The  lower  bowel,  filled 
and  enlarged  with  its  hardened  contents,  reacts  upon  the  womb, 
crowding  it  still  lower  in  its  narrow  quarters,  and  greatly  increasing 
its  excitability.  The  enlarged  bowel  and  womb  combined,  make 
constant  pressure,  sometimes  upon  the  urethra,  or  water-pipe,  causing 
pain  and  difficulty  in  making  water,  and  alioays  upon  the  ascending 
veins,  checking  the  return  of  blood,  and  producing  congestion  in  the 
lower  bowel,  manifested  by  troublesome  piles. 

Treatment  of  Pregnancy.  —  When  the  pregnant  woman  first  recog- 
nizes her  situation,  she  should  determine  to  "observe  moderation  in 
all  things."  Let  her  avoid  violent  and  sudden  exertion,  and  move 
about  more  calmly  and  evenly  than  usual.  By  this  is  not  meant  that 
she  should  give  up  her  customary  occupation  ;  but  that  she  should 
pursue  it  with  becoming  carefulness,  resolved  in  no  case  to  hazard 
over-exertion,  and  rather  leaning  to  the  side  of  indolence.  This 
would  not  be  real  indolence,  for  sh  i  is  doing  a  great  work  internally, 
and  should  not  unduly  withdraw  her  energies  to  external  affairs. 

Let  her  not  be  too  much  in  the  erect  position.  If  of  delicate 
constitution,  and  not  in  vigorous  health,  she  should  make  it  a  point 
to  lie  down  several  times  during  the  day.  The  standing  position, 
continued  for  a  long  time,  especially  if  it  be  under  circumstances 


'A 

ijiii. 

'I 

1 

=r^' 


li;:-;! 


il'M"! 


I  n 


IP' 


-•/: 


i&j  .■  ■  I 


J 


V   I 


378 


FEMALE  DISEASES. 


to  induce  fatigue,  greatly  favors  the  descent  of  the  womb,  —  while 
a  frequent  rest  in  a  horizontal  position,  may  enable  it  to  keep  its 
place. 

An  Objection.  —  It  may  be  objected  by  some,  that  a  large  majority 
of  the  mothers  in  the  world  are  working  women,  and  obliged  to  con- 
tribute by  their  industry  to  the  support  of  their  families;  and  that 
they  cannot  atlbrd,  therefore,  to  lie  still,  and  mind  directions. 

To  this  it  may  be  answered,  that  it  is  a  great  advantage  to  under- 
stand the  best  way,  so  as  to  have  the  privilege  of  at  least  aiming  at 
it.  Much  is  accomplished,  in  all  circumstances,  by  aiming  at  doing 
the  best  thing ;  and  few  womtMi  are  so  situated  that  they  could  not 
go  favor  themselves  as  to  obt!y  the  laws  of  health  a  little  more  per- 
fectly, if  they  thoroughly  understood  them.  All  can  better  aflbrd  to 
avoid  sickness,  than  to  be  sick;  Many  occupations,  also,  unless 
money  tempt  to  excessive  application,  become,  when  steadily  fol- 
lowed, comparatively  easy  and  unexciting.  Thus,  most  people  can 
go  through  their  usual  round  of  duties,  because  they  have  got  used 
to  it.  Indeed,  there  is  nothing  but  indolence  itself,  to  which  we  may 
not  become  accustomed.  The  difference  between  the  laboring  and 
the  privileged  classes  is  more  imaginary  than  real.  All  must  work. 
None  can  escape  the  primeval  decree  — "  In  the  sweat  of  thy  face 
shalt  thou  eat  bread." 

Many  women,  when  they  find  themselves  in  the  family  way,  will 
observe  no  cautions,  but  work  all  the  harder,  and  even  use  other 
means  for  the  purpose  of  bringing  on  abortion,  and  preventing  an 
increase  of  children.  This  unnatural  and  wicked,  but  too  prevalent, 
disposition,  results  sometimes  from  a  fear  of  the  pains  of  child-birth, 
sometimes  from  a  desire  to  avoid  the  necessary  care  and  confinement 
connected  with  raising  children,  but  mOst  often  from  a  wish  to  escape 
the  expenses  which  the  prevailing  fashions  and  customs  of  society 
connect  with  a  large  family.  The  cost  of  a  shattered  nervous  sys- 
tem, rnd  of  a  body  weakened  and  poisoned  by  powerful  drugs,  is  not 
considered,  because  not  understood !  Hence  the  success  of  those 
quack  advertisements,  impudently  professing  to  cure  female  diseases, 
but  whose  chief  object  is  disclosed  by  the  insertion  of  the  hypocritical 
caution  —  "  Be  careful  nc^  to  take  this  medicine  during  pregnancy,  as 
U  will  be  sure  to  produce  au*  jrtion.'" 

It  seems  as  if  the  world  would  never  learn  that  God  loves  children^ 
although  since  Abrrxhari's  day  he  has  said  so  much  about  them  in 
his  word,  —  although  His  Son,  sent  into  the  world  on  purpose  to 
show  the  disposition  of  the  Father,  took  them  up  in  his  arms,  and 
blessed  them,  —  and  although  He  has  implanted  a  most  wonderful 
love  of  them  in  the  soul  of  man. 

Costiveness  and  Piles.  —  Let  the  pregnant  woman  use  all  proper 
means  to  keep  her  bowels  in  order.  She  will  thus  greatly  diminish 
the  distressing  nausea,  and  may  entirely  prevent  the  accession  of 
piles.  To  accomplish  this  object,  the  saline  aperients  (7)  (5),  or,  oc- 
casionally, other  mild  cathartics  (10)  (12)  (14),  may  be  used.  But 
more  important  than  either  or  all  of  these  is  the  frequent  use  of  a 


mm 


FEMALE  DISEASES. 


37» 


3,  —  while 

0  keep  ita 

B  majority 

;d  to  con- 

and  that 

to  under- 
aiming  at 
;  at  doing 
could  not 
more  per- 
■  aHbrd  to 
.so,  unless 
eadily  fol- 
)uo|)le  cati 
s  got  used 
ih  we  may 
oring  and 
lust  work, 
f  thy  face 

way,  will 

use  other 

renting  an 

prevalent, 

child-birth, 

>nfinement 

1  to  escape 
of  society 
rvous  sys- 
ugs,  is  not 
»  of  those 
}  diseases, 
ypocritical 
gnancy,  as 

s  children. 
it  them  in 
)urpose  to 
arms,  and 
wonderful 


all  proper 
Y  diminish 
cession  of 
(5),  or,  oc- 
ised.  But 
t  use  of  a 


good  self-injecting  family  syringe.  An  injection  of  half  a  pint  of 
cold  water  every  morning,  will  do  much  towards  regulating  the 
bowels,  and  preventing  or  curing  piles. 

NaiLSea.  —  If,  as  sometimes  hnppens,  there  should  be  persistent 
nausea  after  the  first  three  niontlis,  it  will  need  to  be  coinbutted 
by  mild  tonics  -and  stimulants,  as  chiiruoniile  tea,  or  clove  tea  (58) 
(ll4),  and  by  seeking  a  kind  of  dlr-t  wlii(!lj  will  be  agreeable  both 
to  the  palate  and  the  stomach.  Dr.  Mtigs  speaks  of  champagne 
as  a  remedy,  and  mentions  some  serious  cases  entirely  relieved 
by  it. 

The  ^'ipplc.H.  —  During  the  last  month,  particular  attention  nhould 
be  paid  to  the  nipples.  Untold  misery  often  results  to  the  young 
mother  from  sore  nipples ;  and  it  is  well  worth  her  while  to  une  every 
precaution  against  them.  The  nipples  are  of  course  in  an  excitable 
state  during  the  whole  period  of  gestation,  and  at  length  frequently 
become  irritable  and  tender.  Let  them  be  daily  bathed,  for  three  or 
four  weeks  be''ore  confinement,  with  some  astringent  and  cooling 
lotion,  as  oak-bark  decoction,  borax  water,  alum  water,  or  a  solution 
of  tannin  (200)  (201)  (202)  (203). 

The  object  of  treatment,  in  this  case,  is  to  toughen  them,  and  ren- 
der th'  .n  less  susceptible,  so  that  they  may  not  be  made  tender  by  the 
subsequent  application  of  the  child's  lips. 

•  When  a  woman  is  peculiarly  liable  to  this  trouble,  the  further  pre- 
caution of  having  them  gently  drawn,  by  some  friend,  every  day, 
during  this  last  month,  would  be  of  great  service. 

At  all  events,  let  no  pains  be  spared  to  guard  against  this  evil ;  for 
sore  nipples  make  sore  breasts;  and  sore  breasts  make  broken  breasts; 
and  broken  breasts  are  terrible  things.  They  make  the  mother  sick; 
and  if  the  mother  is  sick,  the  child  is  sure  to  be  sick ;  and  all  hands 
soon  get  sick  and  worried ;  and  the  whole  business  of  having  children, 
and  taking  care  of  them,  is  deprived  of  its  peculiar  joys  and  consola- 
tions, and  brought  into  undeserved  disrepute.  Whereas,  under  wise 
and  prudent  management,  there  is  something  delightful  to  the  young 
mother  in  yielding  sustenance  to  her  dependent  ofispring.  For,  when 
her  nipples  and  breasts  are  in  a  healthy  state,  she  can  say  with  the 
poet,  as 

"  The  starting  beverage  meets  its  thirsty  lip, 
'T  is  joy  to  yield  it,  as  't  is  joy  to  sip." 

Swathing. —  In  advanced  pregnancy,  much  assistance  in  supporting^ 
the  burden  is  sometimes  derived  from  swathing  the  bowels.     Healthy 
and  vigorous  women,  however,  need  no  such  assistance  ;  it  is  chiefly 
applicable  to  cases  of  debility,  either  constitutional,  or  resulting,  from 
neglect,  or  from  over-exertion  during  former  pregnancies. 

Cramp  in  the  Stomach  is  sometimes  very  severe,  and  if  allowed  to 
continue,  may  kill  the  child.  The  best  remedies  are  warm  carmina- 
tives (114)  (115),  or  anodynes,  etc  (121)  (122),  or  antispxumodies 
(90)  (94). 


•>  J 


i 


,i% 


til 


.:ii. 


4 


lit 


380 


FEMALE  DISEASES. 


Headaches.  —  These  may  be  relieved  b^i  antispasmodics,  etc.  (90) 
(94),  or  anodynes  (121  )• 

Palpitation  of  the  Heart  may  prove  very  distressing  to  delicate 
women.  The  remedies  are  the  antispasmodics,  with  rest.  Some- 
times tonics  are  useful,  such  as  the  muriated  tincture  of  iron  (73). 
The  bowels  should  be  carefully  regulated. 

Fainting,  which  occurs  before  or  at  the  time  of  quickening,  is  some- 
times very  troublesome.  The  proper  treatment  is  ti»a  avoidance  of 
fatigue,  and,  during  the  fainting  fit,  the  recumbent  posture,  cool  air, 
application  of  cold  water  to  the  face,  and  ammonia  to  the  nose. 

Cough  is  sometimes  present.  It  is  caused  by  the  upward  pressure 
of  the  diaphragm  against  the  lungs,  by  which  they  are  irritated  and 
convulsed.  The  remedies  may  be  selected  from  the  cough  prepara- 
tions among  the  prescriptions. 

Varicose  Veins. —  These  cannot  be  removed  during  pregnancy;  but 
they  may  be  relieved  by  great  care  of  the  bowels,  and  by  wearing 
tight  bcmdages,  or  elastic  stockings. 

Swelling  of  Lower  Limbs  is  caused  by  pressure  of  the  enlarged 
womb  upon  the  veins ;  and  may  be  relieved  by  care  of  the  bowels, 
and  diuretics  (130). 

Itching  of  the  Genitals  may  be  much  relieved  by  borax,  morphine^ 
etc.  (204). 

Miscarriage.— Abortion. 

When  a  woman  in  the  family  wav  throws  off  the  contents  of  hei 
womb,  or  loses  her  child,  during  the  first  six  months,  the  accident  is  a 
miscarriage,  or  abortion  ;  when  the  same  thing  happens  during  the 
last  thv: :;  months  of  her  term,  it  is  a  premature  labor. 

Symptoms.  —  If  abortion  occur  during  the  first  month  after  concep- 
tion, the  symptoms  may  not  attract  much  attention,  or,  may  be  re- 
garded only  as  an  irregularity  of  menstruation.  Occuring  at  later 
periods,  it  is  frequently  indicated  by  some  feverishness,  coldness  of 
the  feet  and  legs,  a  puned-np  condition  of  the  eye-lids  with  purplish 
discolorations,  shooting  pains  in  the  breasts,  which  become  soft,  pains 
in  the  back,  bearing-down  pains  in  the  lower  part  of  the  bowels, 
which  come  and  go,  and  at  length  take  the  character  of  real  labor 
pains.  As  these  pains  increase,  blood  begins  to  appear,  and,  sooner 
or  later,  the  bag  of  water  breaks,  and  the  fetus  is  thrown  off. 

Causes.  —  These  are  very  numerous.  Some  of  the  principal  are, 
displacement  of  the  womb  ;  ulceration  of  its  neck  ;  syphilitic  disease 
of  the  fetus  received  from  the  parent ;  too  much  exercise  ;  heavy  lift- 
ing ;  falls,  particularly  when  the  woman  comes  do  vn  upon  the  feet, 
and  ib  heavily  jarred ;  emetics;  powerful  purges;  and  too  much  nup* 
tial  indulgence. 


SJ^ 


Treatment  —  Where  the  symptoms  are  but  slight,  nothing  may  be 
required  more  than  a  little  caution  for  a  fev  days,  and  rest  in  the 
horizontal  posture,  using  cold  drinks,  and  taking  for  two  or  three 
nights,  at  bedtime,  perhaps,  a  pill  composed  of  oii?  g'ain  of  opium 
and  two  grains  of  sugar  of  lead.  Beside  these  remedies,  it  may  be 
well  to  put  a  nmstard  poultice  low  down  upon  the  b.tck. 

If,  notv/ithstanding,  flooding  comes  on,  and  the  symptoms  of  mis- 
carriage increase,  a  napkin  wetted  with  cold  water,  or  vinegar  and 
water,  or  a  bladder  partly  filled  with  ice,  should  be  laid  upon  the  ex- 
ternal genitals,  and  pulvt;rized  alum,  mixed  up  with  a  little  honey, 
must  be  given  internally,  every  half  hour ;  and  if  the  flooding  still 
increase,  it  may  be  proper  in  some  cases  to  resort  to  the  tampon  or 
plug.  To  do  this,  take  either  lint,  or  old  pieces'  of  calico,  or  a  piece 
of  hne  spoiige,  and  having  soaked  it  full  of  a  strong  solution  of  alum, 
or  tannin,  or,  sdll  better,  Monsel's  persalt  of  iron,  one  part  to  six 
parts  of  w^ater,  —  tiU  the  vagina  full,  and  then  place  a  fold  of  linen  in 
the  genital  fissure,  and  apply  a  bandage.  This  will  generally  stop  the 
flow ;  but  the  plug  must  be  removed  in  from  five  to  ten  hours. 

If  the  abortion  cannot  be  prevented,  —  especially  in  the  latter 
months  of  gestation,  then  the  case  is  to  be  permitted  to  go  on,  and  to 
be  treated  the  same  as  a  natural  labor 


Labor.— Delivery. 

The  expulsion,  at  full  term,  of  the  child,  the  after-birth,  the  mem- 
branes, and  the  fluids,  constitutes  labor,  or  delivery.  It  is  supposed 
to  occur  about  two  hundred  and  eighty  days  after  the  last  menstrua- 
tion ;  but  authors  reckon  it  diffe'cntly;  in  truth,  it  is  not  possible  to 
fix  it  exactly,  for  it  evidently  varies  in  difl'erent  cases. 

When  the  time  of  her  lying-ia  arrives,  let  every  woman  meet  it 
with  calmness  and  undoubting  confidence.  There  is  every  reason  to 
encourage  this  state  of  mind.  Think  of  the  vast  multitudes  of  people 
in  the  world.  Each  one  once  existed  in  the  womb  of  a  mother,  and 
had  to  pass  through  its  narrow  portals  to  be  admitted  to  the  light. 
Successful  delivery  is  the  rule,  the  world  over ;  and  it  should  be  the 
rule  to  confidently  expect  it. 

In  the  midst  of  thej)ains  of  labor,  nothing  does  more  to  bring  a 
favorable  result  than  courage  and  patience.  Patience  is  able  calmly 
to  survey  all  the  difliculties  before  iier,  becau:^e  she  never  attempts  to 
encounter  but  f^ue  at  a  time.  There  is  much  philosophy  in  the  story 
of  the  '■^  di^'jutcrUcd  JH  ndiilum^''  which  got  discourai^od,  one  morning 
from  re'lccting  how  many  millions  ol  t'lues  it  would  have  to  swing 
duririg  succeeding  yeai-s,  but  became  reassured  upon  considering  that 
a  single  stroke  cost  but  a  very  trilling  effort,  and  that  it  really  had  to 
make  but  one  at  a  time.  So  it  is  with  labor;  its  pains,  which  are 
really  severe  and  agonizing,  will  beCvMne  comparatively  tolerable,  if 
the  whole  attention  of  the  woman  be  confined  to  present  suflering, 
and  her  vv  hole  stock  of  courage  and  patience  be  brought  to  bear  U[/on 
one  panff  at  a  time. 

Let  her  resist  the  temptation  to  a  feeling  of  haste.     Nature  will 


n  '  '  i 


If 

Tit-" 


.  I 


m 


382 


F.'.MALE  DISEASES. 


^_rAt'\,  lA 


piL»i;cuu  more  evenly,  and  more  ?ipeedily,  if  allowed  to  take  her 
own  time.  A  hurry  to  get  through  is  a  great  obstacle  to  successful 
delivery ;  it  always  puts  things  back.  .    . 

Symptoms. —  Omh  of  the  first  indications  that  labor  is  about  to 
begin  is,  that  the  woman  finds  herself  smaller-  —  the  child  having 
sunk  down  lower  in  the  abdomen,  and  she  accordingly  breathes 
easier.  The  genital  organs  become  relaxed  and  moist,  and  mucus 
escapes,  whirh  is  called  "  the  shows."  The  woman  finds  herf^elf  dis- 
posed to  be  nervous  and  fidgety,  and  perhaps  a  little  depressed  in 
spirits. 

"When  labor  has  fully  set  in,  it  is  marked  by  lowness  of  spirits, 
flashes  of  heat  and  cold,  a  great  desire  to  empty  the  bowels  and  to 
make  water,  and  grinding,  cutting  pains,  which  grow  stronger  and 
more  continuous,  with  intervals  of  ten  or  fifteen  minuves'  ease  be- 
tween. Vomiting  in  the  early  stages  of  labor  often  occur^;,  and  may 
be  regarded  as  favorable,  —  indicating  the  softening  and  opening  of. 
the  mouth  of  the  womb. 

Treatment  of  Labor.  —  When  labor  begins,  the  attention  shtnld  be 
directed  to  the  state  of  the  bowels  and  bladder.  Th-  vhu  head 
begins  early  to  press  upon  the  bladder  and  lower  bowe.^  jun  i.ig  the 
desire  to  make  water,  etc. ;  and  these  should  be  immediately  emptied 
to  make  room  for  the  head  to  pass  more  easily.  The  bowel  may  be 
freed  by  a  dose  of  castor  oil  (10),  if  there  is  time  for  it  to  operate,  — 
but  more  sun.'ly,  and  more  satisfactorily,  by  an  injection.  lielief  in 
the  bladder  may,  perhaps,  be  obtained  by  a  different  position  of  the 
woman  in  the  act  of  making  water.  It  is  the  pressure  of  the  child's 
head  upon  the  water-j)ipe  which  causes  the  t.ouble ;  and  to  relieve  it, 
the  v.'^oman  should  get  upon  her  hands  and  knees,  with  her  shoulders 
lower  than  the  iiips,  so  as  to  throw  the  child  upward  and  forward 
towards  the  cavity  of  the  abdomen.  Thus  situated,  she  may  often 
find  it  easy  to  make  water,  when  in  the  ordinary  position  it  would  be 
impossible.  If,  however,  this  manoeuvre  does  not  succeed,  and  the 
bladder  becomes  greatly  diste.ided,  the  catlieter  must  be  used. 

'riie  Bed  ami  lliibilimeuts. —  In  the  next  place,  fix  the  bed,  f.L 
the  patient's  habiUments.  Reject  feather  beds;  use  th*^  matl,:  s- 
Cover  this  with  a  rubber  cloth,  if  convenient,  and  then  with  lolu  H 
sheets  to  absorb  the  discharges,  and  protect  the  bed.  Let  the  woman 
be  arrayed  in  the  same  garments  she  expects  to  wear  after  the  com- 
pletion of  the  labor,  and  let  these  be  well  tucked  up  under  her  arms, 
and  let  the  lower  portion  of  her  body,  from  the  waist  downwards, 
be  enveloped  in  a  sheet.  This  sheet  can  be  easily  removed,  and  the 
clean  clothes  pulled  down  without  greatly  disturbing  the  patient  when 
in  the  exhausted  state  which  follows  labor,  and  when  it  would  subject 
her  to  great  fatigue  to  be  obliged  to  sit  up  in  bed  to  have  her  clothes 
changed.  Let  her  lie  up<.»n  her  left  side,  with  her  body  shorten:^  ^  V/ 
bending  forward,  so  that  the  muscles  may  be  relaxed;  let  her  h«  li'I  ?>» 

J)laced  in  the  middle  of  the  bed,  and  her  feet  press  against  the  f   '  t 
bot-post.     Around  tbis  post  a  shawl  or  towel  may  be  fastened,  upoa 
which  she  may  be  allowed  to  pull  during  the  pains. 


It 
h 


ake  her 
ccessful 

bout  to 
having 
areathes 
,  mucus 
self  dis- 
etsscd  in 

f  spirits, 
I  and  to 
iger  and 
ease  be- 
ind  may 
ening  of 

bonld  be 

'\    head 

:  liig  the 

emptied 

1  may  be 

jerate.  -- 

llelief  in 

)n  of  the 

le  child's 

relieve  it, 

houlders 

forward 

lay  often 

ATould  be 

and  the 

bed,  ?'■  I. 
mati/i   S' 
th  loiti  ^-^ 
li  woman 
the  com- 
her  arms, 
^vnwards, 
,  and  the 
ent  when 
d  subject 
r  clothes 
teiio^  V/ 
r  hiiil  ■'' 
the  r      > 
led,  upoa 


i 


The  Presentation. —  An  examination  with  the  finger  is  to  be  made 
to  learn  the  presentation,  —  that  is,  to  learn  which  part  of  the  child 
comes  first  into  the  mouth  of  the  womb. 

Head  Presentation.  —  If  the  head  present,  the  labor  will  probably 
go  on  without  the  need  of  medical  aid.  But  \n  all  labors  there  is  a 
liability  to  dangers  from  unforeseen  accidents,  which  renders  the  at- 
tendance of  an  intelligent  physician  highly  prudential. 

Breecli  or  Feet  Presentation.  —  If  the  feet  or  breech  present,  it  is 
desiiable  to  have  the  first  part  of  the  labor  proceed  slowly,  so  that 
the  passage  may  become  well  dilated,  and  prepared  for  a  more  rapid 
delivery  of  the  head.  If  the  breech  present,  do  not  pull  down  the 
feet ;  let  the  child  come  double :  it  will  make  more  room  for  the  head. 
If  the  feet  present,  let  there  be  no  pulling  upon  them  to  hasten  the 
birth  of  the  breech. 

After  the  feet  and  breech  have  fully  cleared  the  external  orifice, 
the  delivery  may  be  judiciwu.^'ij  hastened  for  the  purpose  of  prevent- 
ing the  death  of  the  child  from  pressure  on  the  umbilical  cord,  before 
its  head  is  brought  to  the  air,  and  the  act  of  breathing  thus  permitted. 
For  after  the  pulsations  of  the  cord  cease,  the  child  must  either 
breathe  or  die. 

In  this  kind  of  presentation,  therefore,  the  child's  life  is  in  great 
danger.  After  the  birth  of  the  lower  half  of  the  body,  the  cord  ex- 
perience's sei'ere  pressure,  sufficient  to  interrupt  if  not  wholly  prevent 
its  pulsations.  It  then  becomes  necessary  to  hasten  the  birth  of  the 
upper  extremities  and  head  by  all  prudent  means.  Violence  is  never 
in  order  in  midwifery;  but  considerable  for'.e,  skilfully  directed,  may 
sometimes  be  safely  used.  After  the  shoulders  are  delivered,  the  pas- 
sage of  the  head  may  be  facilitated  by  carefully  pulling  down  the 
arms.  Then,  as  soon  as  possible,  introduce  the  finger  into  the  mouth 
of  the  child.  This  will  serve  ^he  double  purpose,  perhaps,  of  per- 
mitting a  little  air  to  make  its  way  into  the  child's  lungs,  and  of  fur- 
nishing a  hold  by  which  its  head  may  be  gently  drawn  along  into  the 
world. 

If  there  is  iimch  deliy  at  this  juncture,  perhaps  in  some  cases  the 
child's  life  may  be  preserved  by  inserting  into  its  mouth  one  end  of  a 
male  'jatheter,  —  thus  furnishing  an  open  tube  for  the  pas^:age  of  air, 
until  more  vigorous  pains  shall  introduce  it  into  the  full  liberty  of  the 
atmosphere.  While  the  head  is  yet  undelivered,  great  care  should  be 
usee  to  ke  ~  the  child's  body  warm  by  covering  it  with  flannel,  and 
also  to  kt  )  i'  in  a  correct  relativ3  position  with  the  head.  If  the 
body  be  inca.  o.ously  tu.u°d  round,  ^f  course  the  neck  will  be  twisted; 
and  the  child' r'  subsequent  d"llvoiy  with  a  broken  neck  will  be  the 
miserable  result,  —  bringing  confusion  to  the  medical  attendant,  &nd 
unhappiness  to  all  concerned. 

Arm  or  Shoulder  Presentation.  —  If  the  arm  or  shoulder  present, 
the  child  will  probably  have  to  be  turned.  In  case  this  cannot  be 
effected,  its  chest  must  be  opened  and  emptied  of  its  contents,  that 
there  may  be  room  to  bring  down  the  head.  It  is  barely  possible  to 
avoid  a  resort  to  art  in  this  presentation. 


384 


FEMALE  DISEASES. 


Floodinjif  or  Hemorrhage,  occurring  to  an  alarming  extent,  is  hiip- 
pily  one  of  the  rare  incidents  or  consequences  of  labor.  But  when  it 
does  occur,  it  demands  the  most  serious  and  prompt  attention. 

Profuse  bleeding  from  the  womb  is  most  commonly  owing  to  a 
partial  separation  o(  the  placenta,  or  after-birth,  from  its  attachment 
to  the  internal  cavity ;  and  it  has  recently  been  observed  that  the  flow 
proceeds  more  rapidly  from  the  detached  portion  of  the  after-birth 
than  from  the  corresponding  exposed  surface  of  the  womb.  A  knowl- 
edge of  this  fact  has  an  important  practical  bearing;  for  if,  in  severe 
cases  of  Hooding,  the  partial'y  detached  after-birth  can  be  entirely 
separated,  the  bleeding  will  often  be  speedily  arrested. 

The  most  dangerous  floodings  occur  in  cases  of  placenta  previa, 
when  the  after-birth  is  over  the  mouth  of  the  womb.  In  such  cases, 
when  the  labor  commences,  and  the  womb  begins  to  open  itself,  the 
after-birth  must  of  course  be  partially  separated.  These  cases,  unless 
p:  n  ptly  relieved  by  art,  may  prove  fatal  iv  a  few  minutes.  Yet, 
tht   t  rdinarily  sufficient  time,  if  it  .be  impicved,  calmly  to  choose 

and  J  .e  the  proper  treatment.  If  the  flooding  be  immediately 
dangerc.j  to  life,  the  child  must  be  turned  and  delivered,  or  the 
tampon  or  plvg"  b3  applied,  as  directed  under  the  head  of  abortion. 
This  expedient  is  used  when,  through  rigidity  of  the  mouth  of  the 
womb,  the  delivery  is  inadmissible. 

Before  Delivery. —  In  all  cases  of  flooding,  we  prescribe  quiet,  the 
recumbent  posture,  cold  applications  to  the  abdomen  and  the  external 
genitals,  and  the  internal  administratioi;  of  astringents  and  anodynes 
(152). 

After  Delivery,  our  object  is  to  promote  contraction  of  the  womb 
by  cold  applications  and  frictions  externally,  or,  if  necessary,  by  the 
introduction  of  the  hand  into  the  womb,  for  the  purpose  of  removing 
the  after-birth,  clearing  out  clots,  or  stimulating  it  to  shut  itself  up  for 
the  expulsion  of  the  offending  substance.  Until  this  contraction  is 
secured,  the  plug  should  not  be  used,  lest  internal  bleeding  into  the 
enlarged  and  expanded  womb  should  be  profuse,  and  fatally  exhaust 
the  patient. 

After  the  Child  is  Bom,  our  first  duty  is,  if  possible,  to  see  that  it 
breathes.  In  the  vast  majority  of  cases,  the  well-known  cry,  whicli 
salutes  the  ear,  gives  proof  that  the  duty  is  unnecessary.  But  some- 
times we  fail  to  hear  this  welcome  sound.  The  umbilical  cord  may 
be  once  or  repeatedly  wound  around  the  child's  neck,  and  must  be 
immediately  removed  to  prevent  strangulation  ;  or,  the  child's  moutli 
may  be  filled  with  phlegm,  or  some  sticky  mucus,  which  must  be 
poked  out  with  the  finger,  and  its  exit  favored  by  turning  the  face 
downward ;  or,  after  tedious  labors,  the  child  may  be  born  in  a  very 
feeble  state,  and  may  need  the  stimulus  of  cold  water  thrown  sud- 
denly, in  small  quantities,  upon  its  chest  and.  body,  with  considerable 
rubbing,  and  perhaps  the  inflation  of  its  lungs  with  air  blown  into  .'ts 
mouth. 

Tyini;  the  Cord. — When  breathing  is  established,  a  piece  of  narrow 


FEMALE  DISEASES. 


385 


«  of  narrovf 


tape  or  eommon  twine  is  to  be  tied  tight  around  the  navel-string, 
about  two  inches  from  the  child's  navel,  and  the  cord  is  then  to  be 
cut  off,  with  a  pair  of  sharp  scissors,  from  half  to  three  quarters  of 
an  inch  outside  the  place  wiiere  it  is  tied.  The  child  is  then  to  be 
delivered  to  the  nurse. 

Wai»hiiiff  the  Child.  —  The  child  is  now,  while  the  physician  is  at- 
tending to  the  mother,  to  be  washed  and  dressed  by  the  nurse.  Its 
skin  is  at  this  time  covered  with  a  suet-like  substance,  called  the 
vernix  caseosa.  To  remove  this,  it  should  be  washed  all  over  gently 
with  warm  water  and  castile  soap.  It  is  not  material  that  this  coat- 
ing should  be  absolutely  all  "emoved  at  the  first  washing ;  but  the 
soap  and  water  should  be  again  gently  applied  in  eight  or  ten  hours 
from  their  first  use.  It  is  improper  to  use  spirits  fo*  this  cleansing. 
All  rougl'  jbbing  must  be  avoided  as  injurious  to  the  delicate  skin 
of  so  tender  an  infant.  Washing  with  cold  water  would  lower  the 
temperature  to  a  dangerous  degree,  and  should  in  no  case  be  allowed. 

Removal  of  the  After-Birth.  —  The  woman  having  rested  fifteen  or 
twenty  minutes,  a  little  gentle  soliciting  or  pulling  with  the  cord  will 
generally  bring  away  the  after-birth.  If,  however,  any  serious  obsta- 
cle prevent  its  expulsion,  it  may  be  slowly  and  cautiously  taken  away 
by  the  hand  introduced. 

€leansiii(^  the  Ited,  and  Applying  tlie  Swathe.  —  Upon  the  removal 
of  the  after-birth,  a  cloth  is  immediately  applied  to  the  external  or- 
gans, a  Hrink  of  water  or  tea  is  administered,  and  another  rest  of  an 
hour  or  uore  allowed.  The  woman  may  then  be  conveyed  to  a 
neighboring  bed,  sofa,  or  easy-chair,  for  the  purpose  of  cleansing  the 
bed,  adjusting  her  clothes,  and  applying  the  swathe.  This  last  men- 
tioned application  may  consist  o*"  a  towel  pinned  snugly  around  the 
body,  or  of  a  cloth,  cut  and  fitted  exactly  for  the  purpose.  Its  object 
is  to  afford  a  firm  and  steady  support  to  the  contracting  womb. 

If  a  chair  is  occupied  while  the  bed  is  being  arranged,  it  L,iiould  be 
well  tipped  back,  and  the  woman's  feet  supported  on  a  high  stool,  as 
it  is  of  great  importance,  so  soon  after  delivery,  to  keep  her  either 
entirely  or  very  nearly  in  the  recumbent  posture,  to  avoid  dangerous 
fioodings. 

The  Dressing  for  the  Child's  ^avel  should  be  so  fixed  that  the 
njivel-string  or  cord  will  not  be  left  in  contact  with  the  healthy  skin. 
To  effect  this,  make  a  hole  large  enough  to  admit  the  cord  in  the 
centre  of  a  piece  of  linen  cloth  four  inches  square;  pull  the  cord 
through  this  hole,  leaving  the  cloth  lying  flat  upon  the  child's  belly ; 
then,  having  bandaged  the  cord  down  to  the  belly,  fold  the  cloth  over 
it,  and  apply  the  belly-band.  The  interposition  of  these  dressings 
will  thus  keep  the  cord,  which  is  dead  and  in  process  of  decomposition, 
from  irritating,  and  perhaps  excoriating  the  living  flesh,  with  which  it 
must  otherwise  be  in  close  contact. 

Nourishment  of  the  Child,  etc.  —  After  being  dressed,  the  child 
should  be  kept  next  the  body  of  the  mother  or  nurse,  that  it  may 

49 


1 


pi 

I 


receive  the  natural  warmth  thus  to  be  derived.  Its  nourishment 
should  be  obtained  exclusively  from  the  mother's  breast.  If  it  is 
hungry,  be  sure  and  keep  it  so.  There  is  nothing  more  appropriate 
than  a  hungry  child  all  ready  to  take  hold  and  exhaust  the  full  and 
almost  bursting  breast  on  the  third  day,  when  the  milk  has  come. 
Alas !  How  many  children  have  been  fed  on  sweetened  water,  and 
on  milk  and  water,  till  they  have  lost  all  instinctive  idea  of,  and  all 
appetite  for,  nursing!  and  how  many  bowel  complaints  and  broken 
breasts  have  been  the  miserable  consequence!  But  meddlesome 
friends  are  afraid  the  "little  dears"  will  starve;  and  therefore  they 
must  first  be  made  sick  by  unnatural  diet,  and  then  for  their  cure  be 
treated  to  that  filthy,  harsh,  and  indecent  substitute  for  medicine, 
"  chamber-lye  and  molasses.'" 

But  it  may  be  asked,  "  must  not  the  ohild  be  fed  at  all,  if  it  is  hun- 
gry, and  cries  a  great  deal,  and  there  is  nothing  in  the  mother's  breast 
for  it?"  Such  cases  will  be  exceedingly  rare,  if  t lie  breasts  have 
been  properly  solicited  from  the  first  by  a  hungry  child.  When  they 
do  occur,  being  themselves  exceptions,  their  treatment  mr.,^t  be  ex- 
ceptional ;  but,  even  then,  only  so  far  as  is  absolutely  necessary.  If 
fed  at  all,  the  child  should  not  be  fed  to  satiety,  but  as  little  as  the 
circumstances  will  possibly  permit.  The  great  rule  remains:  keep  the 
child  as  hungry  as  possible  till  the  milk  comes.  "When  it  has  to  be 
fed,  imitate  the  mother's  milk  as  nearly  as  possible  in  the  preparation 
of  the  artificial  diet.  A  little  sweet  cream,  warm  water  and  sugar, 
should  be  so  mingled,  that  in  warmth,  richness,  and  s'veetness,  the 
mixture  may  closely  resemble  human  milk. 

Diet  of  the  IWuther.  —  For  the  first  few  days  after  confinement,  the 
most  appropriate  diet  for  the  mother, is  gruel,  cocoa,  rice-water,  crust 
coffee,  oi"  some  similar  liquid  nourishment.  DifTerent  constitutions, 
however,  need  somewhat  different  management. 

A  woman  naturally  robust,  and  of  full  habit,  should  confine  herself 
more  strictly,  and  for  a  longer  time,  to  this  light  diet,  than  one  who 
is  more  slender  and  feeble.  In  some  cases,  weakly  women  require 
the  juice  of  meat,  and  even  wine  or  ale,  as  early  as  the  second  or  third 
day.  If  she  be  subject  to  canker,  or  nursing-sore  mouth,  a  generous 
diet  is  particularly  serviceable.  After  the  first  week,  she  may  gradu- 
ally return  to  her  customary  diet. 

Costiveness  may  be  treated  with  the  usual  remedies.  It  was  an 
old  rule  to  give  a  dose  of  castor  oil  on  the  third  day,  when  there  is  a 
little  increase  of  excitement  in  the  system,  from  the  filling  of  the 
breasts.  This  is  not  always  necessary,  and  in  most  cases  an  injection 
would  be  far  better. 

The  Perpendicular  Position. — During  the  first  month,  let  the  woman 
avoid  being  often  or  long  on  her  feet.  This  is  a  very  essential  caution 
to  avoid  prolapsus,  or  falling  of  the  womb,  with  all  its  attendant  weak- 
nesses and  pains,  and  to  ensure  a  good  "  getting  up,"  with  a  sound 
womb,  in  the  right  place,  and  subsequent  months  of  health  and  enjoy- 
ment. 


ishment 
If  it  is 
ropriate 

full  and 
iS  covne. 
iter,  and 
,  and  all 
I  broken 
Idlesome 
ore  they 
r  cure  be 
nedicine, 

it  is  hun- 
r's  breast 
ists  have 
hen  they 
„^t  be  ex- 
ssary.  H 
tie  as  the 
:  keep  the 
,  has  to  be 
reparation 
md  sugar, 
etness,  the 

iment,  the 
ater,  crust 
listitutions, 


ne  herself 
111  one  who 
Ion  ri-quirc 
lid  or  third 
generous 

lay  gradu- 

It,  was  an 

there  is  a 

Ting  of  the 

In  injection 

the  woman 
lial  caution 
Idant  weak- 
\th  a  sound 
land  enjoy- 


FEMALE  DISEASES. 


387 


Milk  Leg. — Phlegmasia  Dolens.  —  Cniral  Phlebitis. 

The  popular  idea  is,  that  in  this  disease  the  woman's  milk  has  fallen 
into  her  leg,  which  has  inflamed.  This  is  of  courHc  absurd.  As  to 
the  real  nature  of  the  complaint,  there  are  various  opinions,  —  some 
holding  it  to  consist  in  inflammation  along  the  sciatic,  crural,  and 
pubic  nerves;  others,  that  it  is  an  inflammation  of  the  lymphatics  of 
the  groin  which  causes  it ;  others,  that  it  is  an  inflammation  of  the 
crural  veins.     Probably  this  latter  view  is  the  correct  oix*. 

SyniptoniS. —  The  disease  beg-ns  in  from  two  to  seven  weeks  after 
delivery,  with  pain  in  the  lower  bowel,  groin,  or  thigh.  The  pain  is 
more  violent  when  the  thigh  is  extended.  T>i  a  day  or  two,  the  pain 
diminishes,  and  the  limb  begins  to  swell,  frequently  in  the  calf  of  the  leg 
first,  thence  extending  upward,  but  generally  in  the  groin,  and  extend- 
ing gradually  down.  The  skin  becomes  entirely  white,  smooth,  and 
glossy,  does  not  pit  when  pressed,  is  painful  to  the  touch,  and  is  hotter 
than  the  skin  upon  the  other  limb.  In  connection  with  this  local 
disease,  there  is  general  fever,  with  small  and  rapid  pulse,  thirst,  etc. 

Treatiiieiif. —  The  patient  must  lie  flat  upon  her  back,  with  the 
swelled  limb  placed  upon  pillows,  or  a  bolster,  raised  so  that  the  foot 
shall  be  a  little  higher  than  the  hip,  and  then  charged  not  to  put  her 
foot  down  upon  the  floor,  until  she  is  very  nearly  well. 

Apply  a  narrow  blister  along  the  course  of  the  crural  vein.  When 
this  is  removed  take  a  large  piece  of  flannel,  —  Dr.  Meigs  says  an  old 
flannel  petticoat,  with  the  h*^m  and  the  gathers  cut  ofl', — and  dip  it  in 
vinegar  and  hot  water,  equal  parts;  wring  it  out,  and  cover  the  whole 
limb  with  it.  Put  a  piece  of  blanket  or  oiled  silk  over  it  to  keep  it 
from  wetting  the  bed.  Repeat  this,  and  keep  it  up  for  six  hours. 
When  it  becomes  tedious  to  the  patient,  remove  it,  and  bathe  the 
limb  with  warm  sweet  oil,  two  parts,  and  laudanum,  one  part,  and 
cover  it  with  flannel.  In  two  or  three  hours,  return  to  the  first  appli- 
cation of  hot  water  and  vinegar.  Continne  this  for  five  or  six  hours, 
and  then  take  warm  sweet  oil  and  laudanum  ;  and  thus  pass  from 
one  to  the  other  until  the  inflammation  is  subdued,  or,  as  Dr.  Meigs 
says,  till  the  calf  of  the  leg  can  be  shaken. 

If  the  bowels  are  confined,  let  them  be  gently  moved  by  some  gen. 
tie  physic  (13)  (14)  (18)  (25)  (27)  (41). 

In  many  cases,  diuretics  and  cathartics  combined  will  be  proper 
(302),  or  diuretics  only  (128)  (130). 

While  the  inflammation  lasts,  and  there  is  fever,  the  tincture  of 
veratrum  viride  must  not  be  forgotten. 

If  recovery  does  not  take  place  after  the  active  inflarrmation  has 
subsided,  the  limb  should  be  bandaged  from  the  toes  to  the  groin. 

Child-Bed  Peyer. — Puerperal  Fever. 

Few  complaints  more  justly  excite  the  dread  of  the  practitioner 
than  this.     It  cuts  down  woman  at  a  time  when  she  can  least  of  all 


388 


FEMALE  DISEASES. 


be  spared  by  her  young  offspring,  and  at  a  moment  when  she  most 
excites  the  love  and  sympathy  of  her  whole  family.  It  is  a  terrible 
disease. 

It  consists  of  inflammation  of  the  peritoneum  or  lining  of  the  ab- 
domen ;  also,  frequently  inflammation  of  the  ovaries,  of  the  womb, 
of  the  veins  of  the  womb,  or  of  the  absorbent  vessels  of  the  womb. 

Its  symptoms  have  already  been  described,  on  page  277,  under  the 
head  of  inflammation  of  the  peritoneum.  The  treatment  is,  likewise^ 
there  given.  I  may  mention  here,  however,  that  an  infusion  of  cham> 
omile  flowers  is  lately  spoken  of  as  a  powerful  means  of  preventing 
suppuration  in  this  complaint. 

There  is  a  diversity  of  opinion  as  to  whether  this  disease  is  conta- 
gious, though  the  best  medical  testimony  seems  now  to  be  on  the 
aflirmative  side  of  the  question.  The  physician  or  midwife  having  a 
case  of  child-bed  fever  in  charge,  should  not  for  some  time  attend 
cases  of  midwifery. 

Nursing  Sore  Mouth. 

Nursing  women  sometimes  suffer  terribly  with  this  complaint  It 
begins  with  a  scalding  sensation  upon  the  tongue,  a  pink  color  in  the 
roof  of  the  mouth,  and  a  hot,  watery  discharge  from  the  mouth. 
After  a  few  days,  small  ulcers  appear  on  the  tongue,  and  in  the 
throat  Costiveness  is  generally  present ;  but  when  the  ulceration 
extends  to  the  bowels,  diarrhcea  occurs.  It  comes  to  an  end  upon 
weaning  the  child. 

Treatment. — To  relieve  costiveness,  give  some  gentle  .cathartic  (12) 
(15)  (25)  (34)  (36). 

Iron  in  some  of  its  forms  and  combinations  is  highly  necessary  (61) 
(71)  (73)  (349). 

Gargles  will  frequently  do  much  good  (227)  (229)  (230)  (235)  (243) 
(244)  (347)  (350). 

The  diet  must  be  simple,  nourishing,  and  digestible,  consisting  of 
stale  bread,  potatoes,  tender  beef  steak,  roast  beef,  broths,  etc. 


Inflammation  of  the  Breast.— Broken  Breast. 

Mammary  Abscess. 

The  mammary  gland,  or  gland  which  secretes  milk  in  the  human 
breast,  consists  of  a  number  of  ducts,  passing  inward  from  their  ter« 
minatioii  in  the  nipple,  and  then  spreading  around  like  the  roots  of  a 
tree,  and  terminating  in  minute  glands.  The  mammillary  tubes  are 
straight  ducts,  ten  or  twelve  in  number,  having  their  mouths  at  the 
centre  of  the  nipple,  dilating  at  its  base  into  larger  reservoirs,  which 
extend  some  distance  into  the  gland.     (Fig.  142.) 

When  milk  is  first  formed,  after  confinement,  these  tubes  and  res- 
ervoirs sometimes  get  so  full  and  hard  that  they  crowd  and  compress 
each  other,  making  it  difficult  to  remove  the  milk,  and  uuder  these 
circumstances,  the  breast  will  inflame. 


FEMALE  DISEASES. 


389 


FlO.  142. 


Symptoms.  —  The  inflammation  generally  begins  with  a  chill,  fol- 
lowed by  fcver,  and  pain  of  a  shooting  kind,  which  is  much  increased 
by  pressure.  An  examination  will  generally  reveal 
a  circumscribed,  hard,  and  painful  tumor,  even  be- 
fore there  is  any  redness  on  the  surface.  After  a 
time,  the  swelling  spreads,  the  skin  becomes  of  a 
dusky  red,  is  hot  and  shining,  will  frequently  pit  a 
little  Oil  pressure,  and  soon  gives  a  sense  of  fluctua- 
tion. Upon  the  formation  v)f  matter,  the  fever  is 
increased,  the  breast  is  enlarged,  and  there  is  local 
tenderness  and  throbbing  pain. 

This  complaint  may  be  caused  by  taking  cold, 
irregularities  in  diet,  or  by  mental  emotion ;  but 
more  commonly  it  is  caused  by  accumulation  of 
milk  within  the  ducts. 


Treatment.  —  These  afllictions  may  generally  be 
prevented  by  keeping  the  breasts  well  drawn.  It  is  the  duty  of  a 
nurse  to  look  well  after  this  matter,  and  see  that  the  breasts  do  not 
get  hard  and  distended  with  milk. 

But  when  the  inflammation  has  fairly  set  in,  the  first  aim  should 
be  to  prevent,  if  possible,  the  formation  of  matter. 

Active  purging  should  be  resorted  to  at  once  (29)  (32).  Sweating 
should  be  encouraged  by  the  tincture  of  veratrum  viride.  If  the 
object  be  to  prevent  the  formation  of  matter,  cold  lotions,  or  cold 
water  compresses,  should  be  used  freely ;  but  if  two  or  three  days 
have  passed  before  active  treatment,  the  suppuration  will  go  on,  and 
it  is  better  to  use  warm  applications.  Dewees  says  warm  vinegar  is 
the  most  beneficial  as  well  as  the  most  comforting.  Poultices  and 
warm  fomentations  are  much  used.  Some  apply  stimulating  lini- 
ments, made  of  essential  oils,  etc.  (195)  (198).  Leeches  are  often 
used  with  advantage.  They  should  be  applied,  not  upon  the  breast, 
but  just  below  it. 

During  the  progress  of  the  disease,  especially  after  the  abscess  is 
opened,  the  breast  should  be  supported,  and  prevented  from  hanging 
down,  by  long  strips  of  adhesive  plaster  carried  below  and  around  it. 
By  this  means  a  gentle  pressure  is  kept  up  by  which  the  matter  is 
more  easily  evacuated. 

The  breast  should  be  opened  with  a  lancet  as  soon  as  the  abscess 
points,  or  fluctuation  is  discovered.  Should  the  ulcer  not  heal,  an 
astringent  wash,  as  a  weak  solution  of  nitrate  of  silver  (211)  may  be 
applied  to  it  once  or  twice  a  day. 

During  the  discharge  of  matter,  the  system  of  the  patient  should 
be  supported  by  a  nourishing  diet,  and  by  wine,  tonics,  etc 


Sore  Nipples. 

Women  suffering  from  excoriated  nipples  are  apt  to  keep  the  infant 
chiefly  to  the  healthy  breast,  and  only  to  apply  it  to  the  tender  side 
for  the  purpose  of  obtaining  present  ease  from  the  pain  of  over-dis- 


I 


i- 


390 


FEMALE  DISEASES. 


tension.  In  this  way  the  ducts  remain  always  full,  and  are  apt  to 
get  inflamed.  Sore  nipples,  therefore,  are  to  be  attended  to  as  nmch 
on  account  of  the  evils  to  which  they  lead,  aa  of  the  suflering  they 
directly  occasion. 

The  excoriation  of  the  nipples  begins  as  a  chap.  This  buows  no 
tendency  to  heal ;  and  the  child's  mouth  being  often  applied,  rubs  off 
the  skin  around  the  crack,  and  this  naked  surface  soon  becomes  an 
ulcer.  These  ulcers  arc  sometimes  only  on  the  surface ;  at  other 
times  they  are  profound,  going  deep  into  the  substance  of  the  nipple. 

Treatment.  —  These  excoriations  and  ulcers  might  be  easily  healed, 
were  it  not  that  the  newly-formed  skin  is  apt  to  be  continually  rubbed 
off  by  the  child's  mouth  in  the  act  of  sucking.  Two  things  are  there- 
fore to  be  done,  —  to  favor  the  healing,  and  to  protect  the  tender  part 
from  renewed  injury. 

For  the  first  object,  a  strong  infusion  of  green  tea  or  port  wine  may 
answer  very  well  in  ordinary  cases.  A  littie  alum  or  borax,  dissolved 
in  rose  water,  or  water  (201)  (202),  is  often  used.  A  weak  solution 
of  sulphate  of  zinc,  or  sulphate  of  copper,  or  nitrate  of  silver  (209) 
(211).  But  one  of  the  very  best  articles  is  composed  of  glycerine  and 
tannin  (306). 

To  protect  the  teat  from  injury  in  the  act  of  sucking,  use  a  shield 
made  of  India  rubber.  When  the  infant  is  not  at  the  breast,  the 
nipple  should  be  covered  by  a  metal  shield. 

Whites.  —  Leucorrhcea.  —  Fluor  Albus. 

Though  leucorrhcea  is  only  a  symptom  of  disease,  —  as  I  have 
stated  on  page  353,  —  yet  I  think,  on  further  rellection,  remedies  should 
be  given  for  it,  and  I  accordingly  insert  them  here. 

If  the  discharge  be  of  a  ropy,  tenacious  character,  one  of  the  best 
remedies  is  a  strong  solution  ot  nitrate  of  silver,  used  as  an  injection 
with  a  female  syringe,  once  a  day  (254).  Of  this,  not  more  than  two 
teaspoonfuls  should  be  used  at  a  time ;  and  great  care  should  be  ob- 
served not  to  stain  the  under-clothes  with  it.  When  the  discharge  is 
either  yellow  and  thick,  or  lighter  colored  and  watery,  some  one  of 
the  following  (200),  (202),  (203),  (207),  (209),  (220),  (230),  (232), 
(243),  (244),  may  be  used  with  advantage  as  an  injection,  twice 
a  day.  An  infusion  of  the  white  pond  lily,  one  ounce  to  the  pint  of 
water,  or  two  drams  of  the  fluid  extract  of  the  same  in  four  ounces 
of  water,  makes  a  very  excellent  injection,  which  may  be  used  twice 
a  day.  A  very  simple  injection,  and  sometimes  quite  effectual,  is  a 
strong  infusion  of  green  tea. 

Some  one  of  the  above  remedies  will  generally  afford  some  relief; 
but  if  whites  exist  in  a  somewhat  aggravated  form,  they  furnish  evi- 
dence of  some  serious  disease  in  the  vagina,  or  neck  of  the  womb, 
and  the  case  ought  to  be  submitted  to  a  competent  physician. 


t\ — 


CARE  OF   CHILDREN   AND  THEIR  DISEASES. 


Pure  Air.  —  The  first  want  of  a  child  is  a  plenty  of  fresh  air ;  and 
this  want  never  ceases  to  the  end  of  life.  Impure  air  kills  thousand^' 
of  infants.  Out  of  7,650  born  in  the  lying-in  hospital  of  Dublin 
2,944  were  destroyed  by  impure  air  within  two  weeks  after  birth. 

Children  should  be  kept  in  the  open  air  as  much  as  possible,  and 
in  well-ventilated  rooms  when  indoors.  It  is  wrong,  when  infants  arc 
sleeping,  to  cover  their  faces  with  bed-clothes,  or  draw  curtains  around 
their  cots,  or  to  envelop  their  heads  in  blankets  and  shawls  when 
carried  in  the  open  air. 

The  Skilli — The  health  of  infants  requires  that  their  skin  should  be 
kept  clean.  Unless  this  is  done  they  are  liable  to  suffer  much  from 
cutaneous  and  other  diseases.  The  skin  of  a  new-born  child  is  cov- 
ered with  a  white,  unctuous  matter,  called  the  vernix  caseosa.  It  is 
injurious  to  let  this  remain  for  any  length  of  time  after  birth.  To 
remove  this,  Dr.  Dewees  recommends  that  the  child  be  smeared  with 
hog's  lard,  and  then  washed  with  soap  and  water.  Dr.  Eberle  says, 
smear  with  yolk  of  eggs,  and  then  wash  with  simple  warm  water. 

The  young  child  should  be  washed  every  day  with  warm  water,  — 
then,  after  a  time,  with  tepid  water,  then  with  temperate,  and  finally, 
after  it  is  some  months  old,  with  co'd  water.  This,  if  persevered  in 
through  childhood  and  youth,  will  ward  off*  a  thousand  ills  and  sick- 
nesses  to  which  the  young  art  liable. 

Tlie  Clothing  of  Cliildreii  should  be  so  adjusted  as  to  give  their 
limbs  ample  play,  and  should  be  thick  enough  to  keep  them  warnu 
They  ought  to  have  flannel  next  the  skin  in  winter,  and  cotton  in 
summer.  At  the  risk  of  wounding  some  i  u  j  people's  feelings,  I 
must  add  that  the  fashion  of  a  child's  clothes   o  not  important. 

Tlie  Food.  —  The  natural  and  proper  food  of  a  young  child  is  its 
mother's  milk.  To  this  it  should  be  confined,  unless  prohibited  by 
imperative  circumstances,  until  a  portion  of  the  teeth  are  cut.  When 
the  mother  cannot  nurse  her  child,  the  breast  of  a  suitable  nurse 
should,  if  possible,  be  supplied.  If  the  infant  need  any  more  food 
than  is  supplied  by  the  breast,  give  cow's  milk  and  water,  sweetened 
with  a  litUe  loaf  sugar.  The  sucking-bottle,  if  used,  must  never  be 
permitted  to  get  sour. 


^ttM, 


ff 


k') 


:V 


392 


CARK  OF  CHILDREN  AND  THEIR  DIREASES. 


Health  of  a  IVarsinf  Woman.  —  During  nursing  the  greatest  atten> 
^ion  to  health  is  required  by  the  mother  or  the  nurse.  A  woman  of  a 
consumptive  constitution  should  never  nurse  an  infant.  Nourished 
at  the  breast  of  such  a  mother,  the  child,  who  has  inherited  her  con- 
stitution, will  be  the  more  likely  to  fall  a  victim  to  her  disease. 

Passion.s  of  a  NurHiii}^  Woniun.  —  Let  the  woman  who  imrses  a 
young  child  be  careful  of  her  passions.  An  irritable  disposition,  giv- 
ing rise  to  gusts  of  violent  passion,  may  so  alt«r  the  character  of  the 
milk  as  to  throw  the  child  into  convulsions.  Grief,  envy,  hatred,  fear, 
jealousy,  and  peevishness,  unlit  the  milk  for  nourishing  the  child,  and 
often  cause  the  child's  stomach  to  be  much  disordered. 

The  Diet  of  the  Nurse  should  receive  strict  attention.  It  should  be 
plain  and  wholesome,  and  the  amount  should  never  be  excessive. 
Her  drink  should  be  simply  water.  She  should  take  gentle  daily  ex- 
ercise in  the  open  air.  ' 

Weaninf.  —  At  the  end  of  twelve  months,  the  first  set  of  teeth  are 
generally  so  far  cut  that  the  child  can  manage  most  kinds  of  plain 
food ;  and  it  may  now  be  taken  from  the  breast.  Should  the  teeth 
appear  earlier,  and  the  infant  be  healthy,  it  may  be  weaned  even  at 
the  end  of  the  tenth  month.  Never  take  the  child  from  the  breast  in 
the  midst  of  summer  heat.  A  disordered  state  of  the  bowels,  or 
cholera  infantum,  would  be  likely  to  be  the  result.  The  spring  and 
the  autumn  are  the  proper  periods  for  weaning. 

If  for  some  months,  it  have  been  accustomed  to  other  beside 

the  milk  of  the  mother,  it  may  be  taken  suddenly  from  oreast. 

It  must  not  have  any  amount  of  solid  food  it  may  crave  immediately 
after  weaning.  It  should  still  be  kept,  for  some  time,  upon  a  simple, 
bland,  half-fluid  aliment,  taken  in  moderate  quantities,  and  at  proper 
intervals.  At  first,  the  food  should  be  bread  and  i.;ilk,  boiled  rice  and 
milk,  soft-boiled  eggs,  roasted  potatoes  and  milk,  oat-meal  gruel,  plain 
rice  pudding,  preparations  of  irrow-root,  tapioca  and  sago,  simple 
mr.at  broths,  mixed  with  crums  of  bread  or  grated  crackers,  or  in 
which  rice  ox  barley  has  been  well  boiled.  From  this  it  may  pass 
gradually  to  a  more  solid  diet ;  though,  until  the  age  of  puberty,  the 
principal  part  of  the  diet  should  be  milk,  the  farinaceous  articles,  and 
vegetables.  Sugar  has  been  thought  to  be  injurious  to  children.  It 
is  not  so.     If  taken  moderately,  at  meal  times,  it  is  wholesome. 

Whatever  be  the  food  allowed  to  children,  it  should  never  be  taken 
in  excess;  and  to  prevent  this,  they  ought  not  to  take  their  meals  alone; 
for  they  have  very  keen  appetites,  and  if  permitted  to  do  so,  they  will 
|*enerally  form  hab.Us  of  gluttony.  Three  or  four  light  meals  a  day  is 
enough. 

Their  drink  should  be  water  simply,  —  nothing  else. 

If  parents  would  observe  these  rules,  and  enforce  them  strictly,  they 
would  confer  blessings  upon  their  children  greater  than  riches.  They 
would  send  them  into  the  world  with  health  and  good  constitutions, 
and  would  save  them  from  untold  misery  and  an  early  death.  Such 
a  course  would  evince  more  love  for  their  children  than  those  weak 


CARE  OF  CHILDREN  AND  THEIR  DISEASES. 


393 


oonoessions  which  aliov  tea  and  coffee,  and  all  sorts  of  food,  in  quan- 
tities to  suit,  which  occasion  early  disorders  of  the  stomach  and 
bowels,  and  bring  later  derangements  of  the  nervous  system,  with 
all  its  regrets  and  horrors. 

Sleep  of  Children.  —  During  the  first  period  of  its  existence,  an  in- 
fant sleeps  a  large  portion  ot  the  time.  This  is  a  wise  provision  of 
nature.  It  withdraws  the  young  child,  for  a  time,  from  those  outward 
exciting  agents,  which  would  too  much  disturb  tht;  nervous  system  of 
so  tender  a  being.  Whenever  a  young  infant  is  restless  or  wakeful 
much  of  the  time,  we  may  feel  sure  it  has  had  too  much  food,  or  is 
in  some  way  disturbed  by  it,  or  by  tight  clothes,  or  that  some  other 
cause  is  giving  it  uneasy  sensations. 

Its  sleep  should  be  the  promptings  of  nature,  and  should  never, 
except  in  rare  instances,  be  brought  about  by  opiat^^s.  It  is  wrong 
and  sinful  for  a  mother  or  nurse  to  put  an  infant  to  sleep  with  an 
opiate,  merely  that  she  may  gain  time  for  pleasure,  or  even  for  other 
duties. 

The  Infant  should  be  kept  warm  while  Sleepinn;.  —  During  the  first 
few  wfteks  it  should  sleep  with  its  mother,  —  especially  if  the  weatheh 
be  cold.  After  that,  it  may  be  in  a  cradle  or  cot.  The  covering  should 
be  warm,  but  lig'ht,  so  as  not  to  press  heavily  upon  its  tender  limbs. 
If  laid  upon  its  back,  the  fluid  of  its  mouth  and  throat  may  get  into 
the  windpipe,  and  obstruct  the  breathing,  or  produce  coughing.  It  is 
better,  therefore,  to  lay  the  infant  upon  its  side,  —  taking  care  not  to 
produce  distortion  of  the  spine  or  limbs  by  always  laying  it  upon  the 
same  side. 

Children  should  not  be  allowed  to  sleep  either  with  the  aged,  oi 
with  sick  persons.  It  is  not  healthful  for  them  to  breathe  the  exhala- 
tions from  the  bodies  of  such.  For  a  somewhat  similar  reason,  some 
kinds  of  plants,  and  flowers  generally,  should  be  excluded  from  their 
sleeping  rooms.  Their  beds  should  be  so  placed  as  to  turn  their  faces 
away  both  from  the  sun-light  which  comes  in  at  the  windows,  and 
from  the  artificial  light  in  the  room. 

They  should  be  taught  to  retire  early  at  night,  and  to  rise  imme- 
diately after  waking  in  the  morning.  This  habit  will  be  worth  much 
to  them  through  life.  After  the  meconeum  has  passed,  the  bowels  of 
an  infant  should  be  opened  from  two  to  four  times  in  twenty-four 
hours.  If  the  stools  are  less  frequent  than  tvice  a  day,  or,  if  they  are 
Vimpy,  some  gentle  cathartic  is  called  for.  From  half  a  dram  to  a 
dram  of  fresh  castor  oil,  or  a  dessert-spoonful  of  mixture  (24)  an- 
swers a  good  purpose.  During  childhood,  the  bowels  should  be  moved 
once  or  twice  a  day.  When  a  cathartic  is  required,  a  table  spoonful 
txf  mixture  (25),  or  a  teaspoonful  of  (17),  will  be  found  very  excel- 
lent •» 

Exercise.  —  During  the  first  few  weeks  of  an  infant's  life  it  requires 
but  little  exercise ;  indeed  its  organization  is  not  sufficiently  settled 
and  compacted  to  permit  much  without  injury.  A  little  gentle  rub- 
bing with  the  hand  over  the  whole  body,  is  about  all  it  needs  or  will 


=s^ 


k 


394 


CABE  OF  CHILDItKN  AND  TIIEIR  DISEASES. 


\f^c.  To  dandle  and  toss  it  about,  and  especially  to  set  it  upright,  b 
injurious  and  wrong.  Ita  bones  are  i  '  soft,  and  will  not  endure  to 
be  much  twisted  about,  and  its  spine  is  not  stiff  enough  to  bear  up 
the  weight  of  its  head. 

After  u  fevr  weeks,  riding  in  a  carriage  drawn  by  a  careful  and 
trusty  nurse,  is  both  a  healthful  and  pleasurable  exercise  for  children. 

Learning  to  Walk.  —  At  the  end  of  the  ninth  or  tenth  month,  a 
child  may  begin  to  learn  to  walk.  It  is  not  safe  to  teach  it  this  exer- 
cise much  tari'er  than  this,  as  the  bones,  being  soft,  may  be  bent  by 
the  weight  of    he  body,  and  the  limbs  be  permanently  deformed. 

As  soon  as  ilne  child  has  learned  to  walk  alone,  it  should  be  allowed 
perfect  freedom  of  exercise.  Thenceforward,  the  open  air  is  its  proper 
place  during  the  day ;  and  such  an  unrestrained  use  of  its  limbs  as 
its  own  instincts  may  dictate,  is  its  proper  calling.  For  five  years 
after  it  has  learned  to  walk,  it  should  do  little  else  than  to  use  its 
limbs  out  of  doors,  as  it  pleases.  The  books  and  the  school-room 
will  be  in  season  after  that.  First  compact  the  body,  —  then  bring 
out  the  mind.  The  mind  is  of  no  use  without  the  body,  —  the  body 
must  be  developed  first,  or  never. 

Moral  Treatment. —  We  charge  upon  nature  many  of  the  bad  pa«- 
«?ions  which  we  ourselves  implant  in  children.  The  moral  treatment 
of  children  in  generally  bad.  We  arfl  apt  to  begin  by  either  making 
them  our  masters  or  our  slaves.  Sometimes  we  do  both,  —  allowing 
them  to  govern  us  for  a  time,  and  then,  getting  into  a  passion,  or  a 
mood  for  playing  the  tyrant,  we  turn  upon,  and  govern  them  as  if  we 
were  autocrats.  We  submit  to  their  whims  until  we  grow  irritable, 
and  then,  by  way  of  retaliation,  we  compel  them  to  s'ibmit  to  ours. 

This  is  all  wrting.  Children  should  be  governed  always,  but  with 
an  even,  a  gentle,  and  a  loving  hand.  They  should  early  be  subjected 
to  habits  of  self-control,  and  of  regularity  in  eating,  and  sleeping;  and 
should  be  taught  absolute  and  continued  obedience.  All  this  can  be 
brought  about  only  by  firmnet^s,  self-control,  anc'  ^reat  gentleness  on 
the  part  of  the  parents.  If  they  would  makv^  a  child  cheerful  and 
happy  jn  its  disposition,  they  must  themt^elves  be  cheerful,  and  never 
let  it  see  anger,  passion,  and  fretfulness,  marring  their  conduct. 
Nothing  is  more  injurious  to  the  health  of  a  child  than  a  peevish, 
complaining,  and  soured  disposition ;  and  these  vicci  are  seldom  ac- 
quired, unless  seen  in  the  lives  of  parents. 


How  to  Nurse  Sick  Children. 

As  the  educL'tio'i  of  the  young,  whether  religious,  moral,  or  intel- 
lectual, is  more  important  than  that  of  adults,  so. is  the  care  of  their 
physical  life  of  more  importance.  Death  aims  to  "out- Herod  Herod," 
and  seeks  the  life  of  all  infants,  male  and  female,  and  in  fact  destroys 
one  half  of  all  below  the  age  of  five  years. 

But  few  know  how  to  train  and  take  care  of  children.  It  is  a  still 
more  rare  gift  to  know  how  to  nurse  them  when  sick.     No  persons 


1  !''t 


CARE  OF  childrp:n  and  their  diseases. 


395 


t  upright,  b 
)t  en'lure  to 
ti  to  bear  up 

areful  and 
or  children. 

th  rnonth,  a 

it  this  exer* 

be  bent  by 

'orraed. 

1  be  allowed 

is  its  proper 

its  limbs  as 

►r  five  years 

an  to  use  its 

school-room 

-then  bring 

—  the  body 


the  bad  pas- 
al  treatment 
ther  making 
,  —  allowing 
passion,  or  a 
lem  as  if  we 
ow  irritable, 
lit  to  ours. 
%?/&,  but  with 
be  subjected 
leeping ;  and 
11  this  can  be 
;entlencss  on 
cheerful  and 
ul,  and  never 
leir  conduct, 
m  a  peevish, 
e  seldom  ac- 


:)ral,  or  intel- 
care  of  their 
erod  Herod," 
fact  destroys 

It  is  a  atill 
No  persons 


can  properly  nurse  sick  children  who  are  in  feeble  health,  or  have 
fretful  tempars,  or  are  low-spirited ;  for  they  can  neither  endure  the 
fatigue,  nov  bear  the  trials,  nor  hear  the  prattle  which  such  a  respon- 
sibility would  bring.  Some  will  manage  a  well  child  very  well,  who 
are  not  fit  to  have  the  care  of  a  sick  one ;  for  there  is  a  great  differ- 
ence between  a  child  when  well,  and  the  same  child  when  sick. 
When  well,  and  full  of  fun,  and  frolic,  and  life,  laughing,  and  jump- 
ing, and  shouting  aloud  for  very  joy  at  being  alive,  it  is  an  easy  thing 
for  a  person  or'  even  a  morric  temper  to  attend  upon  them.  But 
when  sickness  comes,  and  the  child's  playfulness  is  all  laid  aside; 
when  it  becomes  so  fretful  thr.t  nothing  goes  right  with  it ;  when  it 
crJUje  to  be  laid  down,  and  then  cries  to  be  taken  up ;  streiches  oui  its 
haAd  for  drink,  and  pushes  away  the  cup  when  it  is  presented, — 
apparently  made  more  angry  by  your  attempts  to  serve  it ;  —  when 
these  things  are  repeated,  day  and  night,  until  the  nurse  is  weary  and 
exhausted,  and  even  a  change  of  disease  and  amendment  only  brings 
a  crcs'<  and  fractious  temper,  it  is  only  by  possessing  peculiar  qualifica- 
tions, that  the  nurse  can  maintain  an  even  and  unrulHed  disposition. 

Wh'Je  passing  through  such  scenes,  it  is  hard  for  the  nurse  to  re- 
member that  sickness  does  not  destroy  the  little  loving  heart,  but  only 
hides  its  affection  for  a  short  time. 

Sijfiis  of  Btsease  in  Children.  —  It  is  important  that  the  nurse  of 
sick  children  should  know  what  to  observe,  and  the  meaning  of  the 
signs  of  disease.  A  biby  has  only  cries  to  express  its  sick  feelings. 
To  one  person,  these  cries  inean  no  more  than  that  the  baby  has  some 
sort  of  illness.  To  another,  with  more  experience  and  bette/  powers 
of  observation,  they  point  to  the  head,  or  chest,  or  stomach,  as  the 
disorder.  A  baby  with  the  stomach-ache,  utters  long;  loud,  and  pas- 
sionate cries,  and  sheds  tears  plentifully.  Suddenly  it  stops  for  a  mo- 
ment, and  then  begins  again,  —  drawing  up  its  legs  to  the  stomacti, 
and  as  the  pain  passes  off,  stretching  them  out  again,  and  with  many 
sobs,  passing  off  into  a  gentle  sleep. 

If  there  be  inflammation  in  the  chest,  it  neither  cries  aloud,  nor 
sheds  tears,  but  after  every  long  breath,  or  hacking  cough,  it  utters  a 
short  cry,  which  is  cut  off  before  it  is  half  finished,  —  apparejitly  be- 
cause crying  is  jjainful. 

If  the  disease  be  in  the  head,  the  cries  will  be  sharp,  piercing'  shrieks^ 
with  hw  moans  ami  trails  between.  Or,  there  will  be  quiet  dozing, 
interrupted  by  startling  pains. 

When  a  child  is  tak<'n  ill,  what- "er  the  disease  which  is  impending, 
there  is  always  a  change  of  som'  sort,  which  soon  attracts  attention. 
It  either  loses  its  appetite,  or  is  fretful,  or  soon  tired,  or  sleepy,  or 
restless,  or  thirsty,  or  has  a  hot  skin,  or,  rather,  has  a  number  of  these 
symptoms.  It  vomits,  or  is  purged  or  bound  in  its  bowels.  It  loses 
its  merry  laugh  and  cheerful  look  ;  it  no  longer  watches  its  mother's 
or  its  nurse's  eye,  as  before,  but  clings  to  her  more  clo.i  '.y,  and  will 
not  be  out  of  her  arms  a  moment.  If  lulled  to  sleep  in  her  arms,  it 
wakes  immediately  on  being  placed  in  its  cot. 

Such  symptoms  often  continue  a  day  or  two  before  it  can  be  de- 


a. 


n 


S^ 


* "  ff 


39H 


CARE  OF  CHILDBEN  AND  THEIR  DISEASES. 


termined  what  disease  is  impending.  An  intelligent  nurse  may  do 
much  towards  solving  the  question.  It  is  frequently  proper  at  such 
times  to  place  the  child  in  a  warm  bath.  When  stripped  for  the  bath, 
it  should  be  carefully  examined  to  see  if  there  is  any  rash  upon  its 
body.  If  it  be  a  rash  from  which  it  is  about  to  suffer,  the  bath  will 
help  bring  it  out.  The  rash  should  be  looked  for  at  least  every  twelve 
hours,  until  the  nature  of  the  disease  is  determined. 

The  Appearance  of  the  Different  Rashes  may  be  distinguished  with 
a  little  care  ai.id  experience.  Measles  has  a  number  of  dark  red  spots. 
in  many  places  running  into  each  other,  and  is  generally  seen  first 
about  the  face,  and  on  the  forehead,  near  the  roots  of  the  hair,  and  is 
preceded  by  running  at  the  eyes  and  nose,  and  all  the  signs  of  a 
severe  cold.  Scarlet  fever  does  not  show  separate  spots,  but  presents 
a  general  bright  red  color  of  the  skin,  much  like  a,  boiled  lobster.  At 
firdt  there  is  more  of  it  about  the  neck  and  chest  than  on  the  face, 
and  it  is  preceded  by  a  sore  throat  Chicken  pox  is  attended  by 
fever,  but  not  so  much  running  at  the  nose  and  eyes  as  in  measles, 
nor  is  there  so  much  cough.  The  spots,  too,  are  smaller,  and  are  not 
BO  much  run  together ;  and  they  come  out  more  over  the  whole  body. 
They  appear  a  few  hours  earlier  on  the  body  than  elsewhere  ;  and  in 
a  day  or  two  they  are  found  to  be  enlarged,  and  turn  into  little  blad- 
ders  of  water  as  big  as  the  head  of  a  shawl-pin. 

And  now  a  few  Words  as  to  what  should  be  Done  in  the  sick-room 
of  a  child.  The  room  should  be  kept  cool,  and  its  temperature  should 
be  measured  by  a  thermometer.  This  instrument,  when  hung  away 
from  the  nre,  should  show  a  temperature  of  about  55°.  That  is  about 
the  right  degree  of  warmth.  Sick-rooms  are  generally  kept  too  hot. 
The  room  should  be  darkened ;  not'  made  totally  dark,  but  its  light 
shaded  down  by  closing  the  outside  blinds,  or  by  dropping  the  cur- 
tains, so  as  to  give  a  kind  of  twilight ;  and  the  cot  should  always  be  so 
placed  as  to  turn  the  little  one's  face  away  from  the  light.  The  room 
should  be  kept  quiet ;  and  this  requires  attention  in  the  whole  house, 
as  well  as  among  the  persons  in  the  room.  Those  present  should 
never  whisper,  but  speak  in  low  and  gentle  tones,  —  should  not  walk 
on  tip-toe,  but  move  about  carefully.  There  is  a.fussi/  quietness  which 
disturbs  the  sick  far  more  than  noise.  The  child  must  be  spoken  to, 
and  roused  from  its  slumbers,  and  turned  from  side  to  side,  and  raised 
for  its  food  or  medicine,  with  a  soothing  tenderness,  and  a  delicacy 
which  never  forgets  itself. 

In  applying  leeches  or  cold  to  a  child,  judgment  is  needed,  to  suc- 
ceed well.  The  leeches  should  be  put  either  behind  the  ear  or  on  top 
of  the  head,  so  that  the  child  cannot  see  them.  Cold  is  best  applied 
by  means  of  a  couple  of  bladders  half  filled  with  powdered  ice,  and 
wrapped  in  two  large  napkins ;  one  of  them  should  be  placed  under 
the  child's  head,  the  corner  of  the  napkin  being  pinned  to  the  pillow- 
case to  prevent  its  being  disturbed,  while  the  other  is  allowed  to  rest 
upon  the  head,  with  the  corner  of  the  napkin  again  pinned  to  the 
pillow,  to  take  off  the  greatt;r  part  of  its  weight    In  this  way  the  child 


urse  may  do 
jper  at  such 
for  the  bath, 
»sh  upon  its 
le  bath  will 
every  twelve 


ifuished  with 

rk  red  spots. 

ly  seen  first 

hair,  and  is 

!  signs  of  a 

but  presents 

lobster.     At 

on  the  face, 

attended  by 

in  measles, 

and  are  not 

whole  body. 

ere ;  and  in 

)  little  blad- 


le  sick-room 
ature  should 
hung  away 
hat  is  about 
ept  too  hot. 
>ut  its  light 
ing  the  cur- 
Iways  be  so 
The  room 
/hole  house, 
sent  should 
lid  not  walk 
itness  which 
3  spoken  to, 
,  and  raised 
a  delicacy 

ded,  to  suc- 
ir  or  on  top 
est  applied 
ed  ice,  and 
laced  under 
the  pillow- 
wed  to  rest 
ned  to  the 
ly  the  child 


PARE  OF  CHILDREN  AND  THEIR  DISEASES. 


397 


will  not  be  wetted,  or  irritated,  as  by  the  changing  of  wet  cloths, 
nor  will  the  cold  applications  get  displaced  by  its  movements. 

A  word  should  be  said  respecting  the  nursing  of  children  in  cases 
of  lung-inflammation,  —  an  affection  from  which  they  often  suffer. 
The  lungs  are  much  like  two  large  sponges,  and  the  air  enters  them 
through  the  windpipe ;  and  passing  through  smaller  and  yet  smaller 
tubes,  it  comes  at  last  into  tiny  cells,  so  small  that  they  can  only  be 
.seen  by  a  magnifying  glass.  When  the  lungs  are  inflamed,  some  of 
the  tubes  become  stopped  up ;  and  the  very  small  cells  are  pressed 
on  by  the  flow  of  more  blood  than  natural  to  the  part ;  and  so  the 
air  enters  less  easily,  and  in  smaller  quantities,  than  it  should.  If 
now  you  let  the  child  lie  flat,  it  is  not  only  less  able  to  draw  a  deep 
breath,  and  fill  the  lungs,  but  the  blood  also  flowing  to  the  inflamed 
portion  oi  the  lung,  returns  less  easily  than  if  the  child  were  propped 
up  in  bed.  When  a  whitlow  is  on  the  finger,  if  the  hand  be  hung 
do'.vn,  the  inflamed  finger  will  become  redder,  and  will  beat  and 
throb  so  as  hardly  to  be  endured,  while,  if  the  hand  be  raised,  the 
pain  will  abate.  The  same  increase  of  pain  does  not  follow  an  accu- 
mulation of  blood  in  an  inflamed  lung,  because  the  lung  is  not  as 
sensitive  as  the  finger ;  but  the  consequences  are  very  serious.  The 
air-cells  being  more  and  more  pressed  upon,  the  admission  of  air  is 
more  and  more  difficult,  until,  at  length,  a  large  part  of  the  lungs  is 
rendered  useless,  and  the  child  dies. 

In  this  disease,  the  temperature  of  the  room  needs  attention.  The 
air  should  not  be  quite  so  cool  as  in  other  diseases.  From  60°  to  65° 
is  about  right. 

Of  course  crying  will  irritate  inflamed  lungs,  and  it  is  all  important 
that  a  child  sick  with  this  disease  shi)nld  be  soothed  and  quieted  as 
much  as  possible.  Every  good  nurse  knows  how  to  do  this  better 
than  any  rules  can  teach  her. 

Sometimes  sickness  and  v  ting,  from  which  a  child  may  suffer, 
are  increased  by  want  of  judgiiKnt  in  givine^  lood  and  drink.  ^Vhen 
there  is  nausea,  the  stomach  will  brar  only  very  small  quantities  of 
food  at  a  time,  while  cold  drinks  are  almost  always  borne  much  bet- 
ter than  warm.  When  there  is  nausea,  it  is  best,  for  ai,  hour  or  two, 
not  to  attempt  to  give  any  food  or  drink.  After  the  stomach  has  been 
thus%!ompletely  rested,  give  a  single  teaspoonful  of  ro/r/  '  iter.  If 
this  is  not  thrown  up,  it  may  be  succeedetl,  in  ten  or  tiftrcui  miimtes, 
by  a  second  or  a  thinl.  If  this  is  borne,  give  a  litih;  water  thickened 
with  isinglass,  or  cold  barley  water,  or  cold  milk  and  water;  and 
then,  with  the  same  precautions,  and  in  very  small  4u;>iitities,  beef 
tea,  or  chicken  broth,  or  whatever  else  the  doctor  in  att-  .dance  may 
direct.     The  smallness  of  quantity,  the  coldness  ol'  articles,  and 

the  giving  it  without  moving  or  disturbing  the  child,  if  pc^sible,  are 
the  important  points  to  Ix^  attended  to. 

It  is  of  great  conse(]uence  that  children  suffering  from  diarrhoDa 
should  have  their  skin  kept  very  clean.  The  pores  should  be  kept 
well  open,  so  that  the  fluid  matter  which  is  passing  off  by  the  bowels, 
and  through  the  mucous  membrane  or  inner  skin,  may  be  diverted  to 
the  outer  skin.     In  this  disease,  the  skin  of  children  is  apt  to  become 


i 


irritable,  or  even  sore.  In  these  cases,  soap  and  water  are  quite  apt 
to  increase  the  soreness,  while  a  little  starch,  made  as  for  use  upon 
clean  clothes,  though  much  thinner,  will,  if  used  in  place  of  soap,  very- 
much  soothe  the  inflamed  skin. 

A  child  much  exhausted  by  diarrhoea,  or  other  disease,  should  be 
moved  or  lifted  out  of  its  cot  or  cradle  as  little  as  possible.  Suddenly 
moving  it  when  very  weak,  may  cause  fainting,  or  even  convulsions. 
Let  it  be  sponged  and  cleaned  by  mere'y  turning  it,  with  great  gentle- 
ness, from  side  to  side. 

In  such  cases,  too,  the  child  hould  be  supported  witii  proper  nour- 
ishment. When  worn  down  by  diarrhoea,  its  desire  for  food  may  be 
nearly  lost.  Though  at  one  time  it  cried  much,  and  seemed  to  suffer, 
it  will,  in  this  condition,  grow  quieter,  and  doze,  and  even  sleep  on 
for  hours,  appearing  fretful  only  when  roused.  If,  in  such  cases,  the 
child  be  allowed  to  go  without  food  because  it  does  not  seek  it,  or 
declines  it  when  offered,  it  will  sink  into  a  deeper  and  deeper  sleep, 
and  finally  into  a  stupor  which  will  end  in  death.  To  give  a  little 
arrow-root,  or  wine,  or  broth,  inay  now  require  troubl.:  anJ.  persever- 
ance ;  but  it  must  be  done,  for  upon  it  depends  the  child's  life.  The 
effort  to  administer  fcod  must  not  be  abandoned  because  opce  c 
twice,  or  several  times  unsuccessful,  for  the  food  which  is  refusea  one 
minute,  may  be  accepted  five  minutes  after. 

In  the  various  rashes  from  which  children  suffer,  there  is  a  very 
general  fear  of  washing  the  surface  lest  the  rash  be  driven  in.  Tnere 
is  no  ground  for  this  fear,  unless  it  be  in  measles ;  and  even  in  this 
complaint,  there  is  no  danger  if  lukt-warm  water  be  used.  If  only  a 
small  part  of  the  body  be  sponged  at  a  time,  there  is  nothing  to  fear 
even  from  frequent  washing ;  and  the  passing  of  a  wet  sponge  fre- 
quently over  the  surface  is  a  great  comfort  wiien  the  skin  is  burning 
with  fever.  The  same  remark  applies  to  the  changing  of  the  linen. 
The  same  kind  of  objection,  and  with  no  better  reason,  is  often  urged 
against  cold  water  in  fevers,  though  it  is  most  refreshing,  and  if 
taken  in  small  quantities,  and  often,  never  doe;3  harm,  but  often  much 
good. 

The  Warm  Bath.  —  The  best  method  of  giving  a  child  a  warm 
bath  is  a  matter  of  importance.  There  should  be  as  little  pyade 
about  it  as  possible.  If  the  child  sees  the  bath  prepared,  is  taken  out 
of  bed,  undressed  and  put  into  it  smoking  before  its  eyes,  it  may  be 
much  alarmed,  and  cry  so  passionately  as  to  be  really  injured  by  it. 
The  bath  should  be  prepared  out  of  its  sight,  and  brought  to  the  bed- 
eide  with  a  blanket  spread  over  it  to  hide  the  steam.  The  child 
should  then  be  laid  upon  the  blanket,  and  gently  let  down  into  the 
water,  and  then  set  to  play  with  a  couple  of  corks  with  feathers  stuck 
in  them. 


Inflammation  of  the  Mouth. — Erythematic  Stomatitis. 

This  is  a  simple  inflammation  of  the  mucous  membrane  of  the 
mouth ;  and  is  very  common  during  infancy.  It  may  be  confined  to 
the  tongue,  or  spread  over  the  whole  mouth.     It  is  sometimes  very 


CARE  OF  CHILDREN  AND  THEIR  DISEASES. 


399 


quite  apt 
use  upon 
oap,  very 

ihould  be 
Suddenly 
ivnlsioiis. 
[it  geiitle- 

per  nour- 

d  miiy  be 

to  suffer, 

sleep  on 

cases,  the 

jeek  it,  or 

per  sleep, 

ve  a  little 

persever- 

ife.     The 

i  onr^e  c  • 

fusea  or.e 

is  a  very 
1.  Tuere 
en  in  this 
If  oily  a 
\g  to  fear 
longe  fre- 
burning 
the  linen, 
tea  urged 
g,  and  if 
ten  much 


a  warm 
le  p^ade 
taken  out 
,t  may  be 
ired  by  it. 
:>  the  bed- 
rhe  child 
n  into  the 
lers  stuck 


matitis. 

ne  of  the 
onfined  to 
imes  very 


severe,  going  down  into  the  gullet  and  stomach,  and  into  the  wind- 
pipe. It  occasions  redness  and  pain  in  the  mouth,  and  fretfulness  of 
the  infant.  —  causing  it  to  quit  the  nipple  suddenly  when  sucking. 
A  frequent  result  of  this  inflammation  is  the  secretion  and  exudation 
upon  the  surface,  of  a  white,  matter-like  curd.  It  appears  in  small 
ptiints  and  patches.  This  is  the  thrush,  or  what  nurses  call  children's 
wre  mouth.     It  is  commonly  confined  to  the  period  of  suckling. 

Treatment.  —  For  the  simple  inflammation  of  the  mouth,  a  wash 
.rade  by  infusing  the  inner  bark  of  slippery  elm  in  wattT,  answers  a 
good  purpose  ;  and  in  more  severe  cases,  a  wash  made  of  sugar  of 
lead  (227)  will  be  found  useful. 

In  some  mild  cases  of  curdy  exudation,  this  last  wash  will  do  well, 
if  united  with  the  daily  use  of  the  warm  bath,  and  proper  care  of  the 
diet.  But  in  the  more  severe  cases,  a  little  pulverized  borax  and 
white  sugar  or  honey  (274)  (275),  placed  occasionally  on  the  infant's 
tongue,  will  do  good  service.  A  decoction  of  equal  parts  of  blue 
cohosh  and  golden  seal  is  a  good  remedy.  When  the  curdy  patches 
are  large,  touch  them  with  a  mixture  of  hydrochloric  acid  and  honey 
(276).  If  the  exudation  have  a  look  as  if  mortification  were  taking 
place,  use  a  wash  of  chloride  of  lime  (228),  or  chloride  of  soda,  etc. 
(229),  or  creosote  and  mucilage  (230),  or  alcohol  and  vinegar  (231),  or 
nitrate  of  silver  (211).  When  diarrhoea  is  present,  with  acidity,  /jive 
(26).  In  the  more  severe  cases,  when  appearances  of  mortincadon 
are  seen,  quinine  (69)  should  be  administered. 

Follicular  Inflammation  of  the  Mouth. — Aptha. 

This  disease  attack.3  the  little  glands  of  the  mouth,  called  follicles, 
and  appears  about  the  time  of  cutting  teeth.  Small  white  specks,  a 
little  elevated,  first  show  themselves  on  the  lips,  insides  of  the  cheeks, 
and  under  side  of  the  tongue,  etc.  The  specks  enlarge,  a  whitish, 
curdy  matter  flows  out  from  their  centre,  and  ulcers  are  formed,  with 
elevated  edges,  surrounded  by  a  red,  inflamed  circle.  Sometimes, 
instead  of  curdy  matter,  a  bloody  exudation  takes  place,  and  dark- 
colored  crusts  are  formed  which  are  mistaken  for  mortification.  In 
bad  cases,  there  is  great  resdessness,  with  hot  mouth,  dry  skin,  thirst, 
and  diarrhoea,  with  green  stools,  and  sometimes  salivation. 

Treatment.  —  The  milder  forms  of  this  disease  are  treated  like 
simple  inflammation  of  the  mouth.  If  there  is  thirst,  give  several 
times  a  day,  a  spoonful  of  cold  water,  with  a  little  gum  arable  dis- 
solved in  it.  If  the  child  be  weaned  at  this,  time,  its  food  should  be 
barley  or  rice-water,  sweetened  with  loaf  sugar.  An  occasional'  doso 
of  magnesia,  with  or  without  a  little  rhubarb,  will  remove  the  acid 
which  abounds  in  the  bowels.  After  ulceration  has  taken  place, 
borax  (274)  will  do  well.  When  watery  discharges  from  the  bowels, 
and  griping  pains  appear,  preparation  (28)  shotfld  be  used.  If  th« 
strength  be  reduced,  give  (69). 


4«0 


CARE  OF  CHILDREN  AND  THBIK  DISEASES. 


1 


Inflammation  of  the  Gums. —  Gengivitis, 

During  the  cutting  of  teeth,  the  guni»  are  apt  to  be  inflamed,  red 
or  livid,  swelled  and  painful.  The  child  is  languid,  with  a  hot  and 
dry  skin,  small  and  quick  pulse,  little  appetite,  much  thirst,  and  a 
tongue  covered  with  a  thick,  yellowish  fur.  When  ulceration  takes 
place,  and  is  allowed  to  go  on,  the  teeth  become  loose,  black,  and 
rotten,  and  often  soft  and  pulpy ;  a  flow  of  fetid  spittle  takes  place, 
the  breath  of  the  child  becomes  oflensive,  and  its  countenance  pale 
and  Sii  »w.  The  gums  bleed  under  the  least  pressure,  and  a  profuse 
diarrhceci  Ills  up  the  list  of  ills. 

Treatment.  —  In  the  first  stages,  mild  washes  to  the  gums,  such  as 
(227),  will  do  well.  Clear  out  the  bowels  once  with  magnesia  and 
rhubarb  (26).  After  ulceration  has  taken  place,  use  oak  bark  (232), 
or  chloride  of  lime  (228),  or  diluted  hydrochloric  acid  (233).  A  daily 
tepid  bath.  If  the  strength  be  reduced,  use  an  infusion  of  Peruvian 
bark,  or  quinine  (69), 

Gangrene  of  the  Mouth.— Canker. —  Cancrum  Oris. 

This  disease  attacks  weakly  children,  of  a  lymphatic  temperament, 
and  having  inflamed  gums.  It  often  follows  intermittent,  remittent, 
or  bilious  fever,  and  is  also  frequently  connected  with  disease  of  the 
stomach  and  bowels. 

Symptoms.  —  It  is  attended  with  languor,  listlessness,  indisposition 
to  play  or  move  about,  thirst,  loss  of  appetite,  peevishness,  and  ina- 
bility to  sleep.  The  countenance  is  "pale  and  sunken,  and  there  is  a 
peculiar  puckering  of  the  cheeks  about  the  corners  of  the  mouth. 
The  breath  is  bad,  the  gums  have  the  appearance  of  salivaiion,  the 
teeth  become  loose  and  fall  from  their  sockets,  or,  if  they  remain,  they 
become  covered  with  a  thick  coating  of  a  dirty  white  or  ash  color. 
A  few  ash-colored  \yater  pimples  appear  upon  the  gums,  which  en- 
large, run  together,  and  finally  break,  —  presenting  a  black  appearance 
of  mortification.  The  gangrene,  sooner  or  later,  goes  to  the  lips  and 
cheeks. 

Treatment.  —  When  bowel  complaints  exist,  they  are  to  be  treated 
with  the  usual  remedies,  such  as  (70)  or  (156).  If  there  be  active 
inflammation  of  the  gums,  at  first,  leeches  may  be  applied,  after 
which,  the  inflammation  being  subdued,  a  wash  of  &ak  bark  (232), 
will  be  in  place,  with  quinine  given  internally  (69)  to  ward  off  the 
mortification.  As  a  wash,  too,  a  strong  solution  of  sulphate  of  cop- 
per (234)  is  excellent,  —  so  is  white  vitriol  (235),  and  nitrate  of  silver 
(219),  and  creosote  (336). 

The  diet  should .  be  beef-tea,  plain  beef  or  mutton  broth,  with  rice, 
milk  and  rice,  tapioca,  sago,  and  the  like. 


CARE  OF  CUILDUEN  AND  THEIR  DISEASES. 


401 


lamed,  red 
a  hot  and 
rst,  and  a 
tion  takes 
black,  and 
kes  place; 
lance  pale 
[  a  profuse 

IS,  such  as 
rnesia  and 
t)ark  (232), 
.  A  daily 
f  Peruvian 


m  Oris. 

nperament, 
,  remittent, 
ease  of  the 


disposition 
and  ina- 

there  is  a 
ne  mouth, 
vaiion,  the 
main,  they 

ash  color. 

which  en- 
ippearance 
le  lips  and 

be  treated 
be  active 
)lied,  aft«r 
)ark  (232), 
art!  off  the 
ite  of  cop- 
te  of  silver 

,  with  rice, 


Difficult  Teeth-Catting. 

Teeth-cutting  generally  begins  between  the  ages  cf  five  and  seven 
months.  It  is  indicated  by  redness,  heat,  and  tenderness  of  the  gums, 
an  increase  of  saliva,  and,  occasionally,  redness  of  the  cheeks,  water- 
ing of  the  eyes,  thirst  and  fever,  with  fretfulness,  disturbed  sleep,  and 
more  frequent  motions  of  the  bowels,  a  little  more  fluid  than  usua^ 
and  sometimes  of  a  greenish  hue.  As  the  tooth  comes  near  the  sup* 
face,  the  child  holds  its  fingers  in  its  mouth,  and  presses  the  gums 
harder  upon  the  nipple  when  sucking.  Boside  these  milder  symp- 
toms, there  are  sometimes  ulceration  of  thf  mouth,  gangrene,  exten- 
sive and  long-Qontinued  diseases  of  the  bow^lf.,  —  and  even  disorders 
of  the  brain,  convulsione,  and  palsy. 

Treatment.  —  Watch  the  gums,  and  the  moment  they  are  swollen 
by  the  teeth  pushing  them  up,  lance  them  at  the  elevated  points,  cut- 
ting entirely  down  to  the  adv^.ncing  teeth,  —  so  that  no  tough  mem- 
brane shall  cause  pain  by  imneding  their  growth.  These  incisions 
often  prevent  fatal  disease  of  the  brain,  and  sometimes  almost  in- 
stantly relieve  the  most  threatening  symptoms.  Before  the  teeth  are 
far  enough  advanced  for  lancing,  some  soothing  wash  may  be  applied 
to  the  gums,  or  a  leech  or  two  to  the  angle  of  the  jaw.  For  obsti- 
nate diarrhoea,  with  watery  stools  and  griping,  use  prescription  (157). 
If  the  child  be  drowsy  and  starts  from  sleep,  and  has  heat  and  red- 
ness, with  enlargement  of  the  blood  vessels  about  the  head,  put  three 
or  four  leeches  behind  the  ears,  and  make  cold  applications  to  the 
head.  At  the  same  time,  open  the  bowels  with  castor  oil  (17). 
When  there  is  difTiculty  of  passing  the  water,  ^ive  flax-seed  tea  ;  and 
if  the  pain  be  considerable,  an  opiate  (351). 

Croup. 

This  is  one  of  the  scourges  of  childhood.  Jn  ten  years  prc'ous 
to  1845,  no  less  than  1150  children  were  destroyed  in  Philadelphia  by 
croup.  During  the  year  1840,  the  large  number  of  4,336  died  of  the 
same  disease  in  England. 

Croup  is  an  inflammation  of  the  mucous  membrane  of  the  larynx 
and  windpipe.  It  causes  to  flow  out  upon  the  surface  of  the  mem- 
brane, a  peculiar  flaid,  which  stiffens  into  a  membrane,  or  skin-like 
substance,  and  adheres  to  the  inner  surface  of  the  wind-pipe,  and 
sometimes  extends  through  the  whole  of  t*  o  bronchial  tubes.  This 
is  membranous  croup,  —  the  worst  and  most  fatal  form  of  the  disease. 
Dr.  John  Ware  of  Boston  has  shown  that  there  are  other  forms  of 
croup,  not  so  fatal,  because  not  attended  by  the  formation  of  a  mem- 
brane upon  the  nmcous  surfaces. 

The  Syiiiptoiiis  of  croup  are,  difTiculty  of  breathing,  hoarseness,  and 
a  peculiarly  loud  and  ringing  cough,  with  fever.  In  the  membranous 
and  worst  form  of  the  disease,  the  breathing  is  not,  at  first,  so  labo- 
rious, and  the  symptoms  generally  not  so  violent  and  alarming  as  in 

51 


n 


Iff   !•'  i 


402 


CARE  OF  CHILDREN  AND  THEIR  DISEASES. 


the  less  fatal  but  more  inflammatory  type.     This  latter  kind,  though 

generally  causing  great  alarm,  like  a  highway  robber,  by  the  sudden 
ereeness  with  which  they  seize  the  throat,  are  yet  much  less  fatal, 
and  of  course  less  to  be  feared,  than  the  membranous  form.  The 
disease  is  pretty  much  confined  to  children  between  the  ages  of  one 
and  eight  years. 

Treiitiuent. —  The  old  and  usual  mode  of  treatment  is  first  to  bleed, 
and  then  to  place  the  patient  in  a  warm  bath  ;  and,  after  the  child  is 
returned  to  the  bed,  to  give  nauseating  doses  of  tartar  emetic  (105). 
In  Boston,  this  treatment  is  now  nearly  discarded,  as  being  too  active, 
and  possibly  a  cause  of  evil  rather  than  good.  The  following  is  a 
safer  and  more  successful  treatment. 

Give,  every  three  hours,  Dover's  powder  and  calomel  (352).  Sponge 
the  neck  often  with  water,  and  apply  a  liniment  (192).  It  is  some- 
times proper  to  give  a  gentle  emetic,  —  say,  two  drams  of  wine  of 
ipecac.  A  flax-seed  poultice  applied  to  ,he  neck  is  also  excellent.  If 
the  child  be  large  enough,  let  it  inhale  frt^quently  from  an  old  tea-pot, 
the  vapor  of  hot  water  and  miillein  leaves  ;  and  if  it  be  too  young  to 
do  this,  keep  the  room  full  of  watery  vapor,  by  throwing  water  upon 
hot  bricks.  If  the  bowels  need  moving,  give  a  dose  of  castor  oil  (17). 
In  addition  to  these  measures,  a  strong  solution  of  nitrate  of  silver 
(219)  should  be  thrown  into  the  throat  with  one  of  my  laryngeal 
shower  syringes,  and  repeated  every  two  hours  till  the  membrane  is 
discharged. 

Spasm  of  the  Glottis. — Larpigismus  Stridulus. 

This  disease  consists  in  a  sudden  shutting  up  of  the  glottis,  or  pas- 
sage to  the  windpipe,  which  creates  a  feeling  of  strangulation,  and  a 
difficulty  of  breathing  so  great  that  the  drawing  in  of  the  breath 
causes  a  peculiar  crowing  sound.  There  is  no  fever.  The  child,  upon 
taking  food  or  drink,  or  upon  being  irritated  or  teased,  is  taken  sud- 
denly with  an  impossibility  of  drawing  in  its  breath.  Alter  struggling 
convulsively  for  a  time,  its  head  thrown  back,  its  nostrilr-)  dilated,  its 
mouth  open,  its  eyes  rolled  up,  its  face  pale,  its  legs  and  arms  stitV, 
it  begins  to  breathe  with  a  shrill  crowing  sound.  The  disease  i>; 
sometimes  mistaken  for  croup,  and  for  hooping  cough.  It  is  strictly 
spasmodic  in  its  nature. 

Treatment  —  During  the  paroxysm,  set  the  child  in  an  upright  pos- 
ture, with  the  head  leaning  forward,  exposed  to  a  full  draft  of  cool, 
fresh  air,  and  sprinkle  cool  water  upon  the  face.  Let  nothing  be  tight 
about  the  neck.  Slap  the  child  slightly  on  the  back,  and  apply  fric- 
tion along  the  spine.  If  these  means  do  not  succeed,  pla'^e  it  in  a 
warm  bath  ;  while  in  the  bath,  sprinkle  cold  water  on  the  face. 

When  the  fit  is  over,  examine  the  gums.  If  they  are  swollen,  lance 
them  down  to  the  coming  teeth.  The  bowels  should  be  moved  daily 
with  some  gentle  physic,  but  not  irritated  by  severe  purging.  If  the 
stools  are  light  colored,  use  prescription  (142),  with  warm  water  in* 
jections. 


!;?' 


% 


'%\ 


I,  though 
J  sudden 
ess  fatal, 
m.     The 

es  of  one 

to  bleed, 
;  child  is 
!tic  (105). 
oo  active, 
iving  is  a 

,    Sponge 
;  is  some- 
f  wine  of 
L-llent.     If 
d  tea-pot, 
»  young  to 
ater  upon 
)r  oil  (17). 
e  of  silver 
laryngeal 
smbrane  ia 


ilus. 

tis,  or  pas- 

tion,  and  a 

le  breath 

lild,  upon 
i\ken  sud- 

truggling 

ilated,  it^ 
arms  stiH, 
disease  i>i 

is  strictlv 


jright  pos- 

ft  of  cool, 

ng  be  tight 

apply  fric- 
a-^e  it  in  a 
ace. 

oUen,  lance 
loved  daily 

g.     If  the 
water  in* 


Hpoping  Cough. — Purtussis. 

This  is  a  contagious  disease,  peculiar  to  childhood,  and  occurring 
but  once  in  the  same  individual.  It  is  characterized  by  a  convulsive, 
paroxysmal  cough,  which  is  attended  by  long-continued  hissing,  con- 
vulsive breathing,  with  rattling  in  the  windpipe,  which  is  succeeded 
by  several  short  efferts  to  expel  the  breath,  following  each  other  in 
quick  succession.  The  long,  convulsive  breathing,  attended  by  the 
hooping  sound,  is  immediately  repeated  ;  and  these  paroxysms  con- 
tinue until  a  quantity  of  thick,  slimy,  ropy  mucous  is  thrown  up',  by 
expectoration  or  vomiting,  when  the  breathing  is  again  free.  These 
paroxysms  have  all  the  appearance  of  impending  suffocation,  redness 
of  the  face,  shedding  of  tears,  sweating  about  the  head  and  forehead, 
and  such  agitation  of  the  whole  body  that  the  child  lays  hold  ot 
something  for  support.  Blood  sometimes  starts  from  the  nostrils, 
and  the  child  involuntarily  passes  w^ter,  or  evacuates  the  bowels. 
In  spring  and  autumn,  the  disease  most  prevails.  It  is  not  generally 
dangerous. 

Treatment.  —  First  give  an  emetic,  —  say,  two  drams  of  wine  of 
ipecac.  Afterwards,  give  small  doses  of  ipecac  and  sulphur  (277). 
From  six  to  fifteen  grains  of  sulphur  alone,  three  times  a  day,  is  an 
excellent  remedy.  A  liniment  of  olive  oil,  oil  of  amber,  etc.  (1913), 
applied  to  the  spine,  is  useful.  Belladonna  (278)  is  a  good  remedy. 
Prussic  acid  (96)  is  strongly  recommended  by  many,  and  is  worthy 
of  a  trial.  Lobelia  (lOG)  is  a  valuable  remedy.  Alum  (279)  is  well 
recommended.  Sulphuric  ether,  a  little  being  spilhid  in  the  nurse's 
hand  and  held  to  the  child's  nose,  generally  shortens  the  paroxysm, 
and  frequently  abridges  ihe  disease.  A  solution  of  nitric  acid  in 
water,  as  strong  as  lemon  juice,  and  sweetened,  is  a  very  valuable 
remedy,  —  breaking  up  the  disease  in  two  or  three  weeks.  The  child 
may  drink  it  freely,  a  little  further  reduced  with  water. 

Looseness  of  the  Bowels. — Diarrhoea. 

Infants  and  chilhren  are  more  liable  to  diarrhoea  than  adults,  and 
this  is  the  reason  for  speaking  of  the  disease  here  as  well  as  els<v 
where.  It  may  be  caused  by  inflammation  of  the  stomach  and 
bowels,  by  irritation  produced  by  too  much  or  improper  food,  by  cold 
and  damp  weather,  or  by  teething.  The  discharges  from  the  boweU 
may  be  more  or  less  thin,  of  a  dirty-white  color,  of  a  curdled  appear- 
ance, and  acid  smell,  or  they  may  be  watery,  yellow  or  green  in  color, 
and  often  mixed  with  blood.  Sometimes  they  are  mixed  with  por- 
tions of  undigested  food,  are  very  acid,  and  when  the  looseness  has 
been  caused  by  unripe  vegetables  and  fruit,  in  a  state  of  fermentation, 
like  yeast.  At  other  times,  especially  while  teething,  they  are  a  kind 
of  thick  mucus,  like  jelly. 

If  pressure  on  the  bowels  causes  pain,  the  diarrhoea  is  the  result  of 
inflammation.    When  the  disease  has  become  chronic,  the  skin  is  dry, 


'ji' 


harsh,  and  sliscolored,  the  face  wrinkled,  looking  yellowish,  dirty,  and 
old. 

Treatment. —  First,  regulate  the  diet  This  is  very  important.  In 
the  case  of  older  children,  take  away  every  kind  of  solid  food,  as  well 
as  pastry,  confectionery,  sweetmeats,  and  fresh  vegetables.  Give 
plain  boiled  rice  and  milk,  —  sometimes  boiled  milk,  —  water  gruel, 
crackers  and  milk,  tapioca,  etc.  At  the  beginning  of  the  attack,  give 
Bome  mild  physic,  as  castor  oil,  or  syrup  of  .-nubarb.  A  warm  bath 
at  this  period  is  excellent.  If  the  discharges  are  very  sour,  dissolve 
a  teaspoonful  of  bicarbonate  of  soda  in  half  a  tumbler  of  water,  and 
give  a  teaspoonful  every  hour,  or  the  same  amount  of  lime  water, 
mixed  with  an  equal  quantity  of  new  milk,  or  prepared  chalk  and 
ipecac  (158),  some  slight  astringent  being  used  also  (159).  But  bet- 
ter than  all  other  astringents  for  this  complaint,  is  a  decoction  of  the 
cranesbill  or  spotted  geranium,  with  milk,  or  of  the  bark  from  the 
root  of  the  common  blackberry  which  is  armed  with  strong  prickles. 

The  Summer  Complaint  of  Infants.  —  Cholera  Infantum. 

This  is  confined  to  the  North  American  continent.  It  occurs  in 
large  cities  during  the  hot  season.  Its  subjects  are  infants  between 
the  ages  of  four  and  twenty  months,  —  occurring  most  frequently 
about  the  time  of  cutting  the  first  teeth.  It  is  one  of  the  most  fatal 
diseases  of  infants. 

Sj^iiptoms.  —  It  begins  with  a  profuse  diarrhcea,  —  the  stools  being 
green  or  yellow,  or  more  often  light  colored,  and  very  thin.  The 
stomach  soon  becomes  very  irritable,  —  rejecting  everything  with  vio- 
lence. In  some  cases,  vomiting  and  purging  set  in,  —  the  discharges 
from  the  bowels  being  without  color  or  smell.  The  infant  rapidly 
loses  fiesh,  and  is  soon  reduced  to  great  languor  and  prostration. 
The  pulse  in  the  beginning  is  quick,  small,  and  often  tense.  The 
tongue  is  covered  with  a  white,  slimy  mucus.  The  skin  is  dry  and 
harsh.  The  head  and  belly  are  hot.  The  feet  and  hands  are  either 
of  the  natural  temperature,  or  cold.  There  is  great  thirst,  and  tow- 
ards evening,  fever.  The  belly  is  often  a  little  swollen,  and  tender  to 
the  touch.  Occasionally  there  is  delirium,  as  indicated  by  wild  and 
bloodshot  eyes,  violent  tossing  of  the  head,  and  attempts  to  bite  and 
scratch  the  nurse. 

Treat  Hieut. —  If  possible,  remove  the  child  at  once  from  the  impure 
and  heitod  air  of  the  city  to  the  cooler  and  purer  air  of  the  country. 
If  this  c'.uiiiot  be  done,  keep  it  in  as  large  and  dry  ii  room  as  can  be 
had,  ami  take  it  often  into  the  open  air,  in  clear  wcathtM*.  Confine 
the  infant  entirely  to  the  breast,  or,  if  weaned,  let  its  food  b»»  tapioca, 
pure  arrow-root,  rice  Hour,  and  milk,  and  put  it  daily  iu  a  warm  or 
tepid  bath,  according  as  the  skin  is  hot  or  cold.  Give  it  gum-water, 
or  rennet  whey,  with  a  little  gum  arable  added  to  it 

These  measures,  if  used  early,  will  often  cure  the  disease,  without 
medicine.     If  the  vomiting  be  obstinate,  camphor  and  sulphuric  etiier 


i.| 


i^' 


CARE  OF  CHILDREN  AND  THEIK  DISEASES. 


405 


dirty,  and 

)rtant.     In 
od,  as  well 
les.      Give 
^ater  grael, 
ittack,  give 
warm  bath 
ur,  dissolve 
water,  and 
lime  water, 
chalk  and 
.     But  bet- 
cition  of  the 
rk  from  the 
g  prickles. 

{  Infantum. 

It  occurs  in 
nts  between 
t  frequently 
le  most  fatal 

stools  being 
thin.     The 
ng  with  vio- 
,e  discharges 
fant  rapidly 
prostration, 
tense.     The 
n  is  dry  and 
ids  are  either 
rst,  and  tow- 
ind  tender  to 
by  wild  and 
;s  tx)  bite  and 

Ti  tho  impure 
the  country, 
om  a.s  can  be 
icr.  Confnie 
d  bo  tapioca, 
1  a  warm  or 
t  gum-water, 

(ease,  without 
alphuric  ether 


(280)  will  generally  give  relief.  "When  everything  else  fails,  in  re- 
lieving the  sicknesH,  sugar  of  lead  (160)  is  generally  successful. 
When  the  vomiting  is  stopped,  the  most  prompt  remedy  for  the  dis- 
ordered bowels  is  the  compound  syrup  of  rhubarb  and  potassa. 
When  the  disease  has  become  chronic,  treat  it  the  same  as  children's 
diarrhoea.  But  if  the  discharges  are  sour,  offensive,  and  dark  colored, 
pulveri/ed  charcoal  (42),  with  tartrate  of  iron  (71),  will  be  suitable 
remedies.  Rhubarb,  leptandrin,  etc.  (28),  will  often  answer  a  good 
purpose. 

Colic. 

Infants  are  very  much  subject  to  colic,  from  over-feeding  and  con 
sequent  acidity  of  the  stomach,  from  giving  them  solid  food  at  too 
tender  an  age,  and  from  some  improper  thing  ate  or  drunk  by  the 
mother  or  nurse.  They  often  suffer  intensely  mim  these  pains,  toss- 
ing their  legs  up  and  down,  and  screaming  vehemently.  When  it 
arises  from  costiveness,  the  bowels  are  often  hard  and  swollen. 

Treatment.  —  When  it  arises  from  costiveness,  give  an  injection  of 
a  tablespoonful  of  castor  oil,  and  an  ounce  of  warm  infusion  of  pep- 
permint or  spearmint  At  the  same  time,  administer  internally  an  in- 
fusion of  one  of  the  same  herbs,  with  a  small  portion  of  bicarbonate  of 
soda  dissolved  in  it,  and  sweetened  with  loaf  sugar.  Or,  if  the  bowels 
need  to  be  acted  upon,  the  syrup  of  rhubarb,  or  the  sweet  tincture  of 
rhubarb,  with  a  little  soda  in  it,  will  do  well.  Paragoric  generally 
brings  relief,  but  should  not  be  used,  if  simple  carminatives  will  an- 
swer the  purpose.  Children  are  often  reli<;ved  by  covering  them  with 
a  hot  flannel,  laying  them  upon  the  belly  on  the  knee,  and  trotting 
them,  at  the  same  time  tapping  them  gonrly  upon  the  back.  This 
should  be  done  cautiously  ;  for  if  unsuccessful,  it  might  increase  the 
suffering ;  and  tlie  infant  has  no  language  but  screams  to  tell  its  dis- 
tress. 

Falling  of  the  Bowel.  —  Prolapsis  Ani. 

In  cases  of  long-continued  looseness,  the  lower  bowel  of  children 
sometimes  gets  so  weakened,  that  it  drops  down,  and  projects  through 
the  fundament.  Occasionally,  only  the  mucous  membrane  which 
lines  it  comes  down,  in  the  shape  of  a  small  tumor,  causing  a  stjiise 
of  bearing  down  and  smarting.  These  fallings-down  oerar  when  the 
child  goes  to  stool.  Whether  it  be  the  bowel  or  the  lining  membrane 
which  has  come  down,  if  it  be  allowed  to  remain  long  down,  inflam- 
mation will  take  place,  and  to. return  it  will  then  be  very  diflicult. 

Treatment. —  Place  the  child  apon  his  back,  and,  having  smeared 
the  thumbs,  or  fore  fingers,  with  lard  or  sweet  oil,  press  them  gently 
upon  the  tumor  in  such  direction  as  shall  tend  to  return  it  within  the 
body.  If  this  does  not  succeed,  push  the  forefinger  into  the  gut,  so 
as  to  relax  the  circular  muscle  which  contracts  upon  and  /noIds  it.  If 
the  falling  is  caused  by  straining  at  stool,  made  necessary  by  costive- 


iC6 


CARE  OF  CHILDUEN  AND  TIIEIU  DISEASES. 


I1C88,  some  ripe  fruit  stewed  in  molasses,  or  rye  hasty-pudding  and 
molasses,  should  be  given  to  the  child  daily,  and  it  should  be  caused 
to  empty  the  bowels  while  standing  up.  To  strengthen  the  bowel, 
fcw  things  are  better  than  cold  water,  applied  to  the  fundament  sev- 
eral times  a  day.  An  astringent  wash  of  oak  bark  (232),  is  also  val' 
uable.  Should  the  bowel  become  so  much  relaxed  that  these  means 
fail,  a  tight  bandage  must  be  applied  to  support  the  fundaiTient.  Be 
careful  that  some  ignorant  pretender  does  not,  —  as  has  happened,— 
apply  the  ligature  or  the  knife,  and  cut  off  the  tumor,  instead  of  re- 
turnmg  it  into  the  body. 

Gastric  Fever  of  Infancy. 

Thb  inflammatory  affections  of  the  bowels,  which  happen  aftei 
ttath-cutting,  are  frequently  accompanied  by  remittent  fever,  —  the 
fevt:  showing  itself  very  distinctly  towards  evening,  and  subsiding,  o( 
nearly  cMsappearing,  in  the  morning.  It  is  a  sympathetic  fever,  uid 
is  generally  the  result  of  a  reaction  produced  by  inflammation  of  the 
stomach,  or  ileum,  or  colon.  The  attack  is  sometimes  sudden,  though 
generally  gradual. 

Symptoms.  —  For  several  days,  the  child  will  be  languid  and  fretful, 
with  loss  of  appetite,  increased  thirst,  and  some  heat  of  skin.  Tov.'i 
ards  night  these  symptoms  are  more  intense;  the  skin  is  more  hot, 
the  thirst  and  restlessness  are  greater,  the  pulse  more  rapid.  In  the 
morning,  the  skin  is  more  moist  and  cool,  and  the  child  falls  inlu  a 
short,  disturbed  sleep.  Early  in  the  attack,  the  bowels  are  c*  nati 
pated,  —  though  there  is  sometimes  diarrhcea,  or  a  frequent  desire  to 
go  to  stool  without  much  being  passed.  The  evacuations  are  always 
unnatural  and  very  offensive.  They  are  dark-colored,  or  clay-like,  oi 
of  the  consistency  of  tar,  —  sometimes  mixed  with  mucus,  and  occa. 
sionally  with  blood.  There  is  tenderness  of  ths  belly,  and  pressure 
upon  it  causes  pain.  It  is  also  hot  to  the  touch,  while  the  feet  are 
cold.  The  face  is  flushed,  and  the  breath  has  a  decidedly  sickly 
smell.  The  stomach  is  irritable,  and  vomiting  is  frequent.  The 
tongue,  after  a  time,  becomes  coated,  dry,  and  pointed. 

In  the  chronic  form  of  tlic  disease,  there  is,  frequently,  diarrhcea, 
the  passages  being  unhealthy  and  fetid  ;  the  tongue  is  covered  with  a 
brownish-yellow  mucus,  the  teeth  with  sordes ;  the  lips  are  parched 
and  cracked;  the  urine  is  scanty  and  high-colored,  with  a  white  sedi- 
ment ;  the  skin,  dry,  harsh,  and  dirty-looking ;  the  countenance  con- 
tracted and  wrinkled ;  and  there  is,  frequently,  a  dry,  hacking  cough. 

Treatment.  —  Regulate  the  diet.  This  is  important.  In  recent  and 
acute  cases,  withhold  all  food,  except  some  cold  mucilaginous  flni<l 
as  drink,  as  rice-water,  gum-water,  infusion  of  slippery-elm  bark,  or 
milk  diluted  with  barley  water.  Give  a  warm  or  tepid  bath  daily. 
Purgatives  should  be  used  sparingly.  The  bowels,  when  costive,  had 
better,  generally,  be  opened  by  injections  of  tepid  water,  or  thin  gruel 
If  any  laxative  be  used,  let  it  be  the  compound  rhubarb  powder,  ot 


idding  and 
be  caused 
the  bowel, 
ament  sev- 
is  also  val' 
li);se  means 
iiut'ut.  Be 
ip|)fned,— 
jtead  of  re- 


ippen  aftei 
fever,  —  the 
ibsidin^,  or 
J  fever,  .uid 
ition  of  the 
den,  though 


and  fretful, 
kin.  Toy.'' 
s  more  hot, 
id.     In  tfif 

falls  intu  )i 

are  const; 
nt  desire  to 

are  always 
3lay-like,  oi 

and  occa< 
id  pressure 
he  feet  are 
ediy  sickly 
lent      The 

r,  diarrhoea, 
ered  with  a 
ire  parched 
white  sedi- 
nance  con- 
ing cough. 

recent  and 
inous  fluid 
hn  bark,  or 
bath  daily, 
iostive,  had 
thin  gruel, 
powder,  Oi 


CARE  OF  CIIILDUKN  AND  TIIKIR  DISEA8KS. 


40; 


either  of  the  following,  (28)  (281).  When  the  discharges  have 
become  healthy  and  the  tongue  clean  and  moist,  some  light  bilter, 
as  the  infusion,  of  Peruvian  bark,  or  Colombo,  in  combination  witli 
diluted  sulphuric  or  hydrochloric  acid,  may  be  given.  Those,  can*- 
fullv  given,  with  the  daily  tepid  bath,  and  exercise  in  the  open  air 
will  soon  restore  the  .ntrength. 

Mesenteric  Disease.  ; 

This  attacks  scrofulous  iliildren  between  the  ai3[es  of  three  and  ten 
years.  Its  symptoms  are  a  prominent  belly  and  l«)ss  of  flesh,  —  par- 
ticularly upon  the  arms  and  legs.  To  be  iihle  to  fc-  !  the  cnlarfjcd 
and  hardened  glands,  through  tiic  walls  of  tiie  l>elly,  is  the  surest  sign 
of  this  disease.  When  the  complaint  is  long-continucnl,  the  child 
loses  all  its  flesh,  and  dies  in  almost  a  complete  skeleton  state. 

Treatment. —  If  there  is  inflammation  or  other  disorder  in  the 
stomach  or  bowels,  attend  to  this  first.  Then  put  the  patieirt  on  a 
generous  diet,  such  as  meat  broths,  etc.  (jive  bicarbonate  of  pot4.ssa, 
dissolved  in  'the  infusion  of  columbo  or  quassia,  and  when' there  is 
costiveness,  add  rhubarb  to  the  preparation.  For  the  enlargement  of 
the  glands,  apply,  externally,  an  ointment  (184)  of  the  iodide  of  lead, 
or  of  the  iodide  of  potassium  (185).  Give  an  ioduretted  bath,  daily, 
which  is  formed  by  adding  one  grain  of  iodine  and  two  grains  of 
iodide  of  potassium  to  each  gallon  of  warm  water. 

The  syrup  of  iodide  of  iron  should  be  given,  internally,  three  times 
a  day,  in  a  little  water,  or  the  iodide  of  potassium,  and  compound 
infusion  of  gentian.  Daily  sponging  the  body  in  salt  and  water,  and 
exercise  in  the  open  air,  are  important. 

Rickets. 

This  is  also  a  disease  of  scrofulous  children.  By  some  bad  proces.s 
of  nutrition  in  such  children,  there  does  not  enough  phosphate  of  lime 
enter  into  the  bones  to  harden  them,  and  the  weight  of  the  body,  or 
the  pulling  of  the  muscles,  or  the  pressure  of  the  clothing,  bends  jind 
distorts  them  in  all  manner  of  ways.  The  heads  of  the  thigh  bones 
are  pushed  nearer  together,  making  the  lower  belly  narrow ;  the  back 
bone  is  so  curved  as  to  lessen  the  height ;  the  shoulder  blades  stand 
up  like  wings  when  flying  is  contemplated;  and  the  shoulders  are  so 
lifted  up  that  the  head  seems  only  a  little  higher  than  the  elevatioiu 
on  each  side. 

Treatment. —  A  good,  generous,  wholesome  diet,  properly  regulated; 
out  door  exercise  ;  the  tepid  or  cold  salt  water  sponge  bath,  with  fric- 
tion, and  but  little  medicine.  The  hypo-phosphite  of  lime,  iii  two- 
grain  doses,  given  in  a  little  sweetened  water,  three  times  a  day,  or  the 
syrup  of  the  hypo-phosphites,  in  half-teaspoonful  doses,  three  times  a 
day,  may  be  given  with  advantage. 


tiifc 


408 


CARE  OF  CHILDREN  AND  THEIR  DISEASES. 


The  Blue  Disease. — Cyanosis. 

This  disease  is  known  by  a  blue,  purple,  or  leaden  tinge  over  the 
whole  body.  The  warmth  of  the  body  is  reduced,  there  is  difficult 
breathing,  Wiuv-I*  is  increased  by  quick  motion  or  by  crying.  The 
disease  is  generally  fatal.  The  bluei.ess  is  occasioned,  either  by  the 
passage  between  the  right  and  left  side  of  the  heart  remaining  open 
after  birth,  so  as  to  let  the  blue,  venous  blood  run  through  and  mix 
with  the  red  arterial  blood,  thus  making  the  whole  blue,  or  by  the 
obstruction  of  the  pulmonary  artery,  which  withhoids  the  blood  from 
the  lungs,  and  does  not  allow  it  to  be  arterial3z(>,d  and  reddened. 
This  latter  opinion  is  the  more  general  one  now. 

Treatment* — Keep  (he  patient,  as  much  as  possible,  in  a  state  of 
rest,  so  that  the  circulation  may  not  be  hurried.  Allow  a  pure  fresh 
air,  easily-digested  food,  and  protect  the  body  from  cold  and  damp- 
ness. ]lold  the  infant  near  the  fire,  and  apply  gentle  friction  over  the 
head  and  body  with  a  warm,  soft  cloth. 

Pits. 

Most  persons  have  seen  a  baby  in  fits ;  and  it  is  a  sad  sight,  —  its 
little  face  all  distorted  and  livid ;  its  eyes  rolling  and  squinting  fright- 
fully; its  han<ls  clenched,  and  arms  bent,  and  legs  drawn  up,  and  body 
arched  backward,  and  limbs  twitching  violently,  —  itself  insensible, 
and  unable  to  see,  or  swallow,  or  move.  Aftei'  a  lime,  the  fit  reasey, 
somtUimes  by  degrees,  at  other  times  suddenly,  —  the  child  fetching  a 
deep  sigh,  and  then  lying  quiet  and  pale,  as  if  it  had  fainted.  From 
this  btate  it  passes  into  a  sleep,  and,  on  walking,  .^otne  hours  after,  i 
seems  quite  well. 

Fits  may  attack  a  child  which  is  apparently  well,  and  .il  it  im- 
mediately, or  it  may  have  fits  daily,  or  even  several  tines  a  day, 
and  linger  on  for  weeks.  A  child  may  have  fits  from  a  grtat  vari- 
ety of  causes.  Fits,  therefore,  have  a  dillerent  meaning  in  difierent 
cas<!s.  But  they  always  show  that  the  brain  has  in  some  way  bee»? 
listurbed. 

Treutment. —  As  fits  are  not  a  disease  in  themselves,  but  only  a 
symptom  of  some  disease,  the  treatment  must  have  reference  to  the 
cause,  Sometimes,  vhile  the  fit  lasts,  it  is  wise  to  cio  nothing.  But, 
if  a  fit  come  sudden]}^,  in  the  case  of  a  child  previously  healthy,  it  is 
generally  safe  to  place  it  in  a  hot  bf.lii,  and  at  the  same  time,  ro  dash 
cold  water  on  its  feee,  or  to  pour  cold  water  on  its  head,  or  hold  on 
it  a  large  sponge  dipped  in  cold  water.  The  hot  oatli  will  draw  the 
blood  to  the  skin,  and  away  from  the  over-loaded  brain.  It  will  quiet 
the  disturbance  of  the  system,  and  if  scarlet  fever  or  measles  are 
about  to  appear,  it  will  bring  ther;  out. 


5  over  the 
is  difficult 
ing.  The 
her  by  the 
ning  open 
h  and  mix 
or  by  the 
lood  from 
reddened. 


DISEASES   OF  THE  GENERAL  SYSTEM. 


a  state  of 
pure  fresh 
,nd  damp- 
n  over  the 


ight,  —  its 
ing  fright- 
,  and  body 
insensible, 
tit  reasey, 
fetching  a 
'd.  From 
onrs  after, 

.il  it  im- 

les  a  day, 

^rtat  vari- 

II  different 

way  bee»? 


)ut  only  a 
nee  to  the 
ling.  But, 
^althy,  li  is 
le,  TO  dash 
>r  hold  on 
li  draw  the 
;  will  quiet 
leasles  are 


Having  now  treated  of  those  disorders  which  affect  the  skin,  the 
brain  and  nerves,  the  throat,  the  lungs  and  their  appendages,  the  heart 
and  its  covering,  the  abdominal  cavity  and  its  lining  membrane,  the 
sexual  organs,  and  those  complaints  peculiar  to  females  and  children, 
it  remains  to  speak  of  those  others,  —  fewer  in  number,  —  which  are 
not  specially  developed  in  any  particular  part,  but  disturb  the  whole 
system. 

Fever. 

FyvER  is  a  disease  which  affects  the  system  generally,  and  is  char- 
aetarized  by  more  or  less  excitt^ment  of  the  circulation,  increased  heat, 
diminished  strength,  and,  oftentimes,  unnatural  thirst.  The  degree 
of  excitement  is  measured  by  the  state  of  the  pulse.  Of  this  state, 
there  are  two  characteristic  indications  :  namely,  frequency  and  hard- 
ness. A  pulse  is  frequent  when  its  rapidity  exceeds  that  of  health  ; 
it  is  hard  when  its  stroke  resists  the  pressure  of  the  finger  with 
unusual  force. 

In  health,  the  pulse  of  an  adult  beats  from  sixty  to  eighty  times  in 
a  miimte ;  that  of  children  is  more  frequent.  The  pulsations  of  the 
heart  of  the  unborn  infant,  as  heard  through  the  body  of  the  mother, 
art;  one  hundred  and  fifty  in  a  minute.  After  birth,  the  pulse  varies 
from  one  hundred  and  forty  down  to  the  standard  of  adult  age.  To 
appreciate  hardness  of  pulse,  experience  is  absolutely  necessary. 

The  great  activity  of  the  circulation,  in  fever,  is  intimately  con- 
nected with  the  heat  and  thirst,  and  tends  directly  to  waste  the  ener- 
gies, and  consume  the  strength  of  the  patient.  The  heat  of  fever 
lessens  or  dries  up  the  secretions,  or  different  fluids  of  the  body, 
which,  in  a  state  of  health,  arc  separated  from  the  blood  for  various 
purposes.     This  is  the  cause  of  the  dry  skin,  .scanty  urine,  etc. 

A  crisis  of  fever  is  that  pericnl  in  its  row  Ave  when  unfavorable  symf>- 
tiims  give  place  to  those  of  returning  health. 

A  course  of  fever ^  or,  in  common  language,  a  run  of  fever,  is  dis- 
tinguished by  a  great  variety  of  symptoms,  which  will  be  more  par- 
ticularly spoken  of  in  the  pages  which  follow. 


Typhoid  Fever. 

Op  the  different  kinds  of  fever,  this  is  one  of  the  moat  common  and 
widely  prevalent.  The  name  ti/phoid  is  from  two  Greek  v^rords  which 
mean  IVce  typhus,  or  similar  to  typhus.  The  word  typhus,  from  a  Greek 
word  signifying  stupor,  means  stupid,  dull,  or  low ;  and,  when  applied 
to  a  fever,  implies  that  it  is  low,  or  characterized  by  great  nervous 
depression. 

Typhus  and  typhoid  fevers,  if  not  identical,  are  so  similar  in  history 
and  treatment  as  to  make  unnecessarv  their  consideration  under  sep- 
arate heads.  The  following  is  one  of  the  differences  claimed  to  exist 
between  the  two :  namely,  in  typhus  fever,  the  belly  is  flat ;  there  is 
no  marked  disease  of  the  bowels,  and  generally  no  diarrhoea  until  the 
second  or  third  week.  In  typhoid  fever,  on  the  contrary,  sonie  small 
glands,  called  Peter's  ^/anrf.s,  situated  in  the  lower  part  of  the  small 
intestines,  are  always  inflamed,  and  sometimes  ulcerated ;  and,  con- 
sequently, among  the  symptoms  most  frequently  noticed,  are  diar- 
rhoea, and  drum-like  swelling  of  the  belly,  called  tympanites. 

Symptoms. —  The  disease  often  has  precursory  symptoms.  For 
several  days  before  its  actual  beginning,  the  patient  droops.  He  may 
attend  to  his  various  duties,  but  does  not  seem  well ;  he  is  low-spirited 
and  languid ;  is  indisposed  to  any  exertion  of  body  or  mind ;  has 
pains  in  the  head,  back,  and  extremities ;  loses  his  appetite ;  and 
although  dull  and  perhaps  drowsy  in  the  day  time,  his  sleep  is  inter- 
rupted and  unrefreshing  at  night.  The  immediatt?  harbinger  of  the 
fever  is  a  chill,  often  so  marked  as  to  cause  violent  shivering. 

The  history  of  the  first  week  shows  increased  heat  of  the  surface  ; 
frequent  pulse,  ranging  from  eighty  to  one  hundred  and  twenty ; 
furred  tongue  ;  restlessness  and  sleeplessness ;  headache  and  pain  in 
the  back ;  sometimes  diarrluea  and  swelling  of  the  belly ;  and  some- 
times nausea  and  vomiting. 

The  second  week  is  frequently  distinguished  by  an  eruption  of 
small,  rose-colored  spots  upon  the  belly,  and  by  a  crop  of  little  watery 
pimples  upon  the  neck  and  chest,  having  the  appearanei;  of  minute 
drops  of  sweat  standing  on  the  skin,  and  hence  called  suiUimimi,  or 
sweat  drops ;  the  tongue  is  dry  and  black,  or  red  and  sore  ;  the  teeth 
are  foul ;  there  may  be  delirium  and  dulness  of  hearing ;  and  the 
symptoms  generally  are  more  serious  than  during  the  first  week. 
Occasionally,  at  this  period,  the  bowels  are  perforated  or  ate  through 
by  ulceration,  and  the  patient  suddenly  sinks. 

If  i!ie  disease  proceeds  unfavorably  into  the  third  wee^k,  there  is 
low  muttering  and  delirium  ;  great  exhaustion  ;  sliding  down  of  the 
patient  towards  the  foot  of  the  bed  ;  twitching  of  the  muscles  ;  bleed- 
ing from  the  bowels ;  and  red  or  purple  si)ots  upon  the  skin. 

If,  on  the  other  hand,  recovery  takes  place,  the  countenance  bright- 
ens ;  the  pulse  moderates ;  the  tongue  cleans,  and  the  discharges 
assume  the  appearance  they  have  in  health. 

Treutmeut.  —  Give  the  patient  good  air,  and  frequent  spongings 


mon  and 
ds  which 
I  a  Greek 
1  applied 
;  nervoua 

n  history 
ider  sep- 
1  to  exist 
there  is 
until  the 
Me  small 
:he  small 
and,  con- 
are  diar- 


ns.  For 
He  may 
v-spirited 
ind ;  ha.s 
tite ;  and 
is  inter- 
er  of  the 

surface ; 

twenty ; 

pain  in 

lid  soine- 

ption  of 
e  wat«ry 
f  minute 
amirui,  or 
the  teeth 

and  the 
st  week. 

through 

there  is 
n\  of  the 
bleed- 

bright- 
ischarges 

pongingrt 


with  water,  cold  or  tepid,  as  shall  be  most  agreeable  to  his  feelings. 
Keep  the  bowels  in  order;  by  which  is  meant,  be  more  afraid  of 
diarrhcea  than  of  costiveness.  Diarrha>a  should  be  restrained  by  a 
little  brandy,  or  by  small  and  repeated  doses  of  Dover's  powder  (153). 

For  costiveness,  give  injections,  or  the  mildest  aperients  (7)  (10)  (12). 

To  lessen  the  frequency  of  the  pulse,  reduce  the  f«n-er,  and  pro- 
duce perspiration,  give  from  three  to  ten-drop  doses  of  the  tincture  or 
fluid  extract  of  veratrum  viride,  every  hour.  This  remedy  has  grea*" 
power  in  fever. 

Great  wind-swelling  of  the  bowels  may  be  relieved  by  fomenta- 
tions, or  hot,  steaming  applications.  Sometimes  the  wind  may  be 
let  olF  by  introducing  into  the  bowels  a  long  gutta  percha  tube, — 
thus  reducing  the  swelling,  and  greatly  promoting  the  patient's  com- 
fort. 

If  pain  in  the  hoad  be  severe  and  constant,  let  the  hair  be  cut  short, 
and  the  head  be  frecjuently  bathed  with  cold  water. 

Let  the  strength  be  supported  by  light  nourishment;  and  in  case 
of  bleeding  from  the  bowels,  or  great  debility,  by  broth  and  winei 

For  foul  mouth,  the  weakest  possible  infusion  of  old  hyson  tea  is 
valuable.     Good  nursing  is  eminently  desirable. 

If  the  fever  runs  a  low  course,  the  patient  being  much  prostrated, 
quinine,  even  in  large  doses,  may  be  given  from  the  beginning. 

Bilious  Remittent  Fever. 

There  are  three  principal  varieties  of  periodica/  fever,-w\uch,thongn 
varying  considerably  from  each  other,  in  8«?veral  particulars,  are  yet 
essentiuUy,  in  their  substance,  but  one  disease.  These  are  Bilious 
Remit  lent  Fever,  Pernicious  Intermittent  or  Congestive  Fever,  and 
lelermittent  Fever  or  Fetter  and  Agve.  According  to  the  custom  of 
most  writers,  I  sliall  treat  them  separately,  beginning  with  Bilious 
Remittent  Fever. 

Symptoms.  —  The  attack  is  generally  sudden  and  well  marked. 
Some  writers  say  it  has  no  premonitory  symptoms ;  others,  that  it 
has.  The  more  general  understanding  is,  that  for  a  day  or  two,  or 
even  longer,  before  the  onset,  there  is  a  sense  of  languor  and  debility, 
slight  headache,  lack  of  appetite,  furred  tongue,  bitter  taste  in  the 
mouth  in  the  morning,  pains  in  the  joints,  and  general  tineasincss. 

The  formal  onset  is  nearly  always  marked  by  a  distinct  chill,  or  rigor, 
—  sometimes  slight  and  brief;  at  other  times  severe  and  prolonged^ 
The  chill  may  begin  at  the  feet,  or  about  the  shoulder  blades,  or  in 
the  back,  and  thence  run  like  small  streams  of  cold  water  poured  in 
every  direction  through  the  whole  body.  There  is  ^'•ewem%  but  one 
well-marked  chill,  the  returns  of  the  paroxysms  of  fever  being  seldom, 
after  the  first,  preceded  by  the  cold  stage. 

At  certain  periods  of  the  day,  there  is  an  increased  intensity  in  the 
symptoms  of  the  disease,  occasionally  preceded,  though  generally  not, 
by  the  chill.  Between  this  period  of  severity  in  the  feverish  symp- 
toms, and  a  similar  period  which  follows  it,  there  is  generally  decrease 


i^-_- 


412 


DISEASES  OF  THE  GENERAL  SYSTEM. 


in  the  violence  of  the  symptoins,  during  which  the  fever  moderates, 
but  does  not,  as  in  fever  and  ague,  entirely  go  off;  has  distinct  remis- 
sions, but  not  complete  intermissions. 

During  the  hot  stage,  the  pulse  is  up  to  one  hundred  and  twenty,  or 
one  hundred  and  thirty.  There  are  pains  in  the  head,  back,  and  limbs, 
of  a  most  distressing  kind. 

The  tongue  is  generally  covered  with  a  yellowish,  or  a  dirty-white 
fur ;  and  in  bad  cases,  in  the  advanced  stage,  is  frequently  parched, 
brown,  or  nearly  black  in  the  centre,  and  red  at  the  edges.  There  is 
no  appetite  for  food,  and  generally  nausea  and  vomiting ;  and  usu- 
ally there  is  pain  and  tenderness  in  the  epigastrium.  The  bowels  are 
at  arst  costive,  but  afterwards  become  loose,  and  there  are  frequent 
evacuations  of  dark,  offensive  matter. 

Causes.  —  This  disease  is  produced  by  malarial  exhalations  from 
the  decomposition  of  vegetable  matter.  It  is  most  prevalent  in  hot 
climates,  and  in  the  summer  and  autumn. 

Treatment.  —  If  the  fever  be  in  the  formative  stage,  and  have  not 
folly  developed  itself,  give  an  emetic  (1)  (2),  and  follow  it  with  a  mild 
cathartic  (7)  (13). 

If  the  disease  be  already  developed,  sponge  the  body,  all  over,  sev- 
eral times  a  day,  with  cold  or  tepid  water,  accor^iing  to  the  feelings 
of  the  patient,  and  give  cooling  drinks  (132)  (133)  (298)  (299).  To 
moderate  the  fever,  give  three  to  ten-drop  doses  of  tincture,  or  fluid 
extract  ot  veratrum  viride.  The  compound  powder  of  ipecac  aixl 
opium  is  a  valuable  preparation  for  the  same  purpose.  Give  cold 
water  as  drink  if  desired  >^y  the  patient,  or  let  him  eat  ice. 

When  the  headache  is  very  severe,  let  wet  cups  be  applied  upon  the 
temples,  or  behind  the  ears;. and  the  same  remedy  to  the  pit  of  the 
stomach,  when  there  is  great  tenderness,  is  often  desirable ;  though  a 
mustard  poultice  will  sometimes  do  better. 

During  the  remissions  of  the  fever,  quinine,  and  other  tonics  are  to 
be  given,  as  in  fever  and  ague. 

Congestive  Fever.— Pernicious  Intermittent  Fever. 

This  is  the  pernicious,  or  malignant  form  of  malarious  fever.  It  is 
marked,  either  in  the  earlier  or  later  stage,  by  a  rush  of  blood  towards 
one  or  more  organs,  by  which  they  are  crowded  full  and  congested, — 
hence  its  title  of  congestive  fever. 

Symptoms.  —  It  may  be  intermittent,  or  remittent,  —  more  com- 
monly, it  is  the  former.  It  may  assume  any  of  tha  types  of  peri- 
odical fever,  but  it  is  most  frequently  quotidian  or  tertian. 

The  first  attack  does  not  differ  very  materially  from  a  common 
attack  of  simple  intermittent  The  first  paroxysm  is  simple,  exciting 
but  little  attention.  The  second  is  always  severe,  producing  great 
coldness,  and  a  death-like  hue  of  the  face  and  extremities.  The 
advancement  of  the  disease  brings  dry,  husky,  parched,  and  pun- 
gently  hot  skin,  followed,  after  a  time,  by  a  cold,  clammy  sensation^ 


loderates, 
ict  remis- 

wenty,  or 
nd  limbs, 

rty-white 

parched. 

There  is 

and  usu- 

owela  are 

frequent 

ons  from 
nt  ill  hot 


have  not 
ith  a  mild 

over,  sev- 
B  feelings 
!99).  To 
,  or  fluid 
ecac  aiKl 
jrive  cold 

upon  the 

pit  of  the 

though  a 

lies  are  to 


Fever. 

^er.  It  is 
1  towards 
jested,  — 


ore  corn- 
8  of  peri- 
common 
',  exciting 
ing  great 
les.  The 
and  pun- 
sensatioa* 


DISEASES  OF  THE  GENERAL  SYSTEM. 


413 


The  eyes  are  dull,  watery,  and  sometimes  glassy;  the  countenance 
dull,  sleepy,  distressed ;  the  tongue,  at  first  white,  changes  to  brown 
or  black,  and  is  usually  tremulous ;  the  breathing  is  hurried  and  diffi- 
cult. Pressure  over  the  liver,  stomach,  or  bowels,  produces  pain. 
The  mind  is  often  disturbed,  and  falls  into  lethargy  and  stupor,  or  is 
delirious. 

Treatment  —  This  should  be  very  much  like  the  treatment  of  the 
bilious  remittent  fever. 

While  getting  up  from  the  fever,  the  diet  must  be  light  and  nutri- 
tious at  first,  but  may  be  increased  in  quantity  as  the  strength  returns. 
Exercise  out  of  doors  must  not  be  omitted.  If  recovery  be  slow, 
some  mild  tonic,  or  a  little  wine,  or  ale,  or  brandy,  may  be  taken  two 
or  three  times  a  day. 

Fever  and  Ague. ^Intermittent  Fever. 

This  is  a  kind  of  fever  in  which  there  is  a  succession  of  attacks 
with  equal  intervals,  and  intermissions  that  are  complete  but  unequal, 
on  account  of  the  uncertain  duration  of  each  fit 

An  interval  is  the  poriod  of  time  between  the  beginning  of  one  fit, 
and  the  beginning  of  the  next. 

An  intermission  is  \\w  period  of  time  between  the  close  of  one  fit, 
and  the  beginninji;  of  ihe  next. 

The  diflerent  varieties  of  ague  take  their  designation  from  the 
lon«rth  of  the  interval  in  each  case. 

Th(!  interval  of  a  quotidian,  or  daihj  ague,  is  twenty-four  hours 

The  interval  of  a  ttrtian,  or  third-datj  ague,  is  forty-eight  hours. 

The  interval  of  a  quartan,  or  fourth-day  ague,  is  seventy-two  hours. 

SymptoniH. —  The  disease  first  develops  itself  by  an  agve  fU.  This 
has  three  stages,  the  cold,  the  hot,  and  the  sweating.  The  cold 
stage  is  very  marked.  The  patient  ha  a  sense  of  a  debility,  yawns, 
Btretches,  has  no  appetite,  and  does  not  wish  to  move.  The  face  and 
extremities  become  pale,  the  skin  shrinks,  causing  universal  horripila- 
tion, or  goose-Jlesh ;  the  patient  shakes,  and  his  teeth  chatter. 

After  a  time,  these  symptoms  decline,  and  the  hot  stage  comes  on, 
which  is  characterized  by  high  fever,  with  its  various  uncomfortable 
sensations. 

When  this  fever  passes  off,  it  is  followed  by  the  sweating  stage, 
during  which  a  moisture  breaks  out  which  increases,  frequently,  to  a 
profuse  sweat;  the  body  returns  to  its  natural  temperature,  thu  pains 
and  aches  disappear,  and  a  f(;eling  of  health  comes  back. 

During  the  cold  stage,  the  blood  is  driven  inward  from  the  surface, 
and  particularly  o|)presses  the  spleen,  which,  in  eases  of  long  standing, 
becomes  swelled  and  permanently  enlarged.  This  swelling  may  be 
plainly  felt,  and  is  often  quite  perceptible  to  the  eye.  It  is  called 
o^'-we  cake. 

Agub  fits  begin  at  different  hours  of  the  day,  and  generally  termi- 
nate in  tho  evening. 


A. 


!(" 


I: 


Is  s>^ 


■   i  I 


:^V 


'f     I 


414 


DISEASES  OF  THE  GENERAL  SYSTEM. 


A  quotidian  usually  begins  in  the  morning ;  a  tertian  at  noon ;  and 
a  quartan  in  the  afternoon. 

The  cold  stage  is  shortest  in  the  quotidian,  and  longest  in  the 
quartan. 

Thus  the  longest  fit  has  the  shortest  interval,  and  the  shortest  cold 
stage  ;  while  the  shortest  fit  has  the  longest  interval,  and  the  longest 
cold  stage. 

There  are  also  double  tertians  and  double  quartans,  wliercin  the 
fits  repeat  themselves,  —  sometimes  the  same  day,  at  other  times  on 
alternate  days. 

To  these  varieties,  the  terms  postponing  and  anticipating  are  ap- 
plied, according  as  the  intervals  a*  j  growing  longer  or  shorter.  When 
a  person  is  recovering  from  ague,  the  interval  may  gradually  grow 
longer,  the  attack  being  pat  off.,  or  postponed.  But  if  the  disease  be 
increasing  in  severity,  the  attack  may  anticipate  its  usual  period,  mak- 
ing the  interval  shorter. 

Tertians  are  more  common  than  either  quotidians  or  quartans. 

Agues  are  more  prevalent  in  spring  and  autumn.  Fall  agues  are 
most  severe  and  dangerous. 

Causes.  —  Exlialations  from  the  soil,  called  malaria,  arising  from 
decomposition  of  vegetable  matter  in  new  countries,  or  from  low  and 
marshy  districts  in  which  the  land  is  alternately  covered  with  water, 
and  again  left  dry  and  exposed  to  the  sun. 

In  districts  where  it  prevails,  high  hills  are  exempt^  and  even  the 
upper  stories  of  houses  are  more  healthy  than  the  lower. 

Treatment. —  First  clear  the  bowels  with  the  fluid  ex  "-act  of  senna 
(15),  or  the  preparation  (21).  Then,  in  the  cold  stage,  ^'ive  hot,  and 
in  souie  cases,  stimulating  drinks.  Administer  hot  foot  baths,  and, 
putting  the  patient  in  bed,  apply  bottles  filled  with  hot  water  to  the 
feet,  sides,  and  back,  and  in  every  way  try  to  excite  warmth  and 
comfort. 

In  the  hot  stage,  give  cooling  drinks,  and  opium  (117)  (118)  in  de- 
cided doses  ;  or,  what  is  better,  quinine  (67)  in  two  teaspoonful  doses 
every  half  hour,  at  the  same  time  giving  five-drop  doses  of  tincture  or 
fluid  extract  of  veratrum  viride  every  hour. 

During  the  sweating  stage,  stop  the  veratrum,  and  rub  the  patient 
with  dry  towels. 

In  the  intermission,  give  quinine  (62),  in  three-grain  doses,  once  in 
three  or  four  hours,  and  continue  it,  gradually  increasing  the  dose,  a 
fortnight  after  the  cessation  of  the  attacks.  The  following  is  a  good 
preparation:  quinine,  one  scruple;  elixir  of  vitriol,  one  dram;  dis- 
solve the  quinine  in  the  elixir,  and  add  tincture  of  black  cohosh,  four- 
teen drams.  Twenty  drops  are  to  be  given,  in  a  little  water,  once  an 
hour. 

The  web  of  the  black  spider,  rolled  up  into  five-grain  pills,  and 
taken,  one  pill  at  a  time,  once  in  two  hours  during  the  intermission, 
is  said  to  cure  many  cases. 

It  is  important^  in  fever  and  ague  districts,  to  avoid  the  hot  sun, 
and  the  damp  evening  and  morning  air. 


*il 


on;  and 

t  in  the 

est  cold 
I  longest 

rt'in  the 
times  on 

are  ap- 

When 

lly  grow 

laease  be 

od,  niak- 

ans. 
igues  are 

mg  from 

low  and 

:h  water, 

even  the 

of  senna 

hot,  and 

ths,  and, 

r  to  the 

mth  and 

)  in  de- 
ul  doses 
iicture  or 

patient 

once  in 

dose,  a 

a  good 

am;  dis- 

>sh,  four- 

once  an 

tills,  and 
-mission, 

hot  sun, 


DISEASES  OF  THE  GENERAL  SYSTEM. 


415 


Tellow  Fever. 

This  disease  belongs  to  warm  climates,  being  most  prevalent  in 
Sonthern  cities.  It  makes  its  appearance  chiefly  in  the  latter  part  of 
summer,  and  disappears  upon  the  approach  of  frosty  weather. 

Symptoms.  —  The  complaint  begins,  generally,  with  a  chill,  which 
JB  sometimes  severe,  though  commonly  moderate,  of  short  duration, 
and  rarely  repeated. 

Following  this  chill,  there  is  moderate  fever,  and  a  little  heat  of 
surface ;  but  this  rarely  rises  to  any  considerable  height,  and  only 
continues  to  the  second  or  third  day,  when,  in  fatal  cases,  it  gives 
place  to  coldness  of  surface,  etc.     In  many  cases  there  is  sweating. 

The  pulse  is  peculiar, —  not  easily  described,  —  generally  not  rising 
above  one  I  indred  in  a  minute,  —  a  kind  of  bubble  under  the  finger, 
which  breaKS  and  vanishes  before  it  can  be  fairly  felt. 

The  tongue  is  moist  and  white  in  the  first  and  second  days,  but 
red,  smooth,  shining,  and  dry,  as  the  disease  advances  towards  the 
close,  having  a  dry,  black  streak  in  the  middle. 

The  most  striking  symptoms  are  nausea  and  vomiting.  The  vom- 
iting, in  fatal  cases,  is  generally  very  persistent,  and  towards  the  ter- 
mination, the  yellowish  or  greenish  matters  thrown  give  place  to  thin 
and  black  fluid,  having  a  sediment  looking  like  coffee-grounds.  This 
is  called  the  black  vomil. 

The  bowels  are  generally  costive,  with  frequent  epigastric  tender- 
ness and  distress.  There  is  generally  severe  headacht;,  and  a  pecu- 
liar expression  of  countenance,  in  which  the  lips  smile,  but  the  rest 
of  the  face  is  fixed  and  sad,  sometimes  wild.  The  patient  continues 
wakeful,  night  and  day.  There  are  discharges  of  blood,  often,  from 
the  nose,  the  gums,  the  ears,  the  stomach,  tlie  bowels,  and  the  urinary 
passages. 

Treatment.  —  First,  move  the  bowels  with  some  mild  physic  (40) 
(18)  (19)  (41)  (37). 

During  the  chill,  put  the  feet  in  a  mustard  bath  (242),  g,  'e  warm 
cordial  drinks,  and  apply  hot  bottles  etc.,  externally. 

Cups  may  be  applied  to  the  back  of  the  neck,  or  over  the  stomach, 
according  to  circumstances. 

During  the  second  stage,  or  stage  of  calm,  nothing  is  to  be  done 
but  give  some  light  stimulants,  and  to  promote  sweating  by  warm 
lirink.',  and  tincture  of  veratrum  viride  ;  and  also  quinine  (02). 

The  third  and  severest  stage  is  to  be  met  by  stimulants,  as  brandy, 
freely  given,  with  a  continuance  of  the  quinine. 

During  the  fever  stage,  and  for  the  vomiting,  give  creosote,  twenty 
drops  to  six  ounces  of  spirits  of  Mindererus,  and  alcohol  enough  to 
dissolve  the  creosote.  The  dose  is  half  an  ounce  every  two  hours. 
Said  to  be  excellent  for  putting  o  -cop  to  the  retching  and  vomiting. 

Cleanliness,  temperance,  and  cheerfulness,  are  essential  in  warding 
off  the  disease  when  one  is  exposed  to  its  cause. 


416 


DISEASES  OF  THE  GENERAL  SYSTEM. 


Rheumatism. 

This  is  an  inflammation  of  a  peculiar  character,  being  caused  by 
acid  or  poisonous  matter  in  the  blood,  and  having  for  its  seat  the 
fibrous  tissue^  or  that  thready  texture  which  enters  largely  into  the 
composition  of  the  cords  and  muscles  of  the  human  body.  The 
synovial,  or  lining  membrane  of  joints,  is  also  peculiarly  subject 
to  rheumatic  inflammation.  Hence  the  terms,  fibrous  rheumatism, 
and  synovial  rheumatism.  There  are  also  acute  and  chronic  rheu- 
matism. 


Acute  Rheumatism 

Is  a  very  painful  aflection.  It  is  most  frequently  brought  on  by 
exposure  to  wet  and  cold  after  violent  and  fatiguing  exercise  of  the 
muscles. 

Symptoms. —  Its  principal  characteristics  are,  high  fever,  with  a 
full,  bounding  pulse ;  furred  tongue ;  profuse  sweat,  which  has  a  sour 
smell,  and  seems  to  increase  the  weakness  without  relieving  the 
pain  ;  scanty  and  high-colored  urine,  with  brick-dust  settlings ;  and 
swelling  of  the  joints,  with  slight  redness,  great  tenderness,  and  severe 
pain,  which  is  particularly  agonizing  when  the  patient  attempts  to 
move. 

This  aflection  often  changes  suddenly  from  one  part  of  the  body  to 
another,  or  from  one  set  of  joints  to  another.  This  sudden  shifting, 
termed  metastasis,  is  peculiarly  dangerous  ;  for  sometimes  the  inflam- 
mation, seeming  to  regard  the  constantly  moving  heart  as  a  large 
central  point,  suddenly  seizes  upon  its  lining  membrane,  and  occasion- 
ally proves  speedily  fatal. 

Treatment.  —  It  is  well  first  to  open  \.ie  bowels  freely  with  the 
compound  powder  of  leptandrin,  or  the  compound  powder  jalap. 
Then  give  tincture  of  black  cohosh  and  tincture  of  veratrum  viride 
(124),  and  push  the  preparation  to  the  extent  of  producing  sweating. 
This,  if  no  evil  effects  seem  to  result  from  it,  that  is,  no  prostration  or 
bad  feelings  in  the  head,  may  be  kept  up  till  the  violence  of  the  dis- 
ease abates. 

Sometimes  opium,  nitrate  of  potash,  etc.  (127),  administered  one 
or  more  times,  will  have  a  good  efl'oct. 

The  tincture  of  black  cohosh  root,  two  parts,  and  the  tincture  of 
colchicum  rpot,  one  part,  and  given  in  doses  of  forty  drops,  is  a  valu- 
able remedy. 

For  articular  rheumatism,  iodide  of  potassium,  one  dram,  and 
morphia,  one  grain,  dissolved  in  one  ounce  of  water,  and  given  three 
or  four  times  a  day,  in  two  teaspoonful  doses,  are  said  to  have  the 
power  of  shortening  the  disease. 

It  is  a  valuable  treatment,  after  clearing  the  bowels  with  salts  and 
senna,  to  give  equal  parts  of  wine  of  colchicum  and  spirits  of  tur- 


DISEASES  OP  THE  GKNKUATi  STii^TEM. 


417 


pentine  in  doses  of  ten  drops  every  two  or  three  hours ;  and  after  a 
clay  or  two,  to  give,  in  connection  with  the  above,  at  intervals  of  five 
hour8,  tincture  of  chloride  of  iron,  ten  drops,  with  ten  to  twenty  drops 
of  laudanum. 

Fomentations  of  hops  and  cicuta,  or  stramonium  leaves,  placed 
upon  the  inflamed  and  swollen  joints,  will  have  a  good  eflect  in 
relieving  the  pain.  The  recent  leaves  of  stramonium,  pounded,  mixed 
with  a  little  water,  and  laid  upon  the  joints,  is  said  to  act  very 
favorably.     (See  p.  880.) 

Chronic  Rheumatism. 

Thk  chronic  form  of  rheumatism  may  follow  the  acute  as  its  conse^ 
quence,  but  is  more  oft<ni  an  independent  disease.  It  is  seldom  at- 
tended by  fever,  and  in  this  difTers  from  the  acute  rheumatism.  It 
often  lasts  a  long  time,  and  causes  much  suffering. 

Symptoms.  —  These  are  various,  but  are  generally  understood,  even 
by  the  common  people,  to  consist  of  pain,  lameness,  stiffness,  etc.,  in 
the  joints  and  other  parts.  The  joints  are  often  swollen,  but  not  as 
much  as  in  the  acute  disease.  It  is  peculiar  to  this  form  of  the  com- 
plaint,  that  when  the  patient  remains  at  rest  for  a  time,  he  will  have 

Eain  and  stiffness  in  the  affected  part  on  beginning  to  move,  but  aa 
e  grows  warm,  both  will  disappear. 

Treatment.  —  This  complaint  is  often  palliated,  and  sometimes 
cured,  by  passing  a  current  of  electro-magnetism  through  the  affected 
part. 

The  tincture  or  the  fluid  extract  of  black  cohosh,  taken  in  full 
doses,  is  one  of  the  best  remedies.  It  may  be  taken  alone,  or  mixed 
with  the  tincture  of  poke-berries,  and  a  tincture  of  prickly-ash  bark* 
if  convenient. 

Opium  and  nitre  (127)  form  a  valuable  remedy.  Colchicom  ia 
much  used,  and  has  a  deservedly  high  reputation  (292)  (301). 

Liniments  often  have  a  good  effect  (190)  (195)  (196)  (198).  It  is 
well  to  wear  a  piece  of  oiled  silk  over  the  afi'ected  part.  It  keeps  np 
a  gentle  perspiration  from  the  rheumatic  surface,  and  materially 
hastens  a  cure. 

To  bathe  the  affected  joint  at  bed-time  with  hot  sweet  oil,  and  then 
envelop  it  in  cotton  batting,  to  be  Kept  on  through  the  night,  will 
often  give  much  relief. 

The  bowels  must  be  kept  regular,  and  all  exposure  to  wet  feet  or 
clothes,  and  to  currents  of  cool  air  when  sweating,  must  be  carefully 
shunned. 

Gont. 

Gout  is  rheumatism's  cousin  ;  the  parentage  of  both  belong  to  the 
brotherhood  of  the  adds. 

A  very  acid  state  of  the  blood,  or  a  state  favorable  to  the  forma- 
tion of  acid,  is  supposed  to  be  the  cause  of  the  inflammation  peculiar 

63 


418 


DISEASES  OF  THE  GENERAL  SYSTEM. 


to  both  these  disorders.  In  rheumatism,  an  acid  which  exists  in  sonr 
milk,  and  in  cider,  called  lactic  acid,  la  thought  to  be  the  disturbing 
element.  In  gout,  lithic  or  uric  aci<i  is  known  to  be  uncommonly 
abundant,  and  to  form  a  principal  ingredient  of  those  concretions, 
found  in  gouty  joints,  and  familiarly  call(xl  chaf/C'Sfones. 

The  larger  joints  are  most  often  uH'ected  by  rheumatism ;  while 
gout  prefers  the  smaller  ones.  In  rheumatism,  the  pain  is  excruciat- 
ing;  in  gout,  it  is  intolerable.  There  is  truth  in  the  humorous 
Frenehman's  description  of  the  pains  of  these  two  complaints,  which 
is,  in  substance,  as  follows:  Piiiee  your  joint  in  a  vice;  turn  the 
screw  till  you  can  bear  it  no  longer;  that  gives  yon  an  idea  of  rheu- 
matism ;  now  give  the  instrument  one  more  turn,  and  you  have 
gout 


Syniptom.s. —  A  fit  of  the  gout,  as  it  is  called,  generally  makes  its 
attack  in  the  night.  Its  unsuspecting  victim  is  lirst  awiikened,  per- 
haps an  hour  or  two  after  midnight,  by  an  intensely  burning,  wrench- 
ing pain  in  the  ball  of  the  great  toe,  or  some  other  small  joint.  This 
pain,  with  its  accompanying  symptoms  of  fever,  continues  with  little 
abatement  for  twenty-four  hours.  There  is  then  a  distinct  remission, 
when  the  sufferer  may  get  some  sleep.  He  has  a  similar  experience 
during  several  succeeding  days  and  nights,  when  tli  ■  disease,  which 
has  been  growing  milder,  leaves  him. 

After  a  considerable  interval,  there  is  likely  to  bi  another  similar 
visitation.  The  length  of  this  interval  is  inversely  as  the  number  of 
attacks,  —  that  is,  it  diminishes  in  length  as  the  attacks  increase  in 
number;  in  yet  plainer  and  more  homely  terms,  the  attacks  come 
"thicker  and  faster;"  the  space  between  them  gradually  shrinking 
from  three  or  four  years  to  one  or  two  months. 

Recovery  from  tlie  first  attack  may  be  complete,  —  the  skin  peeling 
off  from  the  red  and  swollen  joint,  and  leaving  it  strong  and  supple 
as  ever.  But,  after  several  repetitions  of  the  inllamniaiion,  the  joint 
becomes  stiff,  its  motions  being  obstructed  by  the  dt'posit  of  lithic 
acid  concretions,  or  chalk-stones.  The  limbs  are 
sometimes  actually  frosted  over  with  crystals  of 
urate  of  soda  (Fig.  143).  This  form  of  urate  of 
soda  crystals  differs  very  materially  from  Fig.  122. 
When  these  crystals  appear  upon  the  surface,  and 
deposits  are  made  in  the  joints,  uric  aeid  is  not 
secreted  as  usual  by  the  kidneys,  but  accumulates 
in  lid  blood. 

But  gout  is  a  disease  by  no  means  entirely  local 
in  its  character.  It  vitiates  the  blood,  affects  the  system  generally, 
and  is  often  betrayed  by  general  symptoms  long  before  the  local  mis- 
chief is  indicated  by  one  of  the  attacks.  Irritability  of  temper,  un- 
pleasant sensations  in  the  stomach  and  head,  and  various  uncomfort- 
able feelings  of  body  and  mind,  have  been  considered  as  premonitory 
of  this  disorder.  Many  other  organs  also,  beside  joints,  are  subject  to 
the  gouty  inflammation.  The  stomach,  heart,  lungs,  head,  and  even 
the  eyes,  are  known  to  have  been  thus  affected. 


Kio.  14a 


in  Bonr 
iturbing 
nmonly 
^retions, 

i;  while 
ccruciat' 
amoroua 
s,  which 
turn  the 
of  rheu- 
ou  have 


nakes  its 
ncd,  per- 
wrench- 
it.  This 
>vith  little 
•emission, 
xpericnce 
Lse,  which 

er  similar 
lumber  of 
icrease  in 
cks  come 
shrinking 


m 


peeling 
id  supple 
,  the  joint 

of  lithic 

143. 


generally, 

local  mis- 

tmper,  un- 

lincomfort- 

jmonitory 

I  subject  to 

and  even 


DISEASES  OP  THE  OENEllAL  SYSTEM. 


41H 


Causes.  —  Luxury  and  indolence,  —  particularly  the  former,  • 
regarded  as  the  principal  causes  of  gout. 


aru 


Treatment. —  Colchicum  is  the  remedy  for  gout  It  removes  the 
disease  by  exciting  the  kidneys  to  action,  so  that  the  poison  is  con- 
veyed ..way  in  tlie  urine.  Perhaps  it  acts  in  some  other  unexplained 
way,  as  an  antidotes  to  the  disease.  One  teaspoonfid  of  the  wine  of 
colchiciun  may  l»t  tala-n  two  or  three  times  a  day,  until  relief  is  ex- 
perienceil.  It  should  then  be  contiinied,  in  ten-drop  doses,  for  a  few 
days  longer,  to  prevent  a  relapse.  The  colchicuni  may  be  taken  in 
the  form  of  prescription  (oOl). 

Codec,  drank  freely  every  day,  is  said  to  be  a  sov«!rei<^n  remedy 
for  gout.  It  is  also  declared  to  be  excellent  for  jj;ravcl,  —  a  fact 
which  i  forgot  to  mention  when  treating  of  the  ailections  of  the 
kidneys,  etc. 

The  bowels  must  be  kept  in  order,  but  not  actually  purged  (3-1) 
(40).     'J'lie  diet  nmst  be  simple  and  unstimulating. 

Let  the  indamed  joint  be  bathed  often  in  a  saturated  solution  of 
bicarbonate  of  soda  in  soft,  warm  water.  Colo  applications  should 
not  be  made,  as  there  is  danger  of  provoking  a  sudden  change  of  the 
inflammation  to  some  internal  organ. 

Scrofula.— King's  EviL 

This  disease  was  once  thought  to  be  peculiar  to  swine,  and  hence 
derived  its  name  from  scrofii,  a  sow.     It  shows  itself  in  various  forms, 

—  as  hip  disease,  white  swelling,  rickets,  salt-rheum,  etc  Persons 
aflfeeted  by  it  are  subject  to  swelling  of  the  glands,  particularly  those 
of  the  neck. 

Symptoms. —  In  the  beginning  of  the  disease,  small,  hard,  movable 
kernels  appear  about  the  neck,  just  under  tlie  skin.  These  are  lym- 
phatic glands,  and  the  swelling  generally  takes  place  long  before  there 
is  any  soreness,  or  perceptible  redness.  Tliey  may  be  felt  under  the 
skin ;  and,  in  the  course  of  six  months  or  a  year,  may  grow  to  the 
size  of  a  filbert,  or  even  a  hen's  egg.  Sometimes  they  are  much 
larger  even  than  this,  and  very  hard.  They  may  appear  in  many 
other  parts  beside  the  neck. 

After  a  time,  though  very  slowly,  they  come  to  a  head,  and  break, 

—  discharging  a  wat,ery  fluid,  or  a  mixture  like  whey  and  curd.  They 
are  seldom  very  sore.  When  they  heal,  they  are  apt  to  leave  a  puck- 
ered condition  of  the  skin,  and  ugly  scars. 

The  scrofulous  humor  may  sometimes  afTect  the  eyes,  when  the 
lids  will  become  red  and  thick,  and  discharge  mucus  and  water  ;  — 
the  under  lid  sometimes  turning  out,  and  presenting  a  shocking 
spectacle. 

The  scrofulous  condition  is  generally  supposed  to  be  indicated  by 
a  white,  delicate  skin,  thick  lips,  light  hair,  and  a  delicate  constitu- 
tion ;  but  these  signs  are  not  worthy  of  much  confidence. 

The  disease  often  attacks  the  cellular  tissue,  causing  numerous 


420 


DISl^ASKS  OV  TIIK  OKNKRAL  SYSTEM. 


»*t; 


Buppurationn  and  abi^cRssng.  It  abo  affects  the  bones,  producing 
cari(>t«,  necroHis,  uiid  other  affections.  It  tthows  itHelf  in  certain  in> 
flainmations  of  the  vyen,  in  the  formation  of  running  tioruii  in  the 
ears,  and  in  various  otht'r  ways. 

CaUMeM. —  It  is  contended  by  some,  that  Hcrofula  is  in  all  cases 
inherited  ;  that  we  receive  it  iroiii  our  progenitors,  as  we  do  their 
other  constitutiotuil  peculiarities  ;  that  the  disease  is  everywhere,  and 
in  all  time,  one  and  the  same,  wliicrh  shows  it  to  come  from  within, 
and  not  from  without ;  that  were  it  dependent  on  external  causes  for 
its  existence,  it  would  be  greatly  modified  by  temperature,  climate^ 
and  the  pecruliarities  of  the  races  affected  by  it. 

They  assert  that  though  the  causes  which  are  usually  assigned 
for  scrofula,  such  as  livmg  in  cold,  damp,  and  impure  air,  and  the 
lack  of  suliicient  food,  connected  with  filthy  habits,  often  have  a 
powerful  effect  in  developing  scrofula  already  existing  in  the  con- 
iititution,  and  of  aggravating  it  when  already  developed ;  it  never 
produces  it. 

How  far  these  statements  are  to  be  received,  I  will  not  undertake 
to  judge.  It  is  certain  that  the  disease  is  often  inherited  ;  and  if  we 
admit  that  the  other  caus(!s  named  have  some  share  in  its  production, 
it  is  possible  we  may  not  go  entirely  astray.  Yet  my  own  strong 
suspicion  that  scrofula  arises  from  the  animal  poison  of  syphilis,  fii- 
tered  through  the  blood  of  many  generations,  inclines  me  to  the  adop- 
tion of  the  above  views. 

Treatment.  —  In  olden  times  of  superstition,  this  disease  was  be- 
lieved to  be  cured  by  the  patient  coming  into  the  presence  of  the 
king,  and  being  touched  by  his  royal  hand.  The  ceremony  was 
called  the  *<  sacred  touch."  It  was  from  this  that  the  disease  took 
its  name  of  **  king's  evil."  This  superstition  reached  its  height  in 
the  reign  of  Charles  II.  After  the  Restoration,  the  numbers  who 
flocked  to  Whitehall  and  Windsor  to  receive  the  "  touch,"  are  said  to 
have  been  immense,  —  no  less  than  ninety-two  thousand  in  twelve 
years ;  and  the  writers  of  that  day  declare  that  none  failed  to  receivo 
benefit 

In  modern  times,  believing  that  the  ceremony  of  the  touch  waa 
best  adapted  to  the  period  when  kings  were  thought  to  have  sacred 
persons,  we  rely  for  the  cure  of  this  disease,  upon  rational  medicinft 
and  hygiene. 

The  medical  treatment  of  it  is  constitutional  and  local. 

Iodine  is  the  great  remedy  for  scrofula.  Dissolve  one  scruple  of 
iodine  and  two  scruples  of  iodide  of  potassium  in  seven  teaspoonfuls 
of  water.  Of  this,  give  ten  drops  three  times  a  day,  in  a  little 
water,  gradually  increasing  the  (lose  to  once  and  a  half  or  twice 
that  amount  The  iodide  of  potassium,  as  in  prescription  (101),  is  a 
good  remedy. 

Where  there  is  considerable  debility,  the  iodide  of  iron,  in  doses 
of  twenty-five  or  thirty  drops,  in  water,  three  times  a  day,  is  a  good 
preparation. 


roducing 
Tlaiii  in- 
;i}  in  the 


all  caaes 
do  their 
here,  and 
n  within, 
lauses  for 
I,  climate, 

assigned 
,  and  the 
ti  have  a 
the  con- 
it  never 

undertake 
and  if  we 
roduction, 
vn  strong 
^philia,  fii- 
the  adop- 


wa»  be- 

ice  of  the 

nony  waa 

tease  took 

height  in 

nben  who 

ire  said  to 

in  twelve 

to  receive 

touch  waa 
ave  sacred 
il  medicintt 


scruple  of 
>aspoonful8 
in  a  little 
f  or  twice 
(101),  is  a 

n,  in  doses 
f,  is  a  good 


The  compound  syrup  of  yellow  dock  root,  and  the  compound 
syrnp  of  stiilingia,  taken  sometimes  ulune,  and  at  other  times,  with 
two  to  five  grains  of  iodide  of  potassium  in  each  dose,  arc  both  ex- 
cellent medicines  for  stTofulu. 

The  bowels  nmat  be  kept  open  by  laxative  food,  or  in  the  failure 
pf  this,  by  some  gentle  physic  (12). 

Medicinal  springs,  pariieularly  those  confaining  io<line,  are  ex- 
cellent. 

Before  the  tumors  become  very  sore,  let  them  be  bathed  several 
times  a  day  with  a  solution  of  nmriate  of  lime,  or  ammonia,  or  soda, 
two  drams  to  the;  ounce  of  water.  When  they  are  iiiilamed,  apply 
poultices  of  ground  slippery  elm  and  powdered  bayberry,  e<juid  parts. 
Powdered  poke-root,  or  blue-Hag  may  be  substituted  for  the  baybi'rry. 
If  these  things  are  not  at  hand,  use  white  bread  and  milk,  or  flax-seed 
poultices. 

When  the  tumors  have  opened,  and  ulcers  have  formed,  the  ulcers 
must  be  washed  out  with  soap  suds,  and  dressed  with  salve  ttiade  of 
beeswax  and  sweet  oil;  or,  when  the  ulcers  are  indolent,  with  the 
red  iodide  of  mercury  ointment.  Ia'X  the  dressing  be  changed  two 
or  three  times  a  day. 

(Jreat  attention  should  be  paid  to  the  improvernt!nt  of  the  general 
health.  The  diet  must  be  ample  and  nourishing,  —  consisting  of  fresh 
meat,  poultry,  brotns,  soups,  milk,  and  wholesome  vegetables  in  such 
variety  as  the  st'uson  allows. 

The  skin  must  be  washed  daily  with  cool  water  and  spirit,  or  water 
and  salenitus ;  and  fubbed  to  redness  witli  a  coarse  towel,  or  flesh 
brush.  Either  flannel  or  silk  should  be  worn  next  the  skin,  summer 
and  winter. 

Kxereise  must  be  regular,  and  eheerfully  performed,  in  the  open  air. 
If  the  residence  be  in  a  damp  and  unhealthy  air,  it  should  be  <'hanged 
at  once,  if  possible.  In  any  ease,  a  ehaii<^e  of  residence,  from  time  to 
time,  when  travelling  is  not  possible,  is  nau;h  to  be  desired. 

Scurvy.  —  Scorbutus, 

Owing  to  a  better  knowledge  of  this  disease,  and  of  its  proper 
treatment,  it  is  much  less  common  than  in  ft)rmer  years.  It  t;hi''lly 
afi'ects  seamen  who  make  long  voyages ;  but  is  not  entirely  unHnovvn 
on  land. 

Syiiipt4)ins.  —  Languor,  loss  of  strength,  and  great  depression  of 
mind,  are  among  the  first  signs  of  scurvy.  To  one  about  being  at- 
tacked, work  and  j)lay  are  alike  burdensome.  There  is  no  heart  even 
to  move.  The  face,  and  the  whole  skin,  look  pale  and  bloated,  and 
the  breath  has  a  fetid  smell.  The  gums  are  swelled,  soft,  red,  and 
spongy;  and  they  bleed  upon  the  slightest  touch, —  sometimes  the 
blood  oozes  from  them  spontaneously.  The  teeth  get  loose,  and 
often  fall  out.  The  skin  becomes  covered  with  bluish  or  purple 
spots,  —  looking  precisely  like  bruises.  These  spots  spread  and  run 
into  each  other,  forming  large  patches  of  discoloration. 


I  I 


422 


r/ISEASKS  OF  THE  GENERAI,  SYSTEM. 


These  spots  appear  to  be  formed  by  the  bursting  of  the  small  capil- 
larieei  of  the  veins  and  arteries,  which  have  grown  too  weak  and  rot- 
ten to  hold  tlirir  contents,  and  the  infiltration  of  dissolved  blood  into 
the  cellnlar  .-iubHtaiiee  under  the  skin. 

Ulcerous  sores  break  out  in  various  parts  of  the  body,  which  smell 
badly,  and  UMcharge  a  thin  matter.  These  uleer.s  are  covenrd  with  a 
crust.  Various  parts  of  the  luxly,  the  l)on('s  included,  an;  twinged 
with  })!iins.  Ti^e  pulse  is  weak  and  soft,  All  the  secretions,  includ- 
ing thtMirinc.  hav*-  ail  olftMisivc  smell,  —  us  though  the  whole  body 
were  approaching  putridity.  In  truth,  the  whole  man  s«;ems  to  he 
disintegratinj;;,  decaying ;  the  llcsh  becomes  soft,  and  dwindles  ;  and 
tin'  bdines  brt-ak  easily,  —  being  alHicttid  with  a  decay  approaching  to 
rottenness. 

In  bad  cast's,  blood  is  discharged  from  tlu;  bladder,  bowels,  womb, 
nose,  and  nioutli ;  and  the  smallest  exertion  is  followed  i)y  fainting, 
atid  in  many  cases,  by  sudden  death. 

^'sMlsOH. —  The  disease  is  owing  to  thi'  use  of  Ibod  and  drink  begin- 
ning to  he  decomposed,  and  to  living  long  at  sea  without  vegetal)les 
(rontaining  certain  acid-.  Its  attacks  arc  likewisi*  encouraged  by 
what(,'vcr  weakens  antl  depresses  the  nervous  system,  —  as  long  expos- 
wre  to  a  moist,  damp  air,  particularly  when  this  is  comiccted  with 
confmrment  on  board  a  ship,  uncle;ui  linen*,  (xvasional  loss  of  the 
usual  rest,  and  great  falii.Mie,  as  in  storms,  'i'lie  force  of  these  causes 
is  increased  by  the  loneliness,  the  sadness,  and  the  despomh'iicy  of 
the  sailor's  life. 

Treatment. —  Sailors  are  very  mueli  protectee'  from  the  disease 
now,  by  frequi-nt  returns,  to  land,  during  lon«^  voyages,  to  procure 
fresh  meats,  vegetables,  an<i  vkatcr.  'J'liis  pracfice  is  very  generally 
adopted,  particularly  by  o»ir  whale  ships,  which  nnike  long  voyages; 
and  the  result  is,  very  little  scurvy,  and  general  health  among  the 
men. 

One  of  the  best  medieines  for  the  di.sease  is  (piinin<: ;  it  maybe 
givc/i  in  from  one  to  two-grain  doses  twice  or  tliret;  tintes  a  day, 
(ientian  and  (jnassia  are  also  suitable  remedies  ;  so  is  the  muriatic 
tincture  of  i/ou  (7')). 

Hut  the  best  of  all  remedies  are  fresh  jmkI  succulent  vegetables,  and 
also  fruits.  Spiuage,  Ictuice,  dimdelion,  sorrel,  cresses,  and  th(>  like, 
are  among  the  very  b(\st  things  v  ,  ii  tlity  can  be  had.  Lemon  jiv'T. 
|(r(xluces  the  happiest  cireels.  I'ot.Uoes  are  iuuong  !hc  very  L,^-* 
renu  tlies,  —  |/articularly  if  snaped  and  ate  raw.  They  ar«!  al.so  valu- 
able when  cookcil.  Spriic(^  beer  is  a  go«»d  antidote;  and  may  be 
made  .!t,  sea  from  the  essence.  Many  kinds  of  beer  may  \>r  brewed 
at  sea,  whieli  are  valual)le. 

When  the  bowels  are  coslive,  ci't'am  of  lartar,  dissolved  in  wafer, 
and  draidv  f«'eeiy,  will  be  f(»uud  tin;  best  remedy.  If  there  be  loose- 
nes.s  of  iIh^  bowels,  morphine,  laudamun,  a  tea  madi  of  log\vtx)d,  or 
geniniuui,  or  the  tincttir<!  of  catechu,  will  be  suitable. 

For  the  sponyy  gums,  a  solution  of  alum  applied  to  them  will  Ihj 


DISEASES  OF  THE  GENERAL  SYSTEM. 


423 


proper,  or  a  mixture  of  equal  parts  of  tincture  of  myrrh,  catechu,  and 
Peruvian  bark  ;  and  ulcers  may  be  washed  with  the  same. 

Vinegar,  which  is  an  excellent  prevention  in  this  disease,  may  be 
nade  at  sea  from  molasses  and  water  exposed  to  the  sun.  Two 
ounces  of  nitre  dissolved  in  a  quart  of  vinegar,  and  given  in  table- 
spoonful  doses,  three  times  a  day,  is  said  to  be  an  excellent  remedy. 

Every  ship,  on  going  to  sea,  should  be  supplied  with  dried  fruit,' as 
raisins,  currants,  whorth^berries,  prunes,  etc;. ;  and  should  have  peas, 
beans,  rice,  Hour,  sugar,  and  molasses.  Beside  these,  ships  should  have 
essence  of  spruce  and  lemon,  and  dried  balm,  sage,  pennyroyal,  and 
other  herbs. 

Seamen,  wlirn  down  with  this  disease,  should  be  moved  with  care, 
as  the  spark  of  life  may  be  easily  extinguislied. 


ill  be 


Purple  Disease. — Purpura  ITemorrhafjka. 

Tnis  has  been  sometimes  ranked  as  an  afr»'ciion  of  the  skin;  but  it 
is  not  sueli ;  it  is  rather  a  disease  of  the  general  system. 

Symptoms.  —  This  complaint  is  known  by  tlu^  a|)p«'aratiee  U|>on  the 
skin  of  iwo  kinds  of  spots;  ihe  oik;  kind  are  siiiall,  round,  bright-red 
points,  even  with  the  surface,  and  changing  in  a  day  or  two  to  a  pur- 
ple or  livid  color,  which  are  yellowish  brown  when  about  to  disap- 
pear. 'J'his  vari(>ty  of  the  purpl(>s  is  quite  simple,  attacking,  geuerally, 
youtig  persons,  and  in  warm  weather.  It  is  soinetiuies  tedious  in  its 
conrs«',  l)ut  never  dangtirous.  It  recjuires  little  treatment;  —  pure  air, 
wholesome  tliet,  with  quinia  and  the  mineral  acids,  make  up  the  chief 
part  of  it.  It  may  be  known  by  the  spots  not  disappearing  when 
pressed  upon  by  the  finger. 

The  other  and  more  dangerous  variety  of  the  disease  is  attended, 
generally,  by  faintness,  wandering  pains,  great  debility,  and  the  ap- 
pearance upon  the  legs,  arms,  and  body,  of  dark-red  spots,  and  irreg- 
ular, livid  patches,  looking  just  like  the  marks  of  n'cent  bruises. 
These  marks  are  caused  by  the  effusion  of  blood  in  patches  under  the 
skin  ;  and  in  this  respect,  thi^y  are  just  like  bruises,  only  they  are  pro- 
duced by  dillercnt  causes. 

In  the  rapid  progress  of  the  disease,  dark  venous  blood  freipjently 
oozes  from  the  tongue,  mucous  membrane  of  the  mouth,  nt)se,  l)reath- 
ing  tubes,  ears,  vagina,  womb,  slomaeh,  etc.  The  oth(>r  symptoms 
vary  in  difVercnt  cases  very  much,  but  generally  indicate  great  dis- 
turbance of  the  system. 

It  often  runs  a  very  rapid  course,  but  sometimes  remains  for 
months. 

Trentinoiit. —  The  bowels  are  to  be  kept  regular  by  gentle  physic 
(20)  (21)  (I-J)  (10). 

Iron  is  a  valuable  remedy  (73). 

Astringents  generally  have  a  good  en'<'et  (150)  (109)  (279)  (305). 
The  best  astringent  in  this  complaint,  is  gallic  acid,  taken  in  live- 
grain  doses,  every  three  oi  four  hours. 


424 


DISEASES  OP  THE  GENERAL  STSTEIL 


The  sponge  bath,  twice  a  day,  with  tepid  or  cool  water,  and  fol- 
lowed with  gentle  rubbing  with  a  coarse  towel,  will  do  much  to 
irestore  and  equalize  the  circulation  in  the  skin. 

During  the  active  stage  of  the  disease,  the  diet  should  be  very 
light, — simple  toast-water,  rice  and  arrow-root  gruel,  and  either  alum 
or  wine  whey. 

While  getting  well,  the  patient  may  have  a  more  nourishing  diet, 
consisting  of  tender  fresh  meat,  broths,  etc. ;  and  must  take  gentlfl 
Exercise  in  the  open  all". 


nd  fol- 
uch  to 

»e  very 
;r  alutn 

!g  diet, 
gentle 


SURGICAL   DISEASES. 


U 


Inflammation. 

Every  par!  of  the  body,  which  has  vessels  and  nerveia,  is  liable  to 
inflammation.  Where  there  are  no  nerves,  it  cannot  exist.  Many 
diseases  are  caused  by  it.  Mechanical  injuries",  such  as  cuts,  bruises, 
and  fractures,  produce  it.  And  many  other  disorders,  not  caused  by 
or  causing  it  in  the  beginning,  become  entangled  with  it  in  their  pro- 
gress. It  is  very  important,  therefore,  to  understand  tlie  nature  and 
management  of  inflammation.  It  is  not  always  to  be  looked  upon 
as  a  disease  ;  it  is  frequently  a  simple  process  of  repair,  whereby 
nature  restv)res  injured  parts  to  health. 

Tlie  Si*»;iis  of  lllflillllllliltiuil  arc  redness,  pain,  heuL  and  swelling, 
though  in  soitie  eases,  these  do  not  all  .i|)p('!ir. 

Acilte  lulliliilliiatioii. —  When  th'  redness,  the  pain,  th<'  heat,  and 
the  -welling,  are  clearly  marked,  aiii!  the  irifhimmation  is  so  rapid, 
that  it  either  subsidts  in  ii  few  days,  or  (piickly  l)rings  on  suppuration^ 
or  ulceration.  t)r  morti/ieation.,  ii  is  said  to  l>e  aeute. 

Chronic  IlltlilllllllUtioil.  --  When  it  is  less  painfnl,  and  slower  in  its 
progress,  beginning  very  gratluullv-  .md  lingcnug  u  long  tiav,  it  is 
tlien  chronic. 

€0111111011,  or  Siiiiph\  or  lleuithy  liitlamtMurion  uslMknttcfa  is  not 
mixed  up  wiih  any  di&^t  ai»e,  but  is  t"»tablislied  by  nature  foi  some 
salutary  purpose. 

I^llhcilltliy  Illftailiniilth'l  is  that  whk-h  has  been  caumeti  by  some 
other  disease,  and  is  un<ler  its  cx»iitrt>l. 

Specific  Illfluillllliltion  is  that  which  seeins  tt)  vary  from  si!  ordinary 
cases,  being  dependent  on  a  particular  j«tat.e  of  the  syh;em,  on  an 
animal  poison,  or  si  princi|)l(!  of  eoiitagion  or  mitstnum,  and  a  power 
of  propagation  from  on»'  person  to  anoth'-r 

Some  of  these  produce  such  perrnaiMau,  effects,  that  thoitc  hanoK 
them  are  not  liable  to  a  second  attack. 

^ 

Inflaiiiiiiiition  is  l*riiiiary,  or,  as  the  doctors  say,  idiapatkm^  when  it 
ia  the  original  disease. 


J 


426 


SURGICAL  DISEASES. 


Inflammation  is  Secondary  or  Sympathetic  when  it  is  the  result  of 
some  other  disorder,  which  goes  before,  and  produces  it. 

It  has  been  explained  elsewhere  that  the  different  parts  of  the  body 
are  connected  by  little  threads  or  nervous  strings  which  run  from  one 
to  the  other.  If  one  part  of  the  body  become  injured  or  disordered, 
it  uses  these  nervous  threads,  as  telegraphic  wires,  to  tell  other  parts 
of  its  misfortune ;  and  it  sometimes  happens,  that  when  the  intelli« 
gekice  conveyed  is  of  a  sad  and  alarming  character,  the  part  receiving 
the  news  is  so  excited  and  distressed  as. to  become  inflamed.  Nothing 
can  be  more  pro|x*r  thiui  to  call  this  sympathetic  inflammation. 

"When  the  inflammation  is  violent,  and  is  seated  upon  some  impor- 
tant part,  the  sympathetic  action  is  so  great  as  to  disturb  the  whole 
constitution ;  and  this  general  disturbance  is  sympathetic  or  symptoni' 
otic  inflammatory  fever. 

Tlie  Symptoms  are  quick  and  strong  pulse,  dryness  and  heat  of 
skin,  parched  mouth,  gri-ut  thirst,  scanty  and  high-colorcd  urine,  cos- 
tiveness,  disordered  nervous  sysleiii,  loss  of  appetite,  iuixitsty,  restless- 
ness, sleeplessness,  hciuiiiche,  wanderinfj;  and  coiifiisioM  of  mind,  and 
sometimes  delirium.  This  fever  John  Iltuiter  ciilled  a  universal  sym- 
pathy of  the  body  with  the  disturbed  condition  of  a  pjirt  of  it. 

It  is  only  by  inflammaticMi  that  a  wound  is  healed,  or  a  broken 
bone  re|)aired. 

Upon  the  surface  of  a  wound  nature  pours  out  a  fluid  called 
plastic  lymph.  This  is  composed  of  /76rmc,  —  the  material  of  which 
flesh  is  made,  —  united  with  a  little  of  the  watery  part  of  the  blood, 
chiefly  albumen.  The  watery  part  disappears  sot)n  after  it  is  poured 
out,  and  the  fibrine  hardens  into  a  kind  of  membrane.  Through  this, 
nature  sends  small  nerves,  arteries,  and  veins,  which  she  uses  as 
tiireails  to  seio  vp  the  wound.  Fibrine  being  the  chief  material  with 
which  nature  constructs  our  bodies,'  she  of  course;  uses  it  to  repair 
them  when  wounded, — just  as  a  carpenter,  who  constructs  a  floor 
with  planks,  uses  planks  to  mend  it  when  it  is  broken  through. 

In  the  case  of  highly  inflamed  and  swelled  tonsils,  nature  some- 
times becomes  alarmed,  and,  for  once  making  a  mistake,  she  rushes 
in  with  her  material  for  repair,  and  fills  up  all  the  interspaces  with 
fibrine,  —  thus  hardening  the  glands,  and  making  their  cure  irnpossi« 
ble  without  cutting  them  off.  But  in  most  cases,  nature  is  right,  and 
cures  the  injury  by  inflammation. 

llufT>  ('out  of  the  Blood.  —  The  efTects  of  inflanunation  extend  to 
tlie  blood.  This  fluid,  when  drawn  from  the  veins  of  a  person  suffer- 
ing from  an  inflatuination  active  iuiough  to  disturb  the  constitution, 
\)rms  a  clot  in  the  basin  inon;  slowly  than  usual,  but  the  clot  is 
jarder ;  and  a  layer  of  fibrine  is  left  upon  the  surlace  of  a  yellowish 
jnjf  color^  looking  like  sizi;  or  glue,  and  called  the  bnjlfy  coal.  The 
clot  is  also  scooped  out  in  the  (H-ntn;,  and  the  blood  is  said  to  be 
cupjKd. 

Coin  Discs.  —  It  is  another  pecallarily  of  inflamed  blood,  that  if 
a  drop  of  it  be  examined  under  a  powerful  microscope,  its  globules, 


1 
II 


SURGICAL  DI&KASKS. 


427 


cos- 


or  di8c:^,  which  are  very  numerous,  will  be  found  standing  on  their 
edges,  and  leaning  against  each  other,  like  a  row  of  copper  or  silver 
coip«.     (Fig.  144.) 

Inflammation  may  end  in  one  of  four  different  ways. 

I.  By  Reiwlutioii.  —  Suppose  a  large  splint  of  wood  be  stuck  into 
t!ie  hand  of  a  healthy  man.  It  causes  redness,  heat,  swelling,  and 
pain  ;  and  these,  cornbined,  are  inflammation.  The  splint  is  pulled 
out,  and  the  hand  well  done  up  with  a  water  dressing,  and  properly 
cared  for.  The  redness  fades,  the  heat  declines,  the  swj'lliiig  sub- 
sides, and  the  pain  disappears ;  the  inflammation  is  ended,  and  the 
hand  is  well.  Coming  to  a  fortunate  end  in  this  way,  inflammatio 
<s  said  to  be  resolved^  or  terminated  by  resolution. 


Fio  144. 


Fio.  14S. 


n.  By  Supiiiinitioii.  —  It  does  not  always  end  so  happily.  The 
splint  may  be  broken  off'  below  the  skin,  and  not  pulled  out;  and 
proper  means  may  not  be  used  to  subdue  the  inflammation.  Instead 
of  abating,  it  may  increase  ;  and  the  centre  of  the  injured  part  may 
begin  to  rise  up  to  a  point,  and  grow  white  on  the  top.  This  show^t 
that  there  is  matter  formed  underneath,  wliich  is  lifting  up  the  scarf- 
skin,  and  seeking  to  come  through.  Fig.  14''5  is  a  microscopic  view 
of  pus  corpuscles. 

The  pain  is  now  very  tlirobbing  and  pulsating, — keeping  time 
with  the  beats  of  the  heart.  When  tlic  scarf-skin  t-.m  hold  out  no 
longer,  it  breaks,  and  yellow,  cream-like  lluid  run-  out,  which  we 
call  pus.  The  redness,  pain,  etc.,  now  subside.  This  process  we  call 
svppuration. 

At  this  time,  if  tlio  wound  have  In-en  a  s<'vere  one,  attended  by 
sympathetic  fever,  and  the  discharge  of  pus  be  now  large,  there  may 
be  a  cliunge  in  the  fever,  tuarUed  by  frecjneiit  shiverini!;s  and  chilli- 
ness, followed  by  flushes  of  heat,  which  I'lids  in  sweating.  We  call 
this  ht'ctic  f'cvrr. 

III.  By  rkei'iltioil,  or  the  formation  of  open,  running  sores. 

IV.  By  Moitificiitioii. —  If  the  wounded  part  have  been  so  much 
injured  as  gradually  to  destroy  its  vitality,  it  dies.  The  vivid  red  of 
the  inflammation  changes  to  a  purplish,  or  livid,  or  black  hue.  The 
strained  condition  of  the  skin  ceases.  —  a  bloody  fluid  lifts  up  tile 


4^8 


8UKGICAL  DISEASES. 


cuticlp,  —  the  pain  and  feeling  are  all  gone,  —  the  part  is  dead  and 
putrid,  and  givrs  out  a  peculiarly  offensive  smell.  This  process  is 
cullt.'d  mmlijicalion. 

The  mortified  and  drad  part  is  called  a  slough ;  and  it  is  separated 
from  the  living  party  by  a  peculiar  vital  process  which  has  the  name 
of  ulceration. 

Treiitmnit  of  Iiiflsiinnintion.  —  Though  inflammation  sometimes 
ends  kintlly  by  resolution,  and  though  it  is  often  a  salutary  pnnrss, 
yet  it  is  frequently  very  d(!structive,  —  ending  in  suppuration,  ulceni- 
tion,  and  mortification,  —  thickening,  hard«Miing,  softening,  and  en- 
larging prtrts  affected  by  it;  and  doing  these  things  in  textures  of 
great  delicacy,  and  of  vital  importance  in  the  economy  of  life.  It 
calls,  therefore,  for  judicious,  and,  often,  for  very  active  treatnrtent. 

There  are  two  principal  things  to  l)e  done,  —  to  remove  the  cause, 
if  it  be  still  active,  and  to  take  th(!  blood  away  from  the  inflamed 
part. 

If  a  bullet  be  lodged  in  the  flesh,  or  a  thorn,  or  a  splint  of  wood, 
or  a  piece  of  glass,  it  is  the  exciting  cause  of  the  inflannnation  which 
follows,  and  little  can  be  done  to  advantage,  till  the  offending  sub- 
stance is  extracted.  If  inflammation  be  excited  in  the  bladder  by 
the  irritating  jjresence  of  urine,  which  cannot  i)e  passed,  this  must 
be  drawn  olf  with  the  catheter,  before  relief  can  be  had.  If  the 
stomach  be  inllained  by  iiripro[)er  food,  or  too  much  of  it,  the  diet 
must  cease  to  follow  appetite,  and  take  reason  for  its  master.  If 
ladies  have  excited  infhiriimation  in  tlic  bowels,  or  any  of  th(!  internal 
organs,  l)y  a  dragi,'ing  weight  of  skirls,  tlicy  nutst  citlifr  put  off  the 
burden,  or  hang  it.  upon  the  siiouiders  witli  straps. 

The  blood  is  removed  frouj  the  inlhiuied  piirt  in  two  ways  — 


ing 


Clipping:  ami  liOechin^:. —  It  is  doxw  directly  by  cupping  and  leech- 
J'hfse  methods  Ui\w  the  Itlood  out  of  tlie  siii;»li  vessels,  which 
are  so  full  and  (crowded  as  to  |)r()(luee  pain,  ('old  water,  ice,  et*;., 
applied  to  tlie  jjurt,  cause  these  little  vessels  to  contract,  ami  s(pioe/e 
the  blood  out  of  thems(;lves.  Tli(>se  are  very  useful  applications; 
and  they  are  to  be  pursued  as  long  as  (here  is  any  hope  of  break- 
ing up  the  inflanunation,  or  causing  it  to  end  by  resolution,  lint 
when  this  is  no  longer  tt)  be  expected,  and  it  is  Ibuiul  that  it  will  go 
on  to  suppuration,  then  apply  wmrn  fomentations  and  poultices. 
These  will  mollify  and  soften  the  parts,  and  cause  the  suppurating, 
or,  in  conunon  language,  the  rotting  process,  to  go  on  more  rapidly, 
and  with  less  pain. 

Count«r-Irritiition.  —  The  other  method  of  removing  the  blood 
from  the  inflamed  part  is  by  what  is  called  counter-irritation. 

People  are  apt  to  think  it  very  absurd  that  inflammation  should  be 
induced  in  one  place  to  relieve  or  cure  it  in  another.  But  it  is  not 
absurd.  It  relieves  or  cures  on  the  principle  of  sympathy,  which  I 
have  already  ex|)lained,  We  put  croton  oil,  or  tartar  emetic,  or 
Spanish  flies,  or  cayenne  pepper,  or  mustard,  upon  the  surface  of  the 
bowels  when  the  internal  parts  are  dangerously  inflamed,  and  what 


dead  and 
:)rocess  is 

separated 
the  name 


Dmetimea 
^  prcM-ess, 
n,  ulft-ni- 

uml  <>ii- 
<fur('s  of 

lif<'.     It 
rient, 
le  cause, 
inflamed 

of  wood, 
>n  which 
ing  sub- 
idder  by 
\un  must 
If  the 
the  diet 
stcr.  If 
iMtcrnai 
t  otr  the 


d  loenh- 
S  which 
H-v.,  etc., 

•utioris ; 

break- 

I.      Rut 

will  iTo 


II  It  ices, 
irating, 
rapidly, 


blood 

»uld  be 
t  is  not 
iiich  I 
^tic,  or 
of  the 
I  what 


SURGICAL  DISEASKS. 


429 


is  the,  result  ?  Why,  the  terrible  smarting  and  pain  alarms  nature, 
and  she  rushes  up  to  the  surface  with  a  large  amount  of  the  blood 
around  the  inflamed  parts,  and  there,  for  hours,  perhaps  for  days, 
struggles  to  beat  down  ihe  new  mischief  at  the  surface;  and,  in  the 
mean  time,  the  internal  parts,  relieved  by  the  removal  to  the  surface 
of  so  large  a  quantity  of  hot  blood,  make  a  long  stride  towards  re- 
covery. 

A  popular  orator  is  speaking  to  a  multitude  in  a  hall  which  ia 
thronged  to  excess,  and  a  few  feeble  persons  faint,  and  are  likely  to 
l)e  sulloeated  and  trodden  upon  in  the  dense  mass.  A  person  at  the 
door,  seeing  what  has  happened,  cries  "y?re."  The  crowd  rush  out; 
the  fainting  persons  get  breath,  and  arc  saved.  So,  when  the  thou- 
sand streams  of  blood  rush  through  their  channels  upon  an  inllamed 
and  fainting  internal  organ,  crowding  and  o|)pressing  it,  we  set  the 
skin  on  fire  with  some  inflammatory  substance;  the  blood  rushes  to 
the  new  point  of  excitement,  and  the  oppressed  and  fainting  organ 
recovers. 

Cupping  and  leeching,  which  are  often  necessiiry,  are  n  to  be 
resorted  to  in  very  debilitated  constitutions.  In  some  persons,  h'cch- 
ing  produces  erysipelas. 

Costiveness  is  always  produced  by  the  symptomatic  fever  which 
often  results  from  inflammation.  This  should  be  removed  by  saline 
purgatives,  such  as  rochelh",  cpsom  salts,  glauber's  salts,  salts  of  tartar, 
tartrate  of  potassa,  and  the  tartrate  of  soda  (9)  (7)  (12)  (14)  (18)  (20) 
(25)  (27)  (41).  Sometimes  more  active  purgatives  are  required,  and 
then  the  compound  extract  of  colocynth,  etc.  (29),  will  be  excellent, 
or,  five  grains  of  blue  pill,  at  night,  followed  by  (299),  may  be  used. 

As  a  drink,  cream  of  tartar  (298)  will  be  found  cooling  and  re- 
freshing. In  all  inflammations,  the  diet  must  be  light  and  unstimu- 
lating. 

Snpparation  and  Abscess. 

An  abscess  is  the  collection  of  pus  or  matter  in  the  substance  of 
some  part  of  the  body.  When  the  matter  is  poured  out  from  some 
part,  the  process  is  said  to  be  suppuration;  when  it  collects  in  a 
tissue,  it  is  an  abscess.  When  the  matter  collecting  in  some  orgtfn, 
comes  towards  the  surface,  and  a  place  in  the  centre  rises  above  the 
surrounding  skin,  and  turns  white,  the  abscess  is  said  to  point.  Some 
abscesses  point  and  break  in  a  week  ;  others  of  a  more  chronic  char- 
acter, will  linger  on  for  months. 

Fluctuation. —  Before  an  abscess  points,  a  fluctuation  may  generally 
be  felt  in  the  swelling,  which  is  one  of  the  surest  signs  that  it  con- 
tains pus.  Sometimes  this  fluctuation  may  be  felt  even  when  the 
matter  lies  very  deep  in  the  flesh.  And  when  it  is  so  deep  that  it 
cannot  be  felt,  if  a  sudden  cessation  of  the  symptomatic  fever  should 
occur,  and  shiverings  or  rigors  should  come  on,  attended  by  coldness 
in  the  aflected  part,  we  may  reasonably  suspect  that  pus  is  formed. 
It  is  not  easy,  at  times,  to  say  whether  matter  is  really  present ;  and 


430 


SURGICAL  DISEASES. 


great  care  should  be  used  not  to  plunge  in  a  lancet  where  noDu 
exists. 

Treatment.  —  When  the  abscess  is  completely  formed,  and  there  is 
no  longer  any  doubt  of  the  presence  of  matter,  it  should  be  opened 
at  once.  To  let  out  the  conHned  pus  alleviates  the  pain,  and  lessens 
the  inflamruution.  If  tlic  matter  lie  close  to  a  bone,  the  opening 
shotild  bo  mjule  without  delay.  I'lu!  opening  should  bo  larg«!  enough 
to  lot  the  matter  out  tVcely.  It  is  a  rule  to  keep  the  incision  ofien 
till  the  cavity  of  tin;  aljscoss  is  so  far  filled  up  that  another  coUoition 
of  pus  is  not  likely  to  occur. 

If  the  niHttcr  do  not  readily  get  to  the  s)irfac<!  through  the  opening. 
it  may  burrow  itself  in  the  Hesh,  in  a  h)ng  narrow  channel  (tailed  a 
.sinus.  To  relievo  this,  the  opening  must  be  extended  in  such  a  way 
as  to  give  vent  to  the  new  collection. 

An  abscess  is  soirKttinies  indisposed  io  heal  at  the  bottom,  and  pus 
continues  to  Ix;  formed  a  long  time,  and  is  di.scharg(*(l  through  an 
opening  smaller  than  the  sack  which  contains  it.  This  is  ayt.s7w./a; 
and  the  opening  to  it  should  bi;  enlarged  so  as  to  let  out  the  matter 
more  freely.  -V  little  soft  lint  may  then  be  gently  pressed  into  the 
wound  to  prevent  its  healing  before  the  cavity  below. 

An  abscess  from  acute  iullammation  re(|uires  to  be  poultiettd  for  a 
time  after  it  has  been  opened.  When  the  swelling  and  iullammation 
are  gone,  the  poultices  are  to  be  laid  aside,  and  a  bandage  put  on. 
When  the  inflammation  is  gone,  let  the  diet  be  improved;  and  if  the 
discharge  of  matter  be  largi',  give  wine  and  tonics. 


.    Mortification. 

The  complete  death  of  a  part  of,  the  body,  and  its  change  into  a 
black,  stinking,  cold,  and  insensible  mass,  with  which  the  other  parts 
of  the  system  have  discontinued  all  organic  connection,  is  what  we 
call  mortificatioru  That  form  of  it  which  is  most  common,  is  said  to 
be  humid,  on  account  of  the  moisture  of  the  dead  parts. 

Gailg;rene.  —  Before  the  mortified  part  is  completely  dead,  and, 
consequently,  while  its  recovery  is  supposed  to  be  possible,  the  con- 
dition of  the  part  is  called  g-angrene. 

Sphacelus  is  the  name  given  to  it  after  its  entire  death. 

kSIoiiK;liiii^  is  the  process  of  separating  the  dead  matter,  and  the 
substance  separated  is  a  .sloug'h. 

The  causes  of  mortification  are  quite  numerous.  The  most  com- 
mon are,  stoppage  of  the  circulation  by  inflammation,  by  mechanical 
causes  which  obstruct  the  passage  of  the  blood,  by  chemical  agents 
and  poisons,  and  by  local  or  general  debility. 

In  a  bad  constitution,  which  bears  disease  poorly,  mortification  is 
very  dangerous. 

Treatment. —  In  treating  mortification,  three  things  are  to  be  aimed 
at, — to  stop  its  progress,  to  promote  the  separation  of  the  dead  from 


I' 


SURGICAL  DISEASES. 


431 


the  living  parts,  and  to  heal  the  ulcer  which  in  left  after  the  separa- 
tion. 

To  stop  the  }>rogrcs8  of  mortification,  we  miiHt  remove  its  cause. 
If  it  be  inflammution,  treat  that  according  to  the  prii)cipl(>.s  laid  down, 
though  leeching,  purgatives,  etc.,  should  he  used  sparingly,  as  mortifi- 
cation reduces  the  constitution  so  rapicjiy  that  it  docs  not  bear  rechic- 
ing  as  well  as  usual,  and  sonietinics  not  at  all.  As  soon  as  the  in- 
(lainmation  has  subsided,  particularly  if  the  system  bi;  weakened, 
tonic  bitters  and  a  nourishing  diet  must  be  had.  Wlien  there  is 
fever,  with  great  excitement  i»f  the  nervous  system,  delirium,  picking 
of  the  bed-clothes,  etc.,  the  patient  slioidd  hav('  anodynes  (l"Jl)and 
antispasmodics  («7)  (91)  (90),  with  blisters  upon  the  back  of  the 
neck,  drafts  upon  the  feet,  and  such  other  local  nunedies  as  the  case 
may  recpiire. 

It  is  of  little  use  to  put  anything  upon  the  mortified  part,  except 
with  a  view  of  lessening  the  stench.  For  this  purpose,  lay  upon  the 
part  lint  soaked  in  a  solution  of  chloride  of  lime  or  soda,  or  a  solution 
of  pyrolignet)ns  acid,  or  of  creosote. 

Very  little  can  be  done  to  hasten  the  s«'paration  of  the  dead  part 
from  the  living;  but  while  it  is  taking  place,  a  conunoa  llax-seed 
poultice,  mixed  with  a  little  powdered  charcoal,  may  be  kept  on  it 

The  ulcer  left  after  the  separation  is  to  be  treated  like  other 
ulcers. 

Ulceration  and  Ulcers. 

When  the  small  particles  composing  the  body  have  been  used 
awhile,  they  wear  out,  and  become  useless.  Over  the  whole  body 
are  distributed  a  rrmltitudc  of  small  vessels,  called  absorbents,  whose 
business  it  is  to  pick  up  these  worn  and  loosened  particles,  and  carry 
them  away. 

There  is  another  class  of  small  vessels,  haying  just  the  opposite 
duty,  —  namely,  to  bring  new  particles  of  matter,  and  put  in  the 
places  of  those  taken  away.  These  are  arteries.  Tlu^y  are  the  natu- 
ral artisans,  who  construct  our  bodies.  The  absorbents  are  the  de- 
molishers  who  pull  them  down.  Under  these  two  forces,  our  existence 
is,  for  a  timt^,  a  drawn  game  between  life  and  death.  The  absorb- 
ents, like  myriads  of  hungry  insects,  eat  us  up,  —  the  constructing 
arteries,  like  faithful  builders,  reconstruct  us.  The  work  of  the  ab- 
sorbents, is  called  absorption ;  that  of  the  constructing  arteries  nutri- 
tion. 

When  nutrition  partially  ceases,  and  absorption  continues  una- 
bated, we  grow  thin,  or  lose  flesh.  This  happens  in  consumption, 
if  nutrition  should  stop  altogether,  absorption  going  on  as  usual,  our 
be.ilie^  would  be  quickly  destroyed.  We  should  be  wholly  devoured 
by  thiv.e  little  absorbent  vessels.  This  would  be  ulceration  applied  to 
vh»^  w'lole  body.  But  it  does  not  appear  in  so  general  a  form.  It 
c  -nfisj'  3  itself  to  particular  parts. 

When  nutrition  entirely  ceases  in  any  portion  of  the  body,  the 
absorbents  devour  all  the  skin,  flesh,  and  vessels  of  the  part, —  leaving 


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an  open  cavity.     The  process  of  taking  away  the  flesh,  etc.,  is  ulcere^ 
tioriy  —  the  cavity  left  is  an  ulcer  or  sore. 

Natural  Surgery.  —  Ulceration  sometimes  acts  the  part  of  a  natural 
surgeon.  When  a  pa.'t  dies  from  mortification,  it  is  necessary  to 
have  it  removed ;  so  nature  sets  up,  directly  around  it,  an  acute  in- 
flammation, in  which  all  nutrition  stops,  and  absorption  goes  on 
rapidly.  In  this  way,  a  complete  dike  is  in  a  short  time  made  around 
the  dead  mass,  and  it  is  as  handsomely  amputated,  or  cut  off",  as  any 
surgeon  could  do  it. 

When  the  ulceration  is  going  on,  and  the  blood-vessels  are  being 
cut  off'  by  it,  the  blood  coagulates  or  curdles  iu  them  for  a  short  dis- 
tance back  from  the  breach,  which  prevents  bleeding.  This  is  as 
good  as  tying  the  arteries. 

Some  textures  ulcerate  more  easily  than  others,  —  the  akin  and 
mucous  membranes  most  easily  of  all. 

Ulcers  are  divided  into  healthy ,  unhealthy^  and  specific. 

A  Healthy  ulcer  is  a  simple  sore,  not  showing  any  bad  symptoms, 
'"ut  rather  a  kindly  disposition  to  heal.  It  is  generally  small  in  size, 
of  a  florid-red  color,  and  has  upon  its  surface,  little  elevations,  pointed 
like  cones,  called  granulations^  which  are  not  so  apt  as  in  the  case  of 
unhealthy  ulcers,  to  rise  above  the  level  of  the  surrounding  skin. 

Unhealthy  Ulcers  comprise  those  called  irritable,  indolent,  and  pAo- 
ffedenic,  etc. 

Indolent  Ulcers  are  numerous.  The  edges  of  the  skin  around 
them  are  generally  thick,  prominent,  and  rounded.  The  granulations 
are  pale,  smooth,  large,  and  flabby,  with  a  peculiar  gloss  upon  them. 
These  ulcers  form  most  often  on. the  leg;  and  the  nearer  they  are  to 
the  ankle,  the  harder  they  are  to  cure. 

Phai^edenic  Ulcers  are  those  which  look  as  though  they  literally  eM 
away  the  parts.  Their  surface  has  a  livid  appearance.  The  matter 
formed  is  small  in  quantity,  and  is  frequently  tinged  with  blood. 

Specific  Ulcers  embrace  scrofulous,  cancerous,  venereal,  scorbutic,  and 
others.  They  are  called  specific  because  they  are  produced  by  par- 
ticular diseases,  and  states  of  the  system. 

Treatment  —  The  first  thing  to  be  done  is  to  remove  the  exciting 
cause.  A  venereal,  or  a  scrofu!  jus,  or  a  scorbutic  ulcer,  cannot  be 
cured,  unless  we  first  lessen  the  force  of  the  disease  in  the  general 
system.  If  the  continuance  of  a  sore  depends  on  bad  digestion,  Mife 
cannot  expect  to  cure  it,  tiU  we  put  the  stomach  right. 

Healthy  ulcers  want  no  treatment,  except  some  simple  dressing, 
such  as  marshmallow  or  spermaceti  ointment  It  is  well,  in  some 
cases,  to  touch  the  granulations  near  the  surface,  with  lunar  caustic 

Ulcers  upon  the  legs  and  ankles  do  not  heal  well  if  the  patient 
walks  about  much,  or  even  allows  the  legs  to  hang  do'vn  a  great 
deal 


SURGICAL  DISEASES. 


433 


acute  in- 


Vm.  14G. 


Indolent  ulcers  are   to  be   touched   by  lunar  caustic   stick,  or  by 
diluted  nitric  acid.     Tlie  diluted  ointment  of  the  nitrate  of  mercury 
is  also   often    used  with   benefit.      So  is   the   com- 
pound tincture  of  benzoin;  the  basilicon  ointment, 
[etc.     Or,  apply  a  bread  and   milk  poultice  to  the 
ulcer,  and    keep  the   ])alient   twenty-four  hours  in 
bed.      Then   apply   the   lunar  caustic  stick   to  the 
whole  sore,  and  to  the  skin  around  it.     Afterwards 
cover  the  ulcer  with  sticking  plaster,  and  a  bandage. 
The  following  is  the  b(<st  plan.     Lay  upon  the 
sore  a  number  of  jjieees  of  lint,  soaked  in  the  ni- 
tric acid  lotion  (314),  and  cover  them  with  a  bread 
and  milk  poultice.     Change  these  applicutions  twice 
a  day,  and  continue  them  till  the  discharge  looks 
healthy,  and  the  granulations  begin  to  appear. 

If  there  is  InHamination  about  the  sore,  give  some 
of  the  preparations  of  salts  to  purge  the  bowels,  and 
confine  the  patient  to  bed.  When  the  parts  begin 
to  look  healthy,  lay  some  pieces  of  lint  upon  the 
sore,  wet  with  nitric  acid  lotion  (214),  or  zinc  lotion 
(215) ;  and  then  apply  strips  of  adhesive  plaster, 
one  and  one-half  inches  wide,  two-thirds  round  the 
limb,  and  extending  an  inch  below  the  ulcer,  and  an 
inch  above  it,  —  at  the  same  time,  drawing  the 
edges  of  the  sore  together  with  a  gentle  force,  and 
retaining  them  there  with  the  plaster.  Put  a  compress  of  soft  linen 
over  the  plaster,  and  apply  a  bandage  over  the  whole,  making  it  tighter 
below,  and  a  little  looser  above,  and  extending  to  the  knee.    (Fig.  146). 


Boils. — Ferunculus. 

Undbrneath  the  skin  is  a  layer  of  tissue  composed  chiefly  of  oella.  • 
From  this  tissue  there  are  small  elevations,  in  the  shape  of  cpnes,  \ 
which  rise  up  into  the  substance  of  the  true  skin.     Like  those  papilla  , 
of  the  skin  which  become  inflamed  and  produce  corns,  these  eleva« 
tions  are  subject  to  an  inflammation,  which  causes  boils. 

At  first,  a  tender  knot  or  hardness  is  felt  just  under  the  skin,  which 
soon  begins  to  look  red.  A  painful  tumor  now  begins  to  show  itself, 
of  a  dusky  red  or  purple  color,  which  acquires  the  size  of  a  pea,  a 
hazel-nut,  or  a  walnut.  Sometime  between  the  fourth  and  eighth 
day,  it  becomes  pointed  and  white  at  the  top,  when  the  scarf-skin 
gives  way,  and  lets  out  a  little  pus  mixed  with  blood,  and  exposes  to 
view  a  mass  of  dead  matter,  called  a  core,  which  is  too  large  for  the 
opening,  and  is  not  ready  to  come  away,  if  it  were  not.  This  core  is 
a  mass  of  viortified  or  dead  flesh  ;  and  nature  is  cutting  a  space 
around  it,  that  it  may  be  thrown  oft".  In  two  or  three  more  davs,  it 
comes  away,  leaving  a  cup-like  cavity,  which  gradually  fills  upj  and 
the  boil  is  over. 

Some  costitutions  yield  boils  in  successive  crops.     When  this  hap* 

o5 


^^^mmmmr^mi 


434 


SURGICAL  DISEASES. 


pens  they  are  a  terrible  affliction.     There  are  not  many  Jobs  who  can 
bear  them  with  patience. 

Treatment.  —  A  boil  will  generally  run  its  course.  A  five-grain 
blue  pill,  taken  at  bed-time,  when  the  boil  is  first  showing  itself,  is 
about  the  only  thing  I  know  that  will  blast  it.  And  yet,  my  unwil- 
lingness to  encourage  a  general  use  of  mercu,rials,  makes  me  hesitate 
to  recommend  it.  One  pill,  not  to  be  repeated,  can  do  no  harm,  how- 
ever, and  may  safely  be  taken. 

Boils  may  sometimes  be  stopped  by  touching  them  with  lunar 
caus'ic.  Water-dressing,  if  used  early,  and  persevered  in,  will  some- 
times prevent  their  growing  larger  than  a  pea.  After  the  boil  has 
opened,  apply  poultices  for  a  day  or  two,  then  some  simple,  stimu- 
lating ointment,  as  basilicon  salve,  or  Turner's  cerate,  or  nitric  acid 
lotion  (314).  If  boils  continue  to  come  out  in  successive  crops,  give 
alterative  medicines,  or  sulphurous  mineral  waters,  or  liquor  potasaie, 
or  bicarbonate  of  soda. 

Carbuncle. — Anthrcujc. 

This  is  like  a  boil,  only  much  larger,  and  more  painful.  Instead 
of  one  of  the  little  cellular  elevations  being  inflamed,  as  in  the  case 
of  the  boil,  the  carbuncle  begins  with  the  inflammation  of  severaL 
Its  surface  is  more  flat  than  that  of  a  boil ;  its  inflammation  more 
violent;  and  the  constitutional  symptoms  excited  more  severe.  It 
has  the  breadth,  sometimes,  of  the  top  of  a  quart  bowl.  Like  the 
boil,  it  appears  most  often  upon  the  neck,  the  shoulders,  the  back,  the 
buttocks,  the  thighs,  etc.  It  goes  through  the  same  process  as  a  boil, 
and  ends  in  the  same  way,  only  discharging  a  vastly  larger  core. 

Carbuncles  most  often  appear  in  persons  above  middle  age,  and 
indicate  an  impaired  and  broken  constitution.  They  occasion  great 
suffering,  and  sometimes  prove  fatal.  Upon  the  head  or  neck,  they 
are  more  dangerous  than  in  other  situations. 

Treatment.  —  Apply,  constantly,  during  the  formation  of  the  carbun- 
cle, either  fomentations  and  poultices,  or  cold  water  dressing.  I  pre- 
fer the  latter.  To  stop  both  the  local  and  the  constitutional  disorder, 
make  two  incisions  in  the  form  of  a  cross,  cutting  entirely  through 
the  dead  mass.  Then  apply  a  fermenting  poultice,  or  one  of  oat- 
meal, for  two  or  three  days,  —  after  which,  use  the  basilicon  salve,  or 
apply  daily  a  weak  solution  of  lunar  caustic,  or  the  nitric  acid  lotion 
(314).  During  recovery,  tonics  are  useful,  such  as  quinine,  tincture 
of  Peruvian  bark,  and  sulphuric  acid  ;  and  morphine  to  procure  rest, 
at  every  stage  when  it  is  required. 

Malignant  Pustule. 

This  is  one  of  the  five  diseastL^s  which  man  may  take  from  animals. 
The  other  four  are  the  cow-pox,  hydrophobia,  glanders,  and  pestilential 
carbuncle.     This  last  is  what  the  French  call  charboiiy — pronounced 


SURGICAL  DISEASES. 


435 


sharbo.  My  own  mother  and  an  elder  brother  came  near  losing  their 
lives  by  it,  —  having  taken  it  by  handling  the  flesh  and  tallow  of  a 
dead  cow. 

Malignant  pustule  begins  with  a  water-pi  in  pie,  not  bigger  than  a 
millet  seed.  Underneath  it  is  a  hard  point,  surrounded  with  redness, 
like  a  flea-bite.  This  hardness  is  soon  attacked  by  mor.tiflcation, 
which  spreads  on  all  sides,  a>id  kills  everything  as  it  goes.  Next,  in 
fatal  cases,  come  great  restlessness,  faintings,  sunken  countenance, 
dry  skin,  dry  brown  tongue,  despondency,  delirium,  and  death.  It  is 
supposed  gimerally  not  to  arise;  from  ccnstitutional  causes,  but  to  be 
produced  by  a  specific  poison  applied  to  the  skin,  or  by  eating  the 
flesh  of  e^tt'c  which  die  of  gangrenous  diseases.  The  disorder  is 
probably  the  same  with  the  pestilential  carbuncle. 

Treatment.  —  Deep  incisions,  and  the  application  of  the  most  pow- 
erful caustics,  as  the  caustic  potash,  etc.,  and  tincture  of  peruvian 
bark,  quinine,  aromatic  sulphuric  acid,  wine,  ether,  and  opium. 
Probably  the  best  treatment  is  to  surround  the  pustule  with  a  thick 
layer  of  ointment ;  then  to  fasten  some  lint  to  the  end  of  a  stick,  wet 
it  with  nitric  acid,  and  press  it  upon  the  pustule.  Now  apply  cloths, 
wet  with  cold  water,  and  when  the  slough  comes  off",  dress  with 
simple  ointment,  or  touch  occasionally  with  weak  solution  of  nitrate 
of  silver  (211). 

Chemical  Injuries. 

These  are  of  two  kinds,  produced  by  causes  of  an  exactly  opposite 
nature.    The  first  are 


Burns  and  Scalds. 

A  bum  is  the  effect  of  concentrated  heat  acting  upon  living  tissues. 
The  effects  are  inflammation,  and  sometimes  complete  disorganization 
and  destruction  of  the  parts. 

A  scald  is  an  injury  produced  by  applying  hot  water  or  other  fluid, 
to  the  skin  or  mucous  membrane.  The  natural  temperature  of  the 
human  body  is  ninety-eight  degrees ;  that  of  boiling  water,  two  hun- 
dred and  twelve  degrees  Bringing  the  skin  in  contact  with  a  fluid 
heated  so  far  above  it,  produces  redness  and  pain  ;  and  when  nothing 
is  done  instantly  to  ward  off"  the  injury,  the  scarf-skin  \s  raised  from 
the  true  skin  in  the  form  of  a  blister,  filled  with  water. 

The  degree  of  danger  from  a  burn  or  scald,  depends  upon  the  ex- 
tent  of  the  injured  surface,  and  also  upon  the  depth  of  the  injury.  An 
extensive  scald  or  burn  may  prove  fatal  in  a  few  hours,  —  the  patient 
never  rallying  from  the  first  prostration.  These  injuries  are  most 
dangerous  when  upon  the  head,  neck,  chest,  and  belly.  Old  persons, 
and  those  who  are  feeble,  and  have  shattered  constitutions,  will  sink 
under  burns  and  scalds,  from  which  robust  persons  will  suffer  but 
little. 

Treatment  —  For  slight  burns  and  scalds,  make  cold  applications. 


\'3iS 


SURGICAL  DISEASES. 


Put  the  injured  parr,  in  very  cold  water,  or  lay  upon  it  pieces  of  linen, 
or  lint,  \v(?t  witii  vinegar  and  water,  or  rof^e  water  and  sugar  of  lead 
(238),  or  diluted  solution  of  aeetate  of  ammonia.  When  these  are 
not  to  1)0  (juieldy  had,  lay  on  scraped  potatoes.  The  object  is  to 
reduce  the  inlluuuuation,  and  to  prevent  blistering.  They  must, 
therefore  be  put  on  very  soon.  If  the  scald  be  extensive,  and  on  the 
bod?/,  —  producing  shivering,  faintness,  paleness,  and  coldness  of  the 
skin,  and  a  small  pulse',  —  cold  applications  ar(!  not  proper.  In  such 
case  we  may  use  warm  fomentations,  or,  in  the  case  of  a  child,  the 
warm  bath.  A  liniment  of  spirits  of  turpentine,  linseed  oil,  etc 
( 194),  makes  an  excellent  application. 

Raw  cotton,  s|)read  out  thin,  and  laid  upon  a  burn,  is  a  -jfood  dress- 
ing, and  one  which  is  much  used.  So  is  flour  sprinkled  upon  the 
injured  surface  with  a  dredger.  For  loosening  the  flour  when  it  is 
to  be  taken  off,  poultices  are  useful. 

Keep  the  air  from  the  wound  as  much  as  possible.  With  this 
view,  do  not  remove  the  dressing  often,  and  when  a  cold  lotion  is 
used,  merely  pour  it  upon  the  rags,  letting  them  remain  undisturbed. 


Effects  of  Cold.— Prost-Bite. 

Cold  is  a  relative  term.  The  same  temperature  may  be  called  hot 
or  cold,  according  as  it  is  compared  with  a  hotter  or  colder  tempera- 
ture. If  we  warm  one  hand  by  a  fire,  while  we  lay  the  other  upon 
ice,  and  then  plunge  them  both  into  cold  water,  the  water  will  feel 
cold  to  the  one  which  has  been  by  the  fire,  and  warm  to  the  one  taken 
from  the  ice. 

The  warmth  of  the  body  being  ninety-eight  degrees,  any  tempera- 
ture below  this  may  be  said,  in  a  certain  sense,  to  be  cold.  let  a 
temperature  much  lower  than  this,  namely,  from  sixty  to  seventy,  is 
the  most  agreeable  and  invigorating,  because  it  takes  away  the  heat 
just  about  as  fast  as  it  is  produced  in  a  healthy  body. 

The  first  effect  of  cold  applied  to  the  body  is  to  weaken  the  cirou- 
lation  in  the  small  blood-vessels  of  the  skin.  When  applied  with 
some  intensity,  the  heart  and  arteries  in  general  are  weakened,;  the 
blood  is  delayed  in  the  vessels  near  the  surface,  and  not  being 
changed  to  a  red  color  in  the  lungs  as  fast  as  it  should  be,  the  fin- 
gers, ears,  etc.,  become  blue  or  livid ;  and»  if  the  cold  be  continued 
sufliciently  long,  the  circulation  stops  in  these  parts ;  heat  ceaf^es  to 
be  evolved,  and  mortification  or  death  is  the  consequence.  Parts 
killed  in  this  way  are  said  to  he  frost-bitten. 

A  free  circulation  of  red  blood  is  essential  to  the  continuance  of 
sensibility.  Hence,  when  the  circulation  's  seriously  impeded  by 
cold,  the  body  becomes  numb,  —  it  loses  its  leeling;  the  muscles  act 
feebly ;  a  languor  and  torpor  follows ;  drowsiness  comes  on,  followed 
by  sleep,  from  which  there  is  no  waking.  Drowsiness,  during  expos- 
ure to  extreme  cold,  indicates  great  danger. 

Treatment.  —  It  is  a  great  principle  in  restoring  frost-bitten  parts, 
and  persons  benumbed  with  cold,  to  communicate  heat  in  the  most 


SUIIGICAL  DISEASES. 


437 


gradual  manner.  Mr.  Hunter  says  the  degree  of  external  heat  should 
be  in  proportion  to  the  quantity  of  iife.  When  life  is  weakened  and 
nearly  destroyed  by  frost,  therefore,  Ihe  warmth  imparted  must  be 
small,  and  rise  no  faster  than  life  returns. 

To  restore  a  frozen  limb  or  part,  rub  it  with  snow,  or  place  it  in 
cold  water  for  some  time.  When  feeling  begins  to  return,  still  keep  it 
in  cold  water,  and  let  heat  be  added  in  a  very  gradual  manner,  by 
poring  in,  now  and  then,  a  very  small  quantity  of  warm  water. 

If  a  person  be  reduced  by  cold  to  insensibility,  and  apparenlhj 
frozen  to  death,  take  his  clothes  oil",  and  cover  him  all  over  with  snow, 
except  the  mouth  and  nostrils.  If  snow  is  not  to  be  had,  put  him  in 
water  as  cold  as  ice,  and  let  him  lie  for  some  minutes.  Then  rub 
him  with  cloths  wet  with  cold  water.  When  the  body  is  thus  1  hawed 
by  degrees,  and  the  muscles  begin  to  relax,  dry  the  body,  and  placing 
it  in  a  cold  bed,  rub  with  the  warm  hands,  only  under  the  clothes. 
Contiime  this  for  hours.  If  signs  of  life  appear,  give  a  small  injec- 
tion of  camphor  and  water,  and  put  a  drop  of  spirits  of  camphor  on 
the  tongue.  After  a  time,  rub  with  spirit  and  water,  and  finally  with 
spirit,  and  give  tea,  or  coft'ee.  or  brandy  and  water. 


Mechanical  Injuries. 

Wounds  are  divided  into  several  kinds. 

Incised  Wounds  are  very  common.  Being  made  with  sharp  instru- 
ments, they  ..re  cuts,  and  have  no  laceration  or  tearing  about  them. 

Stabs,  or  Punctured  Wounds,  form  another  class.  They  are  made 
with  pointed  Vv^'apons,  as  bayonets,  lances,  swords,  and  daggers. 
They  are  more  dangerous  than  tlie  former,  because  tlicy  penetrate 
to  a  greater  depth,  —  injuring  blood-vessels,  nerves,  bowels,  and  other 
organs. 

Contused  and  Lacerated  Wounds  form  still  another  class.  They 
embrace  gun-shot  wounds,  and  all  those  produced  by  blunt  instru- 
ments.    They  tear,  and  bruise,  and  mash  the  llesh. 

Poisoned  Wounds  form  yet  another  class.  They  are  sueli  as  ire 
united  with  the  introduction  of  some  venomous  poison  into  the  in- 
cised, or  punctured,  or  contused  part.  Stings  and  bites  of  venomous 
insects  and  snakes  are  of  this  class,  —  also  the  wounds  made  by  poi- 
soned arrows. 

Simple  Wounds  are  such  as  are  inflicted  on  a  healthy  subject  with 
a  clean  sharp  instrument. 

Complicated  Wounds  are  those  inflicted  when  the  state  of  the 
whole  system,  or  of  the  wounded  part,  is  such  as  to  make  it  neces- 
sary for  the  surgeon  to  deviate  from  the  treatment  needed  for  a 
simple  wound,  —  as,  for  example,  when  there  is  bleeding,  or  nervous 
symptoms,  or  great  pain,  or  locked-jaw,  or  much  contusion,  or  ery- 
sipelas. 


43b 


SURGICAL  DISEASES. 


Sympathetic  Fever.  —  All  large  wounds  are  followed  by  symptom- 
atic fever,  which  comes  on  from  sixteen  to  thirty-six  hours  after  the 
accident.  This  is  generally  of  the  inflammatory  kind,  and  is  indi- 
cated by  greater  warmth  of  the  skin,  a  more  frequent  and  stronger 
pulse,  anxiety,  thirst,  and  loss  of  digestive  power.  Where  much 
blood  is  lost,  and  the  constitution  is  feeble,  the  pulse  is  more  quick 
than  strong,  and  the  fever  of  a  lower  and  more  typhoid  type.  In 
this  case,  bjood  must  not  be  drawn. 

Lacerated  wounds  are  more  dangerous  than  incised  ones,  because 
the  parts  arc  stretched  and  otherwise  injured,  besides  being  separated. 

A  very  small  wound  upon  the  brain,  the  spinal  marrow,  the  bowels, 
or  the  heart,  will  often  prove  fatal,  because  the  functions  of  these 
parts  arc  iiitimati-ly  connected  with  life. 

Wounds  of  young  persons  heal  much  more  rapidly  and  kindly  than 
those  of  old  persons. 

Incised  Wounds. 

When  the  flesh  is  divided  with  a  cutting  instrument,  the  cut  edges 
separate,  and  the  wound  has  a  gaping  appearance.  This  drawing 
apart  happens  in  coiisecjuence  of  the  elasticity  of  the  skin.  It  often 
happens  that  vessels  of  considerable  size  are  cut,  so  that  bleeding  is 
the  principal  thing  to  receive  attention. 

Treatment  of  ]Ieniorrh!(«>:e. — Bleeding  is  stopped  by  the  tourniquet^ 
by  tlie  lig-ature,  by  compression^  by  the  application  of  cold  water  and 
tee,  and  by  astringents  and  styptics. 

The  Toiiniiquet.  —  This  instrument  consists  of  a  band  and  btickle, 
a  pad,  and  two  brass  frames,  the  upper  of  which  is  furnished  .vith 
two  small  rollers,  and  the  lower 
with  four,  over  all  of  which  the 
band  plays.  When  the  handle  is 
turned  to  the  right  or  left,  the 
band  is  tightened  or  relaxed  to 
just  the  extent  required.  (Fig. 
147.)  The  band  is  buckled  round 
the  limb  in  such  a  manner  that 
the  pad  is  placed  exactly  over  the 
artery.  When  an  artery  is  cut,  it 
is  known  by  the  blood  being  very 
red,  and  spirlin.g'  out  in  jets ;  and 
in  this  case,  the  instrument  must 
be  placed  upon  iIk;  limb  above 
the  wound,  or  betweiMi  it  and  the 
heart. 


Fio  147. 


The  Lipiture. — When  an  artery 
is  divided,  the  surgeon  lay&  hold 
of  the  end  of  it  with  his  forceps,  and  ties  a  thread  tight  around  it 
This  is  called  a  ligature.     By  it,  the  bleeding  is  instantly  stopped; 


tf 


SURGICAL  DISEASES. 


4sy 


and  long  before  the  thread  becomes  loose,  the  opposite  sides  of  the 
vessel  have  grown  together,  and  all  danger  of  a  renewal  of  the 
bleeding  is  over. 

Application  of  Water  and  Ice.  —  This  is  done  by  saturating  with 
cold  water  several  folds  of  linen  rags,  or  lint  pads,  and  applying  them 
to  the  wound,  remoistening,  and  reapplying  them  as  fast  as  they  be- 
come hot,  till  the  pain  and  inflammation  subside. 

Compression. —  When  the  blood  does  not  come  from  any  largt 
vessel,  but  from  several  small  ones,  compression  is  snUicitMit.  It  con- 
sists in  placing  the  opposite  sides  of  the  woup  '  together,  if  pssible. 
and  then  laying  compresses  over,  and  apply!  a  bandage  with  mod- 
erate tightness. 

Astrin<i:ents  and  Styptics.  —  These  are  spirits,  tinctures  of  myrrh, 
Peruvian  bark,  diluted  uiineral  acids,  sohitioiis  of  taimin,  alum,  sul- 
phate of  copper,  decoctions  of  white  oak  bark,  etc.  Those  have  the 
power  to  stop  bleeding  from  small  vessel^!.  Monsel's  salt,  a  remedy 
just  coming  into  use,  is  said  to  have  more  |)ower  than  all  the  abjve. 
It  is  a  preparatioii  of  iron  and  nitric  acid,  and  has  been  used  with 
great  success  in  stopping  violent  bleeding  at  the  military  hospital  of 
Bordeaux.  It  is  not  a  caustic  or  an  irritant ;  but  it  acts  very  power- 
fully upon  albumen  and  blood,  —  producing  with  the  latter  a  large 
clot,  absohitehj  insoluble,  which  continues  to  enlarge  for  several  hours 
after  the  application,  and  becomes  quite  hard  and  firm,  so  that  no 
blood  can  get  through. 

Beside  these  means,  thr  application  of  the  lunar  caustic  stick, 
potash,  and  the  hot  iron,  are  used,  particularly  the  first,  quite  often. 


Union  by  the  First  Intention. 

When  the  bleeding  is  stopped,  all  foreign  substances  removed,  and 
the  wound  properly  cleansed,  the  next  thing  is  to  bring  the  opposite 
sides  of  the  cut  evenly  together,  and  to  keep  them  steadily  in  this 
position  till  they  have  healed.  If  this  method  succeeds,  the  healing 
takes  place  without  the  formation  of  any  pus.  This  is  called  healing 
by  the  first  intention,  or  adhesion.  The  cut  surfaces  gnnv  to<;ether. 
For  keeping  the  surfaces  together,  straps  of  adhesive  plaster  are  used 
putting  them  at  right  angles  across  the  cut,  and  leaving  spaces  be- 
tween them.     Over  the  straps  should  be  cold  water  dressings. 

Sutures.  —  Incised  wounds  are  sometimes,  —  though  seldom  now,— 
sewed  together,  by  what  is  called  the  inlerrvpled  suture.  After  the 
bleeding  is  stopped,  a  curved  needle  is  threaded,  and,  the  lips  of  the 
wound  being  brought  together,  is  introduced  through  the  right  lip, 
and  then,  being  directed  across  the  wound,  is  pushed  through  the  left 
lip,  from  within  outward.  It  is  now  cut  off,  and  tied  in  a  bow. 
These  stitches  should  be  at  least  an  inch  from  each  other.  The 
adhesive  plaster  is  generally  better  than  the  suture. 

The  first  plasters  and  dressings  should  remain  on  the  parts  at  least 


440 


SUnOICAL  DISEASES. 


three  or  four  days,  unless  very  f^reat  pain,  bleeding,  or  some  other  ball 
symptom,  should  call  for  their  removal. 

Useful  Rules  for  Examining  and  Dressing  Wounds. 

Nkvkr  give  the  |)alieiit  more  pain  from  the  mode  of  handling  and 
dressing  the  wound  than  is  jieeessary  for  his  present  good,  or  future 
safety.  Never  distress  him  l)y  probing,  scpieezing,  ete.,  to  find  things 
that  will  be  of  no  use  wlien  learned. 

Make  all  examinations  as  soon  after  the  accident  as  possible;  for, 
before  inflammation  and  swelling  take  place,  the  probe  or  finger  in- 
flicts iiuich  less  pain. 

In  changing  the  dressing  of  a  wound,  let  all  the  fresh  ones  be  ready 
before  the  removing  of  the  old.  The  sponge,  warm  water,  adhesive 
piaster,  lint,  ointment,  lotions,  bandages,  etc.,  should  all  be  at  hand, 
and  not  have  to  be  looked  aft(>r  when  the  wound  is  exposed. 

Put  the  patient  in  the  most  easy  position,  that  he  may  not  be  need- 
lessly fatigued  during  the  dressing. 

If  the  bandage,  plaster,  and  other  dressings,  have  become  hard,  and 
glued  together,  and  to  the  skin,  by  blood  or  matter,  soften  them  with 
warm  water,  which  is  to  be  pressed  ovit  of  a  sponge,  —  a  basin  being 
held  below  the  part  to  catch  the  water  as  it  falls  from  the  dressing. 

The  strips  of  adhesive  plaster  are  to  be  removed  by  pulling  gently 
at  one  end,  and  then  the  other,  —  each  to  be  drawn  towards  the 
wound,  so  as  not  to  ])ull  its  lips  apart. 

In  large;  wounds,  take  oil"  one,  or  at  most,  two  slrijis  of  plaster  at 
a  time.  Cleanse,  wipe  dry,  'And  again  support  this  part  of  the  wound 
with  new  strips  of  plaster,  before;  any  more  are  taken  oil".  This  will 
prevent  the  wound  being  torn  open  by  t!ie  weig!it  of  its  parts. 

If  the  wound  be  large  and  deep,  its  sides  should  be  su|)ported  by 
an  assistant  wiiile  clianijins^  the  dressinsjfs. 

If  there  are  several  wounds,  dress  but  one  at  a  time,  that  there  may 
be  rr>  needless  exposure  to  the  air. 

Pay  the  utmost  attention  to  cleanliness. 

The  frequency  of  the  dressing  iriust  depend  on  the  amount  and 
quality  of  the  discharge,  the  situation  of  the  injuiy,  the  climate  and 
season  of  the  year,  the  eflect  produced  by  the  dressing,  and  by  the 
feelings  of  the  patient     (See  p.  878.) 


The  Way  in  which  Wounds  Unite. 

When  the  two  surfaces  of  a  wound  are  brought  together,  they  be- 
come impervious  to  the  blood,  but  not  to  coagulable  lymph,  or  fibrine. 
This,  —  the  material  of  which  all  flesh  is  mar^-..,  —  flows  out  upon  the 
two  surfaces,  and  becomes  a  bond  of  union  between  them. 

Into  this  layer  of  fibrine,  the  small  blood-vessels,  —  arteries  and 
veins,  —  which  have  been  cut  asunder,  push  themsvuves  with  open 
mouths,  and,  meeting  in  the  centre,  they  inosculate,  or  grow  together, 
and  the  blood  resumes  its  circulation  through  them. 


SURGICAL  DISF^ASES. 


441 


By  this  method,  incised  wouiida  of  moderate  size  are  often  healed 
in  forty-eight  iiours.  This  method  of  healing  by  the  first  intention 
is  always  to  be  brought  about,  if  possible. 

Punctured  Wounds. 

These  are  produced  by  swords,  daggers,  etc. 

Great  swelling  and  iiifluiiiuiatioii,  large  abscesses,  erysipelas,  the 
wounding  of  large  arteries,  and  the  consequent  extravasation  of  blood, 
Bymptomatic  fever,  and  lock-jaw,  are  the  fretjuent  results  of  punc- 
tured wounds.  They  are,  therefore,  more  dangerous  and  hard  to  cure 
than  cuts. 

Treatment.  —  For  the  first  twenty-four  hours,  use  superficial  dress- 
ings of  lint,  wet  with  a  solution  of  sugar  of  lead  dissolved  in  cold 
water,  or  with  cold  water  simply,  and  a  loose  bandage.  If,  after  this, 
pain  and  swelling  should  increase,  leeches  iwu^;  be  applied  to  the 
neighborhood  of  the  wound,  and  fomentations,  or  poultices,  be  put  in 
place  of  the  cold  water,  —  placing  a  small  linen  rag,  spread  with  sper- 
maceti cerate,  over  the  wound.  When  the  pain  and  inflammation 
are  great,  saline  purgatives  (7)  (18)  (25)  (27),  and  opiates  are  oftiMi 
called  for. 

Contused  and  Lacerated  Wounds. 

These  are  produced  by  cudgels,  stones,  bullets,  or  whatever  else  of 
a  blunt  nature,  tears  asunder  the  muscular  fibres,  leaving  jajLrgcd  anil 
uneven  surfaces.  Tliey  are  rarely  lu^ali'd  v/itliout  snppiu'atioii,  and 
are  frequently  followed  by  violent  iiillaininalion.  Th(!y  suppurate 
and  slough,  but  they  do  not  bleed  umch, —  not  even,  sojuetimes,  when 
large  arteries  are  lorn  asunder.  Whole  limbs  are  oeeasionally  lorn 
away  without  hemorrhage.  In  warm  climates,  loik-jaw  is  a  frequent 
consequence  of  them. 

Treatment.  —  Draw  the  edges  of  the  wound  loosely  together,  and 
retain  them  with  a  few  strips  of  adhesive  plaster.  Sometimes  a 
suture,  here  and  there,  will  be  proper.  If  a  great  deal  of  indamma- 
lion  ensues,  take  away  the  adhesive  plaster  and  the  stitches,  and 
apply  a  poultice,  or  water  dressing;  and  if  there  be  much  fever,  rest- 
lessness, or  delirium,  saline  purgatives  (18)  (25),  ojjium  (118),  and 
i^ery  low  diet,  will  be  needed. 

The  wound  having  thrown  off  its  sloughs,  suppurated,  become 
clean,  and  formed  granulations,  the  poultices  are  to  be  taken  otl",  and 
simple  dressings  substituted.  These  should  be  adapted  to  the  condi- 
tions of  the  sore,  according  to  the  directions  for  treating  ulcers. 

When  the  wound  is  so  severe  that  extensive  mortification  will  be 
sure  to  follow,  the  limb  must  be  immediately  taken  ofT,  to  save  the 
life  of  the  patient 


442 


SURGICAL  DISBA8E& 


Qrannlation  and  Scarification. 

Suppurating  wounds  heal  in  the  same  way  with  ulcere.  The 
chaam  is  filled  up  by  the  appearance  of  little  soft  elevations  of  new 
substance,  which  originate  at  all  points,  and  meet  at  the  centre,  draw- 
ing the  sides  nearer  together,  and  raising  the  bottom  towards  the 
surface.  This  ia  called  granulation,  because  these  elevations  look  like 
grains ;  and  the  result  is  a  new  tissue,  of  a  peculiar  character,  which 
constitutes  the  cicatrix,  or  scar. 

Reproduction  of  Lost  Parts. 

Among  some  of  the  lower  animals,  whole  limbs  which  have  been 
destroyed,  are  easily  reprodiicrd.  It  is  not  so  with  niiiii ;  though  cer- 
tain parts,  when  only  piirliiilly  destroyed,  are  soiiu'tiiiics  n-generatod. 
Thus,  portions  of  skin,  of  eonsidi^rable  ext(Mit,  arc;  often  niproduced  ; 
and  so  are  the  whole  of  some  long  bones,  when  destroyed  by  necrosis. 
The  same  is  true,  to  some  extent,  of  liguiuents.  But  portions  of 
brain,  and  spinal  marrow,  and  muscle,  and  mucous  membrane,  when 
once  removed,  are  never  regenerated. 

Gunshot  Wounds. 

At  a  time  when  fire-arms  are  so  much  carried  about  the  person, 
and  so  often  used  for  purposes  of  duelling,  and  murder,  it  is  proper 
that  every  person  should  know  something  of  the  modes  of  treating 
gunshot  wounds. 

Treatment.  —  It  is  often  proper  to  make  a  gunshot  wound  larger  at 
the  orifice.  When  this  is  done,  it  is  generally  on  the  side  where  the 
bullet  has  passed  out,  if  it  has  gone  entirely  through.  A  bullet  ia 
always  to  be  removed,  if  it  can  be  felt. 

The  dressings  are  at  first  to  be  superficial,  light,  and  unirritating. 
The  common  tepid  water  dressing,  covered  with  a  piece  of  oiled  silk, 
is  one  of  the  best.  Some  use  pledgets  of  simple  ointment,  poultices, 
and  fomentations.  These  latter  are  generally  employed  during  sup- 
puration ;  but  during  the  first  two  or  three  days,  cold  evaporating 
washes,  and  cold  water,  are  best,  when  the  wounded  part  is  inflamed 
and  hot,  and  the  circulation  is  vigorous. 

Poisoned  "Wounds. 

To  the  bites  of  various  creatures  man  is  exposed  in  most  climates, 
and  all  seasons  of  the  year.     These  may  be  divided  into  three  classes. 

Bites  of  Miisquitoos  and  Spiders,  and  Stinn-s  of  Rees  and  Wasps. — 
For  these,  the  best  applications  are  a  solution  of  common  salt,  or 
water  of  ammonia,  or  sugar  of  lead  (239),  or  laudanum,  or  tincture 
of  iodine.  If  none  of  these  are  at  hand,  at  the  moment,  cover  the 
part  with  wet  earth.     Tincture  of  arnica  (240)  is  a  good  application. 


:|l,;  I, 


Bites  of  Venomous  Snakes.  —  Either  instantly  cut  out  a  piece  from 
the  bitten  part,  or  apply  a  dry  cup,  to  prevent  the  abttorption  of  the 
poirton.  Suction  with  the  mouth  will  .sometimes  answer  the  same 
purpose.  After  doing  one  of  these  things,  touch  the  part  with  caustic 
potash.  Internally,  give  Fowler's  solution,  twenty  drops,  in  a  little 
water,  every  two  hours.  Also  purgative?  injections,  —  stopping  the 
arsenic  when  purging  is  well  estal)lii*h('(l. 

For  the  bite  of  tli'e  rattle-snake,  tin;  only  known  remedy  is  alcoholic 
drink,  taken  in  large  quantities,  and  itiiinediately.  (iin  and  whiskey 
are  believed  to  be  the  best.  Fill  tli(?  system  full.  When  \\\r.  poison 
has  begim  to  take  ert'ect,  onorriious  (piantities  will  be  borne,  before  in- 
toxication vMi\  bo  induec^d.  Kt^ep  the  whole  person  i^uturated  until 
the  symptoms  decline. 


i«; 


Fractures. 

TnK  existence  of  a  fracture  is  to  be  known  by  tlic  sjir'|)tom3. 
These  are,  pain,  swelling,  deformity  from  the  liiiil)  bending  to  one 
side,  vsoiiictimes  shortening  of  the  limb,  or  loss  of  power  i  )  use  it,  and 
a  crepitus  or  grating  soinicl  or  sensation  from  tin;  rnbl)l.!^  of  tla-  ends 
of  the  broken  bone  together.  There  are  several  kin«ls  of  fr;icturea. 
They  an* 

The  Traii.>»vei'se  FriictuiT,  which  is  directly  across  tin;  Ijone. 

The  Oblique  Fnicture,  which  runs  from  side  to  side,  In  an  oblique 
direction. 

Tlie  Loiijcitudiuiil  Fnicture,  which  runs  lengthwise  of  the  bone. 

A  Simple  Frueture  is  one  in  which  the  bone  is  broken  simply,  with- 
out any  wound  of  the  flesh  with  it. 

A  Coniitound  Fracture  consists  of  a  simple  fracture,  and  of  an  ex- 
ternal wound  in  addition,  caused  by  pushing  the  end  of  the  broken 
bone  through  the  flesh. 

A  Cuuiplicated  Fracture  is  one  in  which,  beside  the  breaking  of  the 
bone,  there  is  the  dislocation  of  a  joint,  the  wounding  of  an  artery, 
th«  extensive  tearing  of  the  soft  [)arts,  or  the  wounding  of  the  bowels 
or  some  other  internal  organ. 

A  Cuiiimiuuted  Fracture  is  one  in  which  the  bone  is  broken  into 
several  pieces. 

Treatment  of  Fractures.  —  When  a  bone  is  broken,  the  first  thing 
to  be  done  is  to  get  the  injured  person  to  his  iiume,  or  to  the  nearest 
house.  To  do  this  in  a  rough  or  careless  way,  might  add  iimeh  to 
his  sufferings. 

If  it  be  an  arm  which  is  broken,  let  it  be  placed  in  a  'road  sling, 
extending  from  the  elbow  to  the  fingers.  In  this  condition  the  pa- 
tient, if  in  tolerable  health,  and  the  distance  is  not  great,  will  find  it 
easier  to  walk  home,  than  to  bear  the  jolting  of  a  carriage. 


illi 


li 


>    1'  r 


444 


SURGICAL  DISEASES. 


Fio.  14S. 


If  1h(!  I('<,'  or  1li('  llii<j[li  b(!  broken,  then  a  hurdle  of  some  sort  (Fig. 
148),  imiist  i)t'  obtaini'il  as  soon  as  possible,  and,  being  covered  with 
straw,  or  blankets,  or  gar- 
ments, the  patient  .sliouUi 
be  gently  lifted  upon  it  by  * 
just  persons  enough  to  raise 
hitn  easily  from  llie  ground. 
This  fihonid  now  be  earrieil 
by  four  persons,  two  at  each  end,  moving  with  great  gentleness,  and 
keeping  exact  step  with  each  other.  Jf  these  ))ersons  take  hold  of 
the  en('s  of  two  poles,  laid  under  the  hurdle,  they  will  find  tliey  can 
carry  it  much  more  easily.  If  no  hurdle  be  at  hand,  let  four  poles,  two 
long  ones,  and  two  short  ones,  be  laid  across  each  oth.er  at  right  angles, 
and  fastened  together  with  nails  or  strings.  Then  lay  upon  these  an 
old  door,  or  some  loose  boards ;  and  the  injured  person  may  be  easily 
carried  upon  thii  temporary  structure.  A  blanket  fastened  upon  four 
poles,  in  the  maimer  of  a  cot-bi'tl,  will  answer  a  good  purpose. 

Having  placed  the  patient  upon  the  hand  carriage,  bring  the  sound 
limb  and  the;  broken  one  snug  together,  and  tie  them  to  eacli  other 
with  two  or  three  pocket  handkerchiefs;  this  will  support  the  broken 
limb,  and  prevent  its  being  shaken  about  and  injured  by  motion.  In 
doing  this,  the  limb  should  be  laid  as  near  as  possible  in  the  natural 
position,  so  that  the  bones  may  not  get  out  of  place,  and  their  ends 
get  pushed  Hirongh  the  flesh. 

The  Itotliictioii,  or  Sctfiiin'  of  Ihc  FnuJ arc,  is  the  first  thing  to  be 
done.  liy  this  is  meant  the  bringing  ♦'  tlie  ends  of  llie  broken  bono 
togcliier,  and  adjusting  them  to  each  other  in  their  natural  jnisition. 
Tills  is  tlone  by  wliat  surgeons  call  exlensiou,  counlcr-c.dcnsiuii,  and 
coajitation. 

I]\f(>]lsioil  means  taking  hold  of  the  lim!)  below  the  fracture  and 
pulling  //7;w/ the  body. 

Counter-Kvfoilsioil  is  pulling  nlnrtr.  the  fracture  foumrds  the  body. 
Thet'.e  opposite  puUings  are  done  at  the  same;  time  to  overcome  the 
force  of  the  muscles,  which  contract,  and  draw  the  ends  of  the  bone 
by  each  other  and  shorten  the  limb. 

Sometimes  no  extension  or  counter-extension  is  necessary,  the  eiuls 
of  the  broken  bone  not  being  pulled  out  of  their  place.  Wher.  the 
pulling  is  necessary,  it  should  be  gentle  and  steady.     (Sec  p.  877.) 

COiiptilfioii  means  adjuslbi^  the  ends  of  the  bone  to  each  other. 

The  next  thing  is  to  provide  for  keeping  the  ends  of  the  broken 
bone  steadily  in  contact,  so  that  nature  may  have  a  fair  chance  to 
unite  them. 

To  secure  this  object,  mechanical  contrivances  are  used,  which  arc 
simple,  and  may  always  be  had  without  dilTiculty. 

They  consist  of  liru'.n.  ban/ioi^es,  about  the  breadth  of  four  fingers, 
and  from  four  to  ten  yards  long ;  and  pads,  made  of  old  woollen  cloth 
or  blankets  lightly  quilted  together,  or  pillow-cases  filled  with  tow,  or 
chad",  or  cut  stra\y,  or  even  leaves  ;  and  of  splints,  made  of  clapboards, 


i 


SURGICAL    DISEASES. 


445 


or  tliiclc  shingles,  four  finT:crs  wide,  and  in  length  con'esponding  with 
th:it  of  the  broken  limb  ;  or  wheat  straw  laid  side  by  side,  and  quilted 
into  a  piece  of  cloth  to  prevent  thoni  moving  about.  A  very  useful 
splint  may  be  made  from  the  fresh  bark  of  trees. 

The  pads  are  to  bo  placed  under  the  splints,  to  prevent  injuries  to 
the  skin ;  and  the  bandages  to  be  bound  over  the  whole.    (Sco  p.  S78. ) 

For  some  hours  after  a  linib  is  broken,  the  parts  eontiiuie  to  swell ; 
and  if  bound  up  iinmcdiatch/  with  the  pads,  splints,  etc.,  nuich  need- 
loss  pain  will  be  occasioned.  It  is  best,  therefore,  not  to  put  these  on 
under  two  or  three  days,  but  merely  to  lay  the  limb  in  a  natural 
•^o:iition,  and  perhaps  lightly  bind  one  sj)!'nt  to  it.  Broken  ribs  and 
jollar  bones  are  exceptions,  and  shoulu  be  bound  up  immediately. 

A  broken  arm  lies  easiest  half  bent,  upon  a  pillow ;  the  thigh  or 
leg,  upon  the  outside,  with  the  knee  bent. 

When  the  apparatus  is  once  adjusted,  the  less  it  is  meddled  with 
the  better. 

In  fractures  of  the  shoulder  or  arm,  a  sling  is  a  contrivance  of  groat 
importance.  This,  if  well  made  and  adjusted,  keeps  the  broken  bono 
in  its  place,  and  at  tho  same  time,  allows  tho  patient  to  tako  some 
exercise  by  walking  about. 

Fifl.  149. 


MdfiAso  fract'  re-boxes  (Fig.  150),  qx\  A  fracture -era  dies, — tho  latter  to 
keep  tho  bed-clothes  lifted  away  from  the  painful  limb.     Fraoture- 


Beside  tho  above  contrivances,  there  is  the  double  inclined  plane     ; 
(Fig.  149)  for  giving  the  leg  the  advantage  of  a  bent  position.   There 

FlO.  ISO. 


l,i,! 


I 


r 


446 


SURGICAL  DISEASES. 


beds  are  now  brought  to  great  perfection,  and  one  ^^hou]d,  if  possible, 
be  procured  when  the  patient  is  likely  to  be  confined  a  long  time 
with  a  compound  fracture.  The  fracture-box,  represented  by  Fig. 
150,  may  be  made  from  thin  boards,  by  any  carpenter.  It  has  a 
hinge  at  the  knee  to  enable  it  to  fulfil  the  double  purpose  of  a  double- 
inclined  plane  and  a  fracture-box. 

The  Way  in  which  Broken  Bones  Unite. 

The  union  of  broken  bones  is  much  slower  than  that  of  severed 
flesh.  The  ends  of  the  bone  being  kept  steadily  together,  they  »oon 
become  surrounded  by  a  swelling  of  the  soft  parts,  which  change  to 
a  sort  of  osseous  substance,  making  a  kind  of  bony  hoop,  to  act  as  a 
splint  or  support, —  nature  not  being  willing  to  trust  the  surgeon  to 
keep  the  fragments  axactly  in  their  place.  This  is  called  a  provis- 
ional callus,  because  it  only  has  a  temporary  use. 

This  First  Stag-e  lasts  about  ten  days.  At  the  end  of  this  time,  t. 
spongy  substance  appears  between  the  endi;  of  the  bone.  This  sub- 
stance is  not  bone,  but  in  the  swelling  around  the  fracture  specks  of 
bone  begin  to  be  deposited ;  the  fibrine  here  poursd  out  becoming 
first  cartilage,  and  then  receiving  into  itself  phosphate  of  lime,  it  be- 
comes bone.  A  similar  work  is  going  on  within,  in  the  part  called 
the  medullary  membrane. 

Tliis  Second  Sta^e  lasts  from  the  tenth  to  the  twenty-fifth  day. 

Then  Begins  the  Tliird  Stage,  which  goes  to  the  end  of  the  sixth 
or  eighth  week.  During  this  period,  the  external  swelling,  and  the 
internal  medullary  membrane,  become  completely  ossified  and  firm ; 
though  the  ends  of  the  bone  are  not  yet  grown  together. 

The  Fourth  Stage  goes  to  the  end  of  the  fifth  or  sixth  month. 
During  this  time,  the  external  swelling,  or  provisional  callus,  becomes 
covered  with  a  periosteum,  and  the  ends  of  the  bones  themselves  are 
fastened  together  by  a  bony  union. 

The  Fiftli  Stage  extends  from  the  fifth  or  sixth  to  the  twelfth 
month.  During  this  time,  the  ends  of  the  bone  become  grown  to- 
gether so  strongly  that  the  bony  ring,  or  provisional  callus,  is  no 
longer  wanted,  and  it  becomes  absorbed,  and  disappears,  —  in  other 
words,  having  no  further  use  for  it,  nature  takes  off  her  splint.  The 
place  where  the  fracture  was,  is  now  as  strong  as  any  other  part 

Union  in  Compound  Fractures. 

The  union  of  compound  fractures  takes  place  in  a  different  way 
from  that  of  the  simple  fracture,  just  described.  In  this  case  there  is 
Buppuration,  and  the  bones  remain  disunited  several  weeks,  and  there 
is  no  provisional  callus  formed.  But  after  some  weeks,  the  ends  of 
the  bone  soften  and  granulate ;  and  when  the  production  of  pua  de- 
clines, these  granulations  are  gradually  changed  into  bone. 


SUKGICAL  DISEASES. 


447 


Time  Required  for  Uniting  Different  Bones. 

Fractures  of  the  arms  unite  sooner  than  those  of  the  legs. 

The  ribs  and  collar  bone  unite  with  tolerable  firmness  in  about  a 
month ;  those  of  the  arm  in  six  weeks ;  of  the  tnigh  and  leg  in  eight 
weeks.     I  only  mean  the  firmness  derived  from  the  provisional  callus. 

A  broken  bone  will  unite  much  sooner  in  a  healthy  pcrsoii  than  in 
an  unhealthy  one ;  much  sooner  in  a  young  than  in  an  old  person. 

As  a  general  rule,  the  apparatus  should  be  kept  on  thirty  days  in 
the  case  of  children  ;  forty  days  in  that  of  adults ;  and  much  longer 
in  that  of  aged  persons. 

False  Joint. 

The  union  of  a  broken  bone  is  sometimes  prevented  by  a  frequent 
moving  of  the  limb.  The  ends  of  the  bone  having  failed  to  grow  to- 
gether, will  sometimes  become  rounded  a  nd  smoothed,  uniting  only 
by  a  kind  of  ligament,  and  acquire  the  habit  of  sliding  upon  each 
other,  and  thus  form  what  is  called  a  false  or  artificial  joint,  —  the 
limb  being  permanently  capable  of  bending,  to  some  extent,  at  the 
place  of  the  fracture. 


Fractnres  of  the  Skull. 

These  are  always  dangerous  in  their  nature,  and  the  aid  to  be 
derived  from  surgery  much  less  than  in  other  fractures.  If  a  fracture 
of  the  skull  produce  deep  sleep,  and  snoring,  and  the  patient  does 
not  show  any  symptoms  of  pain  when  pinched,  etc.,  we  are  to  infer 
that  a  piece  of  bone  is  pressed  down  upon  or  into  the  bro._  . 

In  this  case,  if  the  position  of  the  blow  be  known,  a  cut  is  to  be 
made  through  the  skin,  two  or  three  inches  long,  down  to  the  bone. 
If  arteries  bleed,  they  must  be  taken  hold  of  with  a  pair  of  forceps, 
and  tied  with  a  silk  thread,  the  ends  of  which  are  to  be  cut  off.  The 
bone  being  well  exposed  by  one  or  two  incisions,  the  piece  which  is 
pressed  down  upon  the  brain  is  to  be  raised  with  a  chisel,  or  some 
similar  iuvstrument,  to  a  level  with  the  other  bones.  The  surface 
must  then  be  cleaned  with  a  sponge,  the  hair  around  shaved  off,  the 
skin  brought  together,  and  the  cut  edges  reunited  by  sticking  plaster. 

When  the  inflammation  appears,  twenty-four  hours  after,  it  is  to  be 
kept  down  by  doses  of  from  five  to  ten  drops  of  tincture  of  veratrum 
viiide,  given  every  one  or  two  hours. 

Fractures  of  the  Bones  of  the  Nose. 

Injuries  of  this  kind  may  generally  be  rectified  by  passing  a  strong 
probe  up  the  nostril,  and  pressing  out  the  bones  to  their  natural  place, 
at  the  same  time  using  the  fingers  on  the  outside  to  prevent  their 
being  pressed  out  too  far.  Inflammation  must  be  kept  down  bj 
vloths  wet  in  cold  water  and  laid  on,  and  by  light  diet. 


w 


■li 


!l!i 


,it- 

^1 


:  ;:ii 


111:'! 


I  i 


44tt 


SURGICAL  DISEASES. 


Fracture  of  the  Lower  Jaw. 

This  usually  takes  place  near  the  chin.  It  may  occur  also  near  the 
aiii^les  of  the  jaw.  It  may  be  .simple  or  compound,  and  is  known  by 
i\\i'.  pain,  the  swelling,  the  inability  to  move  the  jaw,  the  indentation 
lilt  by  the  finger,  the  irregularity  of  the  teeth,  and  tlie  grating  sensa- 
tion felt  while  inoving  the  jaw  with,  the  hand  placed  on  liie  back 
fVigment. 

TreatllU'llt.  —  Let  one  or  both  thumbs  be  introduced  into  the  mouth. 
With  u:>^9e,  keep  the  back  part  of  the  jaw  stationary,  and  pull  for- 
ward tho  fore  part  with  the  lingers  on  the  fio.151. 
on t side.      Tn   this   wuy    the    fracture   can 
S003-  be  put   i-ght.      This  done,  shut  the 
iiioutii  "^irmly,  ar^d  place  a 
of  lint  o/er  the  bioken  part ; 
a  piece  ot   pristeboara,    ^^^etted   so   as  to 
bend  easily  to  tnt  parts,  ar»^  over  this  a 
stro'jg  bandage  oi  muFlin,  twt  and  a  half 
inches  wide,  with  a  emdl  ba^   to  fit  and 
hold  the  chin  ;  ail  which  is  represented  in 
hig.  151. 

For  a  fortnight,  the  patient  must  feed  on  gruel,  broth,  arrow-root, 
and  milk,  that  the  jaw  may  not  be  displaced  by  chewing. 

Fracture  of  the  Collar  Bone,  or  Clavicle. 

Tkis  accident  generaUy  occurs  about  the  middle  of  the  bone,  and 
is  generally  caused  by  falls  on  the  arm  and  shoulder. 


le    iracture   can 
done,  shut  the  y \  \  ' 
thick  compress  \\\ 
t ;  over  this  put    \\\ 
etted    so    as    to      \  N 


Fia.163 


FiQ.158. 


Syniptoins.  —  Pain  and  tenderness  at  the  place  of  the  injury,  arJ 
inability  to  lift  the  arm ;  a  small  bunch  or  prominence  at  the  point  of 


m 


SURGICAL  DISEASES. 


449 


the  fracture ;  the  distance  from  the  point  of  the  shoulder  to  the  breast- 
bone shorter  than  on  the  other  side :  and  the  dropping  downwards, 
forwa'fils,  and  inwards  of  the  shoulder.  To  moke  the  case  sure,  com- 
pare the  two  bones,  and  see  whether  they  agree. 

Trentnient.  —  Place  the  knee  between  the  shoulder-blades,  and 
grasping  the  round  ends  of  the  shoulders  with  the  two  hands,  draw 
them  gently  back  till  the  ends  of  the  bone  come  to  their  proper  place; 
or,  place  the  elbow  of  the  patient  close  to  the  body,  and  a  little  for- 
ward, and  then  push  it  upward. 

To  n^tain  the  shoulders  in  this  upward  and  backward  position  for 
soino  weeks,  pass  a  flannel  bandage,  four  inches  wide,  around  the 
front  of  one  shoulder,  under  the  arm-pit,  across  the  back,  over  the 
opposite  shoulder,  under  the  other  arm-pit,  and  again  across  the  back, 
ill  the  form  of  the  figure  oo.  To  prevent  the  bandage  from  cutting 
the  skin,  put  pads  under  the  arms.     (Figs.  152  and  153.) 

Fracture  of  the  Shoulder-Blade. 

When  this  accident  happens,  the  body  of  the  bone  is  generally 
broken  across  by  some  great  direct  violence.  In  a  few  instances,  the 
end  next  to  the  collar-bone  is  broken. 

Symptoms.  —  Great  pain  in  moving  the  shoulder,  and  the  grating" 
sensation  which  may  be  felt  by  placing  one  hand  on  the  upper  end 
•f  the  bone,  and  moving  the  lower  portion  with  the  other. 

Treatment.  —  A  bandage  must  be  p.  ssed  round  the  chest,  and  a 
few  turns  be  made  around  the  upper  arm,  so  as  to  fasten  it  to  the 
side,  and  prevent  all  motion.  Purging,  low  diet,  and  the  tincture  of 
veratrum  viride  will  be  requiiLvi  to  keep  down  inflammation. 

Fracture  of  the  Acromion,  or  the  end  of  the  scapula  which  unites 
with  the  collar-bone,  may  be  known  by  the  flattening  of  the  shoulder, 
—  the  broken  part  being  drawn  down  by  the  action  of  the  deltoid 
muscle. 

Treatment.  —  It  must  be  supported  by  the  same  bandages  as  are 
used  for  a  fracture  of  the  collar-bone ;  and  the  elbow  must  be  well 
raised,  so  that  the  head  of  the  upper-arm  bone  may  be  lifted  against 
the  upper  p  .  :n  of  the  scapula,  and  act  as  a  prop  to  keep  it  in  plaee. 
No  pad  should  be  put  in  the  arm-pit,  for  this  would  push  the  broktfa 
part  too  much  outward.  '  ,     ' 

Fracture  of  the  Upper-Arm  Bone. 

The  bone  of  the  upper-arm  is  most  frequently  broken  near  the 
centre,  though  it  may  be  fractured  near  the  ends.  It  may  be  known 
by  taking  hold  of  the  arm  above  and  below  the  suspected  fracture, 
and  attempting  to  move  the  ends  of  the  upper  and  lower  fragments 
u|X)n  each'  other.  If  there  be  a  fracture,  the  grating  of  the  broke'n 
ends  against  each  other  will  either  be  heard  or  felt     The  arm  will 

57 


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nil 

Ml 

m 


i 


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450 


SURGICAL  DISEASES. 


Fis.  IM. 


also  be  bent  and  helpless ;  and  if  the  ends  of  the  bone  be  slipped  by 
each  other,  it  will  be  shortened. 

Treatment.  —  Let  a  powerful  man  take  hold  of  the  arm  and  pull 
gently  and  gradually,  but  with  considerable  force,  till  the  arm  is 
brought  to  its  natural  length.  —  another  man  taking  hold  of  the  body 
of  the  patient,  and  pulling  in  an  opposite  direction.  In  the  mean 
time,  the  surgeon  is  to  adjust  the  ends  of  the  bone  to  each  other, 
and  apply  a  bandage,  but  not  very  tightly,  from  the  elbow  to  the 
shoulder,  and  over  this,  four  splints,  with  |)ads  vuider  them ;  one  in 
front,  reaching  from  the  shoulder  to  the  bend  of 
the  elbow,  with  a  few  turns  of  the  bandage  over 
it ;  another  behind,  reaching  from  the  shoulder 
to  the  point  of  the  elbow,  with  a  few  turns  of  the 
bandage  around  it,  also ;  another  on  the  inside, 
extending  from  the  arm-pit  to  the  inner  projection 
of  the  bone  at  the  elbow,  also  secured  by  a  few 
turns  of  the  bandage ;  and  the  fourth  one  on  the 
outside,  reaching  from  the  shoulder  to  the  outside 
knob  at  the  elbow.  The  whole  is  now  to  be  se- 
cured either  by  a  bandage  or  tape.  (Fig.  154.) 
The  arm  is  to  be  confined  tx)  the  side,  and  the  hand  and  fore-arm 
placed  in  a  sling.  In  from  seven  to  ten  days,  the  dressing  should  be 
taken  off  to  see  if  all  is  right. 


Fracture  of  the  Elbow. 

This  may  be  known  by  the  pa+'ent  being  able  to  bend  the  arm,  but 
not  straighten  it,  and  by  the  gratmg  which  may  be  heard  or  felt  when 
the  arm  is  moved  back  and  forth  by  the  operator,  and  also  by  the 
severe  pain  felt  in  the  fractured  parts 

Treatment.  —  First  apply  leeches  and  evaporating  lotions  to  reduce 
the  inflammation.  When  this  is  effected,  straighten  the  limb,  and  ap- 
ply a  bandage  snugly  from  the  fingers  to  the  elbow.  The  broken 
end  of  the  bone  must  now  be  brought  to  its  place,  and  the  bandage 
continued  over  it,  and  for  a  few  inches  above  ir.  Secure  it  heie,  and 
bring  it  back,  —  carrying  it  above  and  below  the  elbow  for  several 
times ;  and  then  extend  it  up  to  the  shoulder.  A  splint  must  now  be 
applied  to  the  inner  side  of  the  arm  to  prevent  its  being  bent,  —  ex- 
tending from  the  hand  nearly  to  the  shoulder,  and  another,  of  similar 
shape,  to  the  outside.  The  joint  should  be  kept  quiet  for  four  or  five 
weeks,  —  during  which  time,  the  splints  may  be  taken  off  three  or 
four  times,  to  see  if  there  is  any  chafing  of  the  skin,  or  any  disturb- 
ance of  the  bones. 

Fractures  Between  the  Elbow  and  Wrist. 

Thk  part  of  the  arm  between  the  elbow  and  wrist,  called  the  fore^ 
arm,  has  two  bones,  —  one  extending  from  the  elbow  on  the  inside  to 
the  wrist  at  the  root  of  the  little  f  iger,  called  the  ulnOf  and  the  other, 


SURGICAL  DISEASES. 


451 


on  the  side  next  the  thumb,  a  shorter  and  a  smaller  bone,  and  called 
the  radius. 

When  both  these  bones  are  broken  at  the  same  time,  the  fracture 
may  be  easily  discovered ;  when  otily  one,  the  sound  bone  keeps  the 
other  in  place,  and  the  injury  i^  not  so  easily  made  out. 

Treatment.  —  Relax  the  nnisclcs  by  bending  tlie  elbow,  and  then, 
by  extension  and  counttjr-extension,  put  the  ends  of  the  bones  in 
proper  place,  and  then  place  two  splints  thickly  padded  in  the  centre, 
one  upon  the  front  of  the  hand  and  fore-arm,  and  the  other  upon  the 
back  of  the  hand  and  fore-arm,  —  the  palm  of  the  hand  being  turned, 
not  towards  the  chest,  but  downwards.  They  are  to  be  covered  with 
a  bandage  from  the  fingers  to  the  elbow.  The  whole  arm  and  hand 
should  be  placed  in  a  sling,  and  remain  in  this  position  four  or  five 
weeks. 

Fractures  of  the  Wrist,  Hands,  and  Fingers. 

The  setting  of  fractured  bones  in  these  parts  is  to  be  done  by  ex- 
tension and  counter-extension,  as  in  the  case  of  other  bones. 

If  the  wrist  be  broken,  a  splint  should  be  applied  in  front  and  one 
behind,  and  a  bandage  bound  tightly  from  the  hand  half  way  to  the 
elbow. 

In  fracture  of  the  bones  of  the  hand,  a  pad  or  compress  must  be 
put  upon  the  palm  of  the  hand,  and  a  splint  placed  over  this,  with 
a  bandage  extending  from  the  wrist  to  near  thp  ends  of  the  fin- 
gers. 

If  one  finger  only  be  broken,  apply  narrow  paste-board  splints  on 
four  sides,  and  cover  them  with  a  narrow  bandage ;  and  then  bandage 
the  whole  hand. 

In  all  these  fractures,  place  the  hand  in  a  sling.  About  three  weeks 
will  be  required  for  the  bones  to  unite  properly,  and  several  weeks  for 
the  parts  to  acquire  their  natural  usefulness. 

Fracture  of  the  Ribs. 

This  accident  occurs  either  by  blows,  or  by  being  crushed  between 
two  opposing  forces.  One,  two,  or  more  ribs  may  be  broken  at  a 
time,  according  to  circumstances. 

Symptoms.  —  A  fixed,  piercing  pain,  made  worse  by  breathing, 
coughing,  or  any  other  motion,  and  also  a  grating  sensation  during 
the  taking  of  a  long  breath,  the  hand  being  laid  upon  the  injured  part 
at  the  time. 

Treatment. —  The  ribs  are  to  be  held  steadily  in  their  place  by  pres- 
sure. To  effect  this,  request  the  patient  to  draw  in  a  long  breath, 
and  hold  it.  While  the  ribs  are  swelled  out  in  this  way,  and  the 
broken  ends  are  thus  brought  to  their  proper  place,  pass  a  woollen 
bandage,  five  or  six  inches  wide,  several  times  tightly  around  the 
chest,  from  the  arm-pits  to  the  pit  of  the  stomach.     This  will  confine 


.     'I 


riii 


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1 1- 


It 


Ijt 


452 


SURGICAL  niSKA8ES. 


the  muscles  of  the  chest,  and  the  breathing  will  have  to  be  done  with 
the  muscles  of  the  belly,  and  the  ribs  will  thus  be  kept  etill,  and 
have  a  chance  to  grow  together. 

If  the  pleura  be  wounded,  and  inflammation  follow  from  this  or 
other  cause,  the  patient  must  be  confined  in  bed,  kept  on  a  low  diet, 
and  his  pulse  be  kept  down  by  tincture  of  veratrum  viride.  The 
bowels  should  be  emptied  by  recipes  18,  or  20,  or  27,  or  41,  both  to 
liubdue  inflammation,  and  to  give  the  diaphragm  a  chance  to  drop 
down  freely. 

Fracture  of  the  Breast-Bone. 

Symptoms. —  The  injured  part  is  frequently  either  sunk  down  or 
raised  up ;  there  is  difficult  breathing,  cough,  spitting  of  blood,  pain, 
inability  to  lie  on  the  back,  and  a  grating  noise  caused  by  breathing. 

Treatment. — The  same  as  that  for  broken  ribs.  Should  the  broken 
part  be  pressed  down  upon  the  lung,  so  as  to  cause  serious  difficulty 
of  breathing,  an  incision  may  be  made,  and  the  broken  piece  raisea 
up  with  a  chisel,  or  stiff*  case  knife,  or  some  similar  instrument. 

Fracture  of  the  Haunch  Bones,  or  Pelvis. 

These  fractures  are  dangerous,  —  being  often  connected  with  aome 
other  injury,  as  tearing  of  the  bladder,  lower  bowel,  or  great  veins  or 
arteries.  Fortunately,  however,  they  are  only  caused  by  some  great 
violence,  and  do  not  often  occur. 

Treatment. —  Place  the  patient  in  the  easiest  possible  position,  and 
keep  him  entirely  at  rest.  Generally  a  catheter  should  be  kept  in  the 
bladder,  that  the  water  may  pass  off  easily ;  and  the  whole  hips 
should  be  bo«ind  round  tightly  with  a  flannel  or  calico  bandage,  and 
made  as  firm  and  fixed  as  possible,  to  keep  the  broken  bones  together. 
The  most  perfect  rest  must  be  ordered  for  six  weeks  or  two  months. 

If  the  extreme  lower  end  of  the  sacrum^  the  os  coccygis  (Figs.  8 — 3) 
be  broken,  the  separated  portion  must  be  put  in  its  place  by  introduc- 
ing the  fi^iger  into  the  rectum ;  and  the  bowels  must  be  kept  loose  by 
gentle  physic,  that  the  broken  bone  may  not  be  pushed  from  ita  place 
by  the  pressure  against  it  of  hard  stools. 

Fracture  of  the  Thigh-Bone. 

The  points  where  this  bone  are  broken  are  at  its  uppet  poffion  or 
neck  and  near  its  middle.  The  break  at  this  latter  place  may  be 
straight  across,  or  oblique,  —  partially  lengthwise.  When  oblique,  the 
point  of  the  bone  may  stick  into  one  of  the  large  muscles,  and  be 
made  fast  by  it. 

Symptffinis.  —  The  fracture  in  the  middle  of  the  bone,  if  it  be  trans* 
verse,  may  be  known  by  some  swelling  or  irregularity  discovered  by 
mnning  the  band  along  the  thigh,  and  grasping  it  here  and  there; 


and  if  it  be  oblique,  the  enda  of  the  bone  will  be  drawn  by  each 
other,  and  the  limb  will  be  shortened. 

Treatment.  —  Place  the  patient  on  his  back,  and  let  two  strong  men 
use  extension, — one  taking  hold  near  the  hip,  and  the  other  grasping 
t.h(^  linib  at  the  knee  and  pulling  steadily  and  strongly  till  the  limb  is 
of  (he  proper  length,  and  the  ends  of  the  bone  are  in  their  place.  The 
man  who  takes  hold  of  the  upper  end  of  th*.'  limb  jr»ay  hold  it  more 
tirmly  and  with  less  fatigue  by  passing  a  folded  sheet  anmnd  the  groin. 

The  extending  force  being  still  continued,  the  operator  is  now  to 
apply  the  splints,  which  are  to  be  four  in  number,  —  one  in  front, 
reaching  from  the  knee-pan  to  the  groin;  out;  behind;  one  on  the 
inside,  frotn  the  upper  part  of  the  thigh  to  the  inside  of  the  knee ; 
and  a  fourth  one,  about  four  inches  wide,  reaching  from  the  arm-pit 
to  a  distance  of  two  or  three  inches  beyond  the  sole  of  the  foot 
Cotton  must  be  placed  under  these  splints  to  prevent  their  injuring 
the  skin,  and  they  must  be  of  a  width  to  nearly,  but  not  quite,  touch 
each  other.  These  being  properly  adjusted,  and  the  extension  stiil 
contiimed  if  the  fracture  is  oblitjue,  the  bandage  is  now  to  be  firmly 
applied  from  the  foot  to  the  upper  part  of  the  thigh,  and  then  passed 
a  few  times  around  the  body.  This  fracture  is  sometimes  treated 
without  eplints,  as  represented  in  Fig.  155. 


Fia.  !£& 


Fio  166 


Six  or  seven  weeks  will  be  required  for  the  bones  to  grow  together, 
during  which  time  the  patient  will  need  to  lie  upon  his  back.  But 
the  dressing  may  now  and  then  be  taken  off  and  put  on  again. 


I 


!'  |,i  I   . 

Ijt     " 

:■      ':  1 

■  !i    i 

454 


SURGICAL  DISEASES. 


SomctimcH  only  a  single  long  splint  is  used ;  sometimes  no  splint ; 
in  still  other  (sascs,  four  splints,  —  the  outside  one  being  short,  and  the 
limb  renting  on  a  double  inclined  plain. 

Fructure  at  the  Xeck  of  the  Itoiie.  —  When  the  bone  is  broken  at 
the  neck,  close  to  the  hip  joint,  the  injury  is  known  by  the  knee  and 
foot  turning  oulivanJ,  and  by  the  limb  being  an  inch  or  two  shorter 
than  the  other  (Fig.  150).  This  is  an  accident  to  which  old  ptirsons 
are  particuhirly  liuL>le.  When  the  bone  is  broken  here,  it  seld  >m 
grows  together  again.  Tlie  miion  which  is  formed  is  generally  by  a 
ligiiment. 

Treiitnicnt. —  This  requires  a  very  long  splint,  reaching  from  the 
armpit  to  Ix'yoiid  the  sole  of  the  foot,  and  bound  firmly  with  a  band- 
age, as  in  rnutnn>  in  the  middle  of  tin;  thiii;h.  The  Ihul)  should  be 
ke|)t  (^xtciuicd,  and  the  injured  one  nuist  be  l)ound  to  the  t)ther  by  a 
bandage,  keeping  both  legs  straight  and  innnovable.  A  i)road  leather 
strap,  lM)und  lirinly  round  the  hips  and  thighs,  will  hv.  serviceable. 

Two  or  three  months  will  be  riupjired  for  *':,'.  lUjuiy  to  become 
repaired,  so  that  the  liiul)  may  be  used.  The  patient  must  get  up 
cautiously,  and  be  rarelnl  not  to  use  the  limb  much  so  long  as  pain 
is  produced.      (See  p.  877.) 

• 

Fracture  of  the  Knee-Pan. 

TiiR  knee-|)an  (patella)  may  be  broken  up  and  down,  or  across;  — 
the  latter  fracture  is  the  more  common.  It  is  a  troublesome  fracture, 
and  is  very  apt  to  leave  a  stiff  knee. 

Syiiiptoniii.  —  When  the  bone  is  brcrken  across,  the  patient  cannot 
stand  upon  the  limb ;  the  leg  may  be  flexed  or  crooked,  but  cannot 
be  straightened ;  the  upper  part  of  the  knee-pan  is  drawn  up  away 
from  the  lower  portion,  leaving  a  wide  gap,  into  which  the  fingers 
may  be  laid,  —  at  the  top  and  bottom  of  which  the  rough  edges  of 
the  movable  bones  may  be  felt. 

TreiitiiiPiit.  ^ — First,  reduce  the  inflammation  by  tincture  of  arnica, 
leeches,  etc.  Then  straighten  the  limb,  and  put  a  well-padded  splint 
behind,  to  keep  the  knee  motionless ;  place  the  patient's  body  in  a 
half-sitting  posture,  and  raise  the  foot  considerably  above  a  level. 
Put  a  bandage  over  the  splint,  beginning  half  way  up  the  thigh,  and 
extending  down  to  the  knee-pan,  and  being  made  very  tight  just 
above  the  broken  bone,  so  lliat  it  cannot  easily  slip  under  it.  The 
broken  bones  must  now  i)e  brought  together,  and  the  bandage  be 
passed  below  and  again  above  the  knee  several  times  in  the  form  of 
a  figure  8,  to  keep  ihe  bones  from  parting. 

The  bandage,  g(>uerally,  may  not  be  removed  for  a  fortnight.  After 
this  i)eriod,  if  everything  has  gone  on  well,  the  limb  may  be  carefully 
bent  a  little  evciry  day,  to  avoid  a  stifl'  knee. 


SURGICAL  DISEASES. 


45o 


Fio. 157. 


Fracture  of  the  Leg. 

The  leg  is  that  part  of  tlie  limb  between  the  knee  and  ankle.  It 
has  two  bones ;  the  sinalior  on  the  outside,  called  the  fibula ;  the 
larger  on  the  inner  and  front  side,  called  the  tibia,  or  shin  bone. 

One  or  both  of  these  may  be  broken  at  the  same  time.  If  both 
are  broken,  it  is  impossible  to  walk  upon  the  limb ;  there  ia  a  change 
in  its  shape  ;  it  may  be  bent ;  and  the  grating  of  the  broken  enda  of 
bone  may  be  felt  or  heard. 

Trentnieilt.  —  First,  adjust  the  bones  by  means  of  extension  and 
counter-extension,  as  in  other  fractures.     Tiien  apply  two  splints,  one 

on  the  outside  from  the  knee  to  the  sole 
of  the  foot;  the  oilier  upt)n  the  inside. 
Over  these  a  bandage  is  to  be  firmly  ap- 
plied, retieliinj^  from  tli(!  toes  to  llie  knee 
Till!  leg  may  rest  upon  the  side  or  the 
back,  as  the  eoinfort  of  the  patient  may 
reciuire.  Upon  the  side  is  generally  the; 
easiest  position,  with  the  knee  a  little 
bent  (Fig.  loT). 

The  dressing  may  b(!  nunoved  in  six  or 
seven  days,  to  see  that  the  bones  are  in  their  propter  phiee.  Five  or 
six  weeks  will  be  re(juired  for  recovery  ;  and  at  the  end  of  this  tiirie, 
the  dressing  may  be  laid  aside.  But  the  patient  must  use  his  leg 
very  gradually. 

One  of  the  simplest  methods  of  treating  a  fractured  leg  is  to  place 
it  in  a  fracture-box.  A  pillow  is  to  be  placed  in  this,  and  the  leg,  the 
bones  being  put  in  place,  is  to  be  placed  in  the  box,  and  the  foot  to 
be  secured  to  the  foot-board  by  a  bandage,  aiid  the  sides  of  tl?e  box, 
movable  upon  hinges,  are  to  be  brought  close  enough  to  the  limb  to 
keep  the  bones  in  place,  —  compresses,  etc.,  being  placed  around  the 
limb  as  required.  Bran  may  be  placed  in  the  box  in  place  of  a 
pillow. 

Fractures  of  the  Bones  of  the  Foot. 

These  are  to  be  treated  in  the  same  manner  with  fractures  of  the 
hand.  They  are  often  attended  with  much  other  mischief,  as  lacera- 
tion of  the  llesh,  ligaments,  etc.  Hence,  cutting  off  the  foot,  or  a 
part  of  it,  is  often  necessary.  Paste-board  splints  are  frequently  used 
in  these  fractures.  If  matter  forms,  it  must  be  let  out  by  opening  the 
parts. 

Compound  Fractures. 

"WdEN,  in  connection  with  a  broken  bone,  there  is  a  wound  of  the 
flesh,  which  leads  to,  and  communicates  with  the  space  between  th(^ 
broken  enda  of  the  bone,  the  whole  injury  is  called  a  compourul  frac- 


\i 


456 


SURGICAL  DISEASES. 


)l!l 


ture.  The  wound  in  the  flesh  may  be  caused  by  the  same  force 
which  breaks  the  bone,  as  a  bullet  from  a  gun,  or  a  cart-wheel,  or 
some  machinery  in  which  the  limb  is  entangled.  Quite  often  the 
flesh  wound  is  caused  by  oik;  of  the  ends  of  the  bone  being  forced 
through  the  flesli  and  skin. 

But,  however  causiHJ,  a  coinjMMUjd  fracture  is  of  a  much  more 
serious  nature  than  a  simple  one  ;  and  it  is  particularly  dangerous 
when  a  joint  is  involved.  It  is  more  serious  above  tlio  kn<'e  and 
elbow  than  below,  and  more  to  be  dreaded  in  the  lower  limbs  than 
in  the  upper. 

Treiltment.  —  An  attempt  should  generally  be  made  to  preserve 
the  limb ;  it  should  not  be  cut  otF,  unless  the  compound  fracture  is  of 
the  worst  kind.  But  if  there  be  no  hope  of  saving  the  limb,  the 
amputation  should  be  performed  at  once,  while  the  constitution  is 
tranquil,  and  before  it  has  been  shocked  and  injured  by  the  sympa- 
thetic  fever,  suppuration,  abscesses,  and  hectic,  which  are  almost  sure 
to  follow  such  grave  injuries. 

But,  suppose  it  be  determined  not  to  cut  the  limb  off",  —  as  it  gen- 
erally should  be,  —  the  first  thing  is,  after  the  bone  is  set,  to  close  the 
wound  against  all  entrance  of  air,  and  to  cause  it  to  heal  by  the  first 
intention,  that  is,  without  suppuration.  To  do  this,  one  method  is  to 
cover  the  wound  with  lint  dipped  in  blood  ;  but  the  more  usual  mode 
is,  to  bring  the  sides  of  the  wound  together,  and  secure  them  very 
carefully  by  strips  of  adhesive  plaster,  in  the  same  way  as  in  common 
cuts.  The  bandage  should  be  kept  wet  with  cold  water,  by  squeez- 
ing a  sponge  over  it,  or  by  sprinkling  cold  water  upon  it  as  fast  as  it 
becomes  dry. 

It  will  be  necessary,  in  thia  case,  to  keep  the  bed-clothes  away  from 
the  limb  while  it  is  thus  wet,  which  may  be  done  by  cutting  a  barrel 
hoop  in  two,  and  nailing  it  to  two  "pieces  of  lath.  There  t5houId  be 
air  circulating  under  the  sheet,  that  the  heat  of  the  inflammation  may 
not  keep  the  limb  in  a  steam-bath. 

Should  the  wound  heal  by  the  first  intention,  the  danger  will  soon 
be  over,  and  the  treatment  may  be  the  same  as  for  simple  fracture. 
But  this,  unfortunately,  does  not  often  occur. 

It  more  often  happens,  that  after  three  or  four  days,  the  patient 
i^rows  restless,  has  very  short  and  disturbed  sleep,  is  hot  and  thirsty, 
has  headache  and  shivering  fits,  is  more  ill  towards  evening,  wanders 
in  his  mind,  or  becomes  delirious,  and  perhaps  dies  in  ten  days  or  a 
fortnight  from  these  constitutional  disturbances.  If  the  symptoms 
are  a  little  less  severe,  the  wound  will  at  first  discharge  a  small  quan- 
tity of  dirty,  bloody  matter,  which,  if  everything  goes  well,  will,  by 
degrees,  change  to  healthy  matter,  without  smell,  of  a  straw  color, 
and  about  as  thick  as  cream. 

The  fever,  and  other  bad  symptoms,  will  now  subside ;  the  sleep 
and  appetite  come  back,  and  a  new  process  begins  that  of  healing  by 
granulation^  or  the  formation  of  new  flesh  to  hll  up  the  gap  made  by 
the  wound. 

For  old  persons,  or  those  whose  health  has  been  broken,  this  stage 


!  ii 


SURGICAL  DISEASES. 


457 


is  full  of  danger,  and  is  apt  to  result  in  death,  if  the  lower  limb  be 
the  injured  part. 

If  the  constitution  proves  unable  to  bear  up  againat  this  stage  of 
the  injury,  alternate  heat  and  sweating  set  in,  the  face  is  (lushed  with 
a  pink  color,  the  pulse  becomes  weak  and  (|uick,  the  body  wastes,  the 
appetite  disappears,  the  tongue  becomes  dry  and  brown,  restlessness, 
wanderinjj;,  and  delirium,  follow  in  quick  succession,  and  all  are 
•pe»;dily  terminated  by  death.  With  the  setting  in  of  the.-ie  symp- 
toms, the  wound  stops  discharging,  or  throws  out  only  a  thin,  watery 
and  stinking  matter.  Quite  ol'tcn  the  skin  and  other  parts  mortify, 
and  if  there  be  strength  enough  to  throw  oil'  the  dead  parts,  the 
broken  ends  of  the  bone  stick  out,  looking  dead  and  white. 

When  the  constitutional  symptoms  begin,  apply  poultices,  to  set 
up,  if  possible,  the  formation  of  good  matter;  for  if  this  can  be 
brought  about,  the  8yn)ptonis  may  be  regardi-cl  as  favorable.  The 
poultice  must  be  continued  till  the  wound  is  tilled  with  new  flesh 
nearly  to  the  surface. 

In  the  First  8tag^e,  the  medical  treatment  must  have  reference  to 
checking  the  inflammatory  condition.  Thin  may  be  done  by  full 
doses  of  tincture  of  veratrum  viride.  Should  the  symptoms  take  a 
typhoid  type,  and  the  powers  of  life  seem  to  sink,  then  quinine,  and 
iron,  and  bitters  will  be  needed. 

In  the  Second  Stn^e,  whatever  inflammation  there  is  depends  on 
exhaustion,  and  everything  fitted  to  prop  and  fortify  the  constitution, 
as  brandy,  wine,  brot  i,  and  easily  digested,  nourishing  food,  must  b<« 
freely  given. 

Dislocations.— Luxations. 

The  surfaces  where  two  bones  meet  and  glide  upon  each  other  for 
the  purposes  of  a  joint,  are  called  articular  surfaces,  and  the  union  is 
said  to  be  an  articulation.  These  surface's  are  covered  by  a  smooth 
cartilage,  to  render  their  play  upon  each  other  easy. 

The  joints  are  held  together  by  cartilaginous  straps  and  ligaments, 
which  serve  as  puUies ;  by  the  aid  of  these,  the  joints  turn  back  and 
forth,  as  a  door  opens  and  shuts  upon  its  hinges. 

When  by  some  external  violence,  or  the  weakening  of  these  liga- 
ments, these  surfaces  are  suddenly  separated,  or  forced  apart,  there  is 
said  to  be  dislocation  or  luxation. 

Joints  are  divided  into  two  kinds,  the  ball  and  socket  (orbicular) 
which  has  a  rotatory  motion,  as  the  shoulder,  hip,  thumb,  —  and  the 
angular,  or  pump-handle  (ginglymoid),  as  the  elbow  and  knee. 

The  ball  and  socket  joints  have  a  greater  diversity  of  motion,  and 
are  more  exposed  to  dislocation.  They  are  likewise  more  easily  put 
in  their  place. ' 

In  a  Primary  Dislocation,  the  bone  is  thr  vn  at  once  into  the  place 
where  the  surgeon  finds  it. 

The  Secondaiy  Dislocation  is  one  in  which  the  muscles  pull  the 


i 


458 


SURGICAL  DISEASES. 


head  of  the  bone  still  further  from  its  natural  place  than  it  was 
thrown  by  the  first  shock  of  violence. 

A  Dislocation  is  Simple  when  there  is  no  wound  penetrating  the 
synovial  membrane. 

It  is  Compound  when  attended  by  such  a  wound. 

A  Dislocation  Ia  Coniplet«  when  the  articular  surfaces  are  entirely 
separated. 

It  is  Incomplete  when  the  separation  is  only  partial. 

Recent  Dislocations  are  rtictified  with  comparative  ease. 

Old  Dislocations  are  hard  to  be  repaired,  and  sometimes  cannot  be 
ireduced  at  all. 

The  Symptoms  of  Dislociition  are,  inability  to  use  the  joint;  the 
head  of  the  bone  being  felt  in  an  unnatural  |)lace ;  llie  limb  shortened, 
lengthened,  or  distorted;  a  ehixnge  in  the  shapes  of  llie  joint,  etc. 

Simple  disloeulions  are  generally  trivial.  C'oinpomul  dislocations 
often  render  amputation  necessary,  and  are  always  perii»->'i8. 

Aged  persons  are  less  liable  to  disloc^ations  than  the  young. 

When  a  dislocation  and  a  fracture;  occur  at  the  same  time,  the  dis- 
location is  to  receive  attention  first. 

A  dislocation  is  to  be  reduced  by  a  g-radiial  and  continuous  extend- 
ing force.  The  reduction  is  kniwn  by  the  limb  recovering  its  natural 
length,  shape  and  direction,  and  by  its  being  able  to  perform  certain 
n  otions  which  are  not  possible  while  in  a  dislocated  state.  The  pain 
is  immediately  reduced  upon  reduction  taking  place.  In  shoulder 
and  hip  dislocations,  the  head  of  the  bone  makes  a  loud  noise  when 
it  slips  into  its  place. 


i!! 


it,  I 
i" ! 


Dislocation  of  the  Lower  Jaw. 

Gaping  very  wide  is  the  usual  cause  of  this.  It  has  been  known 
to  result  from  a  mere  yawn.     One  or  both  sides  may  be  disjointed. 

Symptoms. —  If  but  or*^  '*ide  is  dislocated,  the  chin  is  twisted  to  one 
side,  and  immovable,  and  the  jaws  are  partially  open ;  if  both  sides, 
the  mouth  is  wide  open,  the  chin  projects,  there  is  a  hollow  in  front 
of  each  ear,  great  pain,  inability  to  speak,  and  dribbling  of  spittle 
from  the  mouth. 

Treatment.  —  To  effect  a  reduction,  cover  the  thumbs  with  a  towel 
or  a  piece  of  wash-leather  to  prevent  their  being  injured  by  a  sudden 
snapping  tog^the-  of  the  jaws,  and  then,  staufling  in  front  of  the 
patient,  introduce  them  into  the  mouth,  press  them  upon  the, crown 
of  the  back  lower  teeth,  at  the  same  time  lifting  the  chin  with  the 
fingers. 

After  the  jaw  is  set,  it  should  be  kept  bandaged  for  a  few  days, — 
the  bandage  being  merely  passed  once  or  twice  over  the  tt)p  of  the 
head,  and  under  the  chin.  No  solid  food  requiring  chewing  should 
H«  taken  for  a  short  time. 


L- 


:■«*  ^ 


SURGICAL  DISEASES. 


459 


Dislocation  of  the  Collar-Boue. 

This  may  take  place  by  the  end  attached  to  the  breast-bone  slip- 
ping over  or  under  that  bone,  or  by  the  other  end  slipping  ahove  of 
beloiv  the  bone  to  which  it  is  attached.  When  the  first  named  end 
of  the  bone  slips  over  the  breast-bone,  it  is  said  to  be  a.  forward  dis- 
tocation  ;  when  it  slips  under  the  breast-bone,  it  is  back^vard.  In  this 
latter  form  of  dislocation,  the  end  of  the  collar-bone  sometimes  presses 
upon  the  gullet,  and  prevents  swallowing, 

Sviiiptoiiis. —  In  the  forivard  dislocation  of  the  iimer  end  of  the 
bone,  a  hnncli  may  be  felt  by  the  hand  at  the  top  of  the  breast-bone; 
ill  the  biickivard  disluca/ion,  a  depression  or  hollow.  The  upward  dis- 
location of  the  onter  end  of  the  collar-bone,  may  be  known  by  the 
flattened  and  sunken  condition  of  the  shoulder. 

TrentniPllf.  —  To  put  the  bone  in  its  place  i  i  tlie  first  of  these  ac- 
cidents, draw  the  slionltlers  back,  by  which  means  the  collar-bone 
(clavicle)  is  drawn  away  from  the  breast  bone  (sternum),  and  easily 
slips  into  its  place.  To  reduce  the  dislocation  at  the  oilier  (Mid  of  the 
bone,  place  the  knee  between  the  patient's  shouhler-blades  (seapuhe), 
and  draw  his  shoulders  backwards  and  vpwards.  After  the  reduction, 
support  the  arm  in  a  sling. 

Dislocation  of  the  Shoulder-Joint. 

The  head  of  the  long  bone  of  the  arm  (humerus)  may  be  displaced 
in  three  diflferent  directions,  —  downvmrd^  into  the  arm-pit  (axilla); 
forward,  under  the  muscrles  of  the  breast ;  and  backward,  upon  the 
back  of  the  shoulder-blade. 

Fio.  158. 


It  is  recognized  by  the  shoulder  losing  its  roundness,  and  becoming 
flat;  by  the  lengthening  of  the  arm  ;  by  the  head  of  the  bone  being 
felt  in  the  arm-pit ;  and  by  severe  pain. 


:!l 


W:  i 


!.   ■  'ill 


iijl 
.If: 


ifif 


I'll 
Hi 
liii 


460 


SURGICAL  DISEASES. 


To  effect  the  reduction  in  the  first  form  of  displacement,  put  the 
patient  on  a  bed,  or  upon  the  floor.  Put  one  heel  in  the  arm-pit, 
against  the  head  of  the  bone.  Then,  taking  hold  of  the  arm  above 
the  elbow,  or  at  the  wrist,  pull  steadily,  and  push  with  the  heel. 
(Fig.  158.)  The  extension  may  be  more  steady  and  powerful  by  a 
double  towel  around  the  surgeon's  nock. 

If  the  reduction  cannot  be  eHectod,  relax  the  muscles  by  a  warm 
bath,  or  by  naustjating  doses  of  tartar  emetic. 

After  the  reduction,  a  sling  will  be  required,  and  three  weeks'  or  a 
month's  rest  I 

Dislocations  of  the  Elbow  Joint.  V 

Of  these  there  are  six  varieties.  In  the  first,  both  bones  of  the  \ 
fore-arm  (radius  and  ulna)  are  thrown  backwards;  in  the  second,  both 
are  drav/n  backivards  and  inwards ;  in  the  third,  both  are  thrown 
backwards  and  outwards ;  in  the  fourth,  the  ulna  alone  is  forced  back- 
wards;  in  the  fifth,  the  radius  is  forced  forwards ;  and  in  the  sixth, 
the  radius  is  thrown  backwards. 

In  general,  these  dislocations  are  all  easily  set.  In  the  first  four, 
the  knee  is  to  be  placed  at  the  bend  of  the  elbow,  and  the  fore-arm 
bent  upon  it,  the  surgeon  grasping  the  upper  arm  with  one  hand, 
and  the  fore-arm  with  the  other.  In  the  dislocations  oi  the  radius, 
the  upper  arm  is  to  be  put  in  a.  Jixed  condition,  while  the  surgeon 
takes  hold  of  the  hand  anc'  pulls,  at  the  satne  time  throwing  the  bone 
forward.  If  the  luxation  be  backwards,  there  must  be  the  same  ex- 
tension and  counter-extension,  while  the  fore-arm  is  bent. 

Treatment.  —  The  fore-arm  must  be  placed  in  a  half-  3nt  position, 
and  a  splint  should  be  band&ged  upon  the  front  of  the  whole  limb, 
compresses  being  placed  upon  the  head  of  the  bones  opposite  the 
direction  of  the  dislocation.  This  confinement  must  be  continued 
three  weeks. 

Dislocations  of  the  Wrist. 

These  are  caused  by  falls  upon  the  hand.  Both  the  radius  and 
nlna  may  be  thrown  backwards  or  forwards  upon  the  wrist,  caus- 
ing a  projection  either  in 
front  or  behind.  (Fig. 
159.)  The  bones  are  to 
be  set  by  pulling  in 
opposite  directions  upon 
the  hand  and  the  fore- 
arm, and  pressing  later- 
ally, if  the  displacement  be  at  the  side  of  the  wrist 


Fio.  150. 


Treatment  —  Put  a  straight  splint  on  the  front,  and  another  on  the 
back  of  the  fore-arm  and  hand,  with  compresses  on  both  sides  of  the 
wrist,  and  a  bandage  over  the  whole.  Support  the  fore-arm  in  a  sling, 
and  keep  down  indammation  by  cold  water,  cooling  lotions,  etc 


a  warm 


SURGICAL  DISEASES. 


46] 


Dislocation^  of  the  Bones  of  the  Hand. 

Some  one  of  the  carpel  bones  may  be  pushed  up  out  of  its  place, 
so  as  to  form  a  projection  on  the  back  of  the  hand.  To  put  it  in  its 
place,  press  upon  it  simply,  and  then  put  compres.ses  on  the  front  and 
back,  with  straight  splints  upon,  these  and  a  bandage  over  all.  Put 
the  hand  in  a  sling. 

Dislocations  of  the  finger  joij)ts  may  generally  be  replaced  by  bend- 
ing the  displaced  phalanx  over  the  head  of  the  bone  from  which  it 
has  been  disjoim^d.  Sometimes  a  good  deal  of  extension  and  counter- 
extension  are  required,  for  which  purpose  a  piece  of  cord  may  be 
wound  around  the  finger,  —  the  skin  being  protected  by  <!overing  it 
with  a  piece  of  wetted  buck-skin. 

Dislocations  of  the  Hip-Joint. 

These  are  four  in  number,  —  vpwards^  do'inwmrda,  b(U'kv;a.rds  and 
upvmrds,  forwards  and  upwards. 

To  reduce  these,  a  greater  amount  of  power  is  needed  than  in  the 
dislocations  of  any  other  bone,  —  owing  to  the  greater  power  of  the 
muscled  which  are  to  be  overcome. 


Fio.  leo 


Tio.  161. 


same  ex- 


Dislocations  of  this  joint  are  often  confounded  with  fracture  of  the 
»cad  and  neck  of  the  thigh  hone.     This  latter  may  be  distinguished 


462 


SURGICAL  DISEASES. 


from  the  luxation  by  the  grating  sound  to  be  heard,  by  tl  e  possibility 
of  pulling  the  limb  out  to  its  natural  length,  and  by  its  being  short- 
ened up  again  by  the  fiction  of  the  muscles  the  moment  the  pulling 
is  given  up. 

The  Uinvnnl  IMsIocntioii  of  the  head  of  this  bone  upon  the  back  of 
the  haunch  bone,  is  known  by  the  shortening  of  the  limb,  and  by  the 
knee  and  foot  turning  inward.,  —  the  foot  lapping  over  the  opposito 
foot,  and  the  great  toe  resting  upon  the  other  instep.     (Fig.  100.) 

The  Dislociitioii  Downward  is  known  by  the  lengthenini^  of  the 
limb,  the  projection  of  the  k.iee,  the  turning  of  the  foot  and  knee  out- 
ward, and  the  bending  of  the  body  forward.     (Fig.  IGl.) 

The  DishiCiitioii  Itiickward  and  Upward  is  distinguished  by  the 
inclining  of  the  foot  ami  knee  inward,  the  drawing  up  of  the  heel, 
and  the  resting  of  the  great  to«  against  the  ball  of  the  great  toe  of 
the  other  foot.     (Fig.  162.) 


FI0.16X 


tra.  16& 


The  Dislocation  Upward  and  Forward  is  known  by  the  shortening; 
of  the  limb,  and  the  turning  of  the  foot  and  knee  outward.  (Fii:. 
163.) 

For  replacing  the  bone,  put  t^ie  patient  upon  a  table,  on  his  back 
Draw  a  sheet  between  his  thighs,  and,  extending  it  up  by  the  side  of 
his  body,  let  it  be  fastened  to  a  staple.     Put  a  padded  belt,  with  rings 


SURGICAL  DISEASES 


463 


attached,  around  the  injured  limb,  just  above  the  knee.  To  these 
rings,  fasten  one  block  of  a  pulley,  and  attach  the  other  to  a  post, 
giving  the  pulley-rope  to  an  assistant.  The  surgeon  now  standing 
on  the  injured  side,  directs  gradual  extension  to  be  made,  while  he, 
by  his  hands,  or  by  a  band  passing  around  the  injured  thigh  and  over 
his  own  shoulders,  lifts  the  head  of  the  bone,  and  guides  it  into  ita 
socket 

Treatment. —  Keep  the  patient  in  bed  for  two  weeks  or  more,  with 
his  knees  tied  together  by  a  strip  of  muslin,  and  a  broad  belt  around 
his  hips. 

Dislocations  of  the  Enee-Pan  or  Patella. 

This  bone  may  be  thrown  outward,  causing  a  great  projectioa  on 
the  outside,  and  an  inability  to  bend  the  knee. 

It  may  be  thrown  inward,  causing  the  same  impossibility  to  bend 
the  knee,  and  a  projection  on  the  inside. 

To  restore  the  bone  to  its  place,  put  the  heel  of  the  patient  upoq 
the  shoulder  of  an  assistant ;  then  press  down  the  edge  of  the  knee- 
pan  which  is  farthest  from  the  centre  of  the  joint,  thus  tilting  up  the 
other  edge  of  the  bone,  when  the  muscles,  aided  by  a  lateral  pressure, 
vill  draw  it  to  its  place. 

Treatment.  —  Put  a  straight  splint  upon  the  back  of  the  limb,  and 
make  moderate  pressure  upon  the  knee  by  a  bandage.  Cold  water, 
or  cooling  washes,  should  generally  be  applied.  Keep  the  patient  in 
bed  two  weeks. 

Dislocations  of  the  Knee-Joint. 

There  are  four  of  these, — forward,  backward,  inward,  and  om<> 
ward. 

They  are  readily  corrected  by  extension  and  counter-extension  from 
the  ankle  and  thigh,  and  pressure  upon  the  head  of  the  displaced 
bone. 

Treatment  much  the  same  as  for  displacement  of  the  knee-pan. 


Dislocations  of  the  Ankle. 

These  may  occur  in  a  forward,  backward,  outward,  and  inward 
direction.     (Figs.  164  and  165.) 

To  rectify  it,  bend  the  limb,  so  as  to  relax  the  muscles  on  the  back 
of  the  leg;  then,  while  extension  and  counter-extension  are  made 
upon  the  foot  and  thigh,  press  firmly  on  the  dislocated  bone,  and  thus 
force  it  to  ita  place. 

Treatment. —  Confine  the  foot  and  leg  in  splints  made  of  thick 

Easte-board,  soaked  in  hot  water,  and  moulded  to  the  shape  of  the 
mb|  with  a  foot-piece  at  right  angles.     Keop  the  patient  in  bed  five 


464 


SUl  GICAL  DISEASES. 


or  six  weeks,  and  when  he  begins  to  walk,  snpport  the  ankle  with  a 
roller  bandage,  or  a  laced  gaiter. 


Fie.  161. 


Vio.Ut. 


Hi 


I,. 


Gontasions.— Braises. 

When  any  blunt,  hard  substance  comes  in  violent  c<^ision  with 
the  soft  parts  of  the  body,  without  breaking  the  skin,  the  injury 
received  is  called  a  bruise.  One  of  these  accidents  generally  rup- 
tures a  great  number  of  the  very  smallest  blood-vessels,  which  let 
out  blood  under  the  skin,  producing  " black  and  bluCy*  or  livid  spots 
(ecchymosis).     "What  fis*,-jflffhiers  call  a  black  eye  is  an  example. 

Treatnieilt.  —  Cold  applications  at  fir^  to  prevent  the  bkyod  mn- 
ning  oui  of  the  small  vessels'  under  the  skin.  After  the  iffflammatkm 
has  subsided,  stimulating  applications,  as  vinegar  and  water,  alcohf(i4, 
cara^^Wtfted  liniment,  ai«nmoikie»  auid  alcohol,  equiu  parts,  and  some- 
times bandages. 

Sprains. 

A  SPRAIN  is  a  forcible  wrenching  and  twisting  ot  a  joint  to  {Stich  a 
degree  as  to  stretch  and  more  or  less  lacerate  the  ligaments  of  the 
part,  and  sometimes  to  break  a  tendon,  but  without  entirely  displac- 
ing a  bone.  Its  symptoms  are,  violent  pain,  swelling,  and  discolora- 
tion of  the  parts  from  the  blood  running  into  the  celk  under  the  skin. 
In  elderly  persons,  the  effects  of  sprains  are  very  tedious,  disabling 
tbem  for  many  weeks,  or  even  months. 

Tk^afment  —  Elevate  the  limb,  keep  the  joint  perfectly  qtiie^  and 
apply  cold  lotions,  or  fomentations.     When  the  inflammation  i»  ail 


SURGICAL  DISEASES. 


46,5 


past,  ^pply  »ti(nulating  linimentsi,  and  bandages,  or  shower  the  part 
with  cold  water. 

Ruptures  of  Tendons. 

These  accidents  are  known  by  a  sudden  snap,  followed  by  pain, 
loss  of  motion  in  the  part,  and  swelling  and  discoloration. 

Treutment. —  Place  the  part  in  such  a  position  as  to  relax  the  broken 
tendon,  the  ends  of  which  must  be  brought  together,  and  retained  in 
contact  till  they  grow  together. 

Diseases  of  the  Bones. 

The  bones  are  supplied  with  blood-vesseis  and  nerves ;  and  as  they 
live  and  grow  like  other  parts  of  the  body,  so  they  become  diseased 
and  die  in  like  manner. 

Ulceration  of  Bones. — Caries. 

Bones,  like  the  soft  parts,  when  attacked  by  violent  inflammation, 
may  ulcerate,  discharge  matter,  and  heal  by  granulation  ;  or,  having 
lost  a  portion  of  their  substance,  may  sink  under  entire  disorganiza- 
tion and  death.  This  disease  passes  in  some  parts  of  the  country, 
under  the  name  of  "  fever  sore." 

Treatment. —  Apply  splints,  and  keep  the  part  in  a  state  of  abso- 
lute rest  Subdue  the  local  inflammation  by  the  usual  means.  If 
the  disease  arise  from  scrofula  or  syphilis,  use  the  remedies  for  thoeo 
diseases. 

Death  of  the  Bones. — Necrosis, 

This  is  like  mortification  of  the  soft  parts.  It  occurs  from  injuries 
and  inflammation  of  the  periosteum. 

It  is  known  by  dull,  deep-seated — sometimes  acute — pain  ;  and  is 
followed  by  increase  of  size,  from  the  formation  of  new  bone  around 
the  old,  —  the  old  being  gradually  broken  into  pieees,  and  discharged 
through  external  openings. 

Treatment  —  Poultices  and  quieting  fomentations. 

« 

Unnatural  Growth  of  Bones. — Exostosis. 

This  disease  coi-  ists  either  of  a  tumor  of  a  bony  nature,  growing 
upon  and  arising  from  a  bone,  or  an  enlargement  of  a  bone.  It 
springs  from  the  periosteum,  or  from  the  surface  of  a  bone,  or  from 
its  spongy  texture.  The  enlargement  or  the  tumor  may  be  white 
and  hard,  like  ivory,  or  dark-colored  and  spongy,  or  a  mixture  of  the 
twa 

fift 


466 


SUIIGICAL  DISEASES. 


'n| 


At  first,  a  tumor  of  this  kind  is  not  attended  with  pain  or  incon* 
venicnce.  It  comes  on  slowly,  and  sometimes  remains  nearly  sta- 
tionary for  several  years. 

Treatment — If  the  tumor  be  large  and  inconvenient,  remove  it 
with  the  knife.  If  not,  use  local  pressure  witii  pads  and  bandages; 
also  leech,  blister,  and  restrict  the  patient  to  a  spare  diet. 

Diseases  of  the  Joints. 

SoMK  of  these  diseases  begin  in  the  cartilages,  some  in  the  svnovial 
membrane,  and  others  in  the  heads  of  the  bones. 

Disease  of  the  Hip-Joint.  —  Cojcalgia. 

This  generally  consists  in  inflammation  of  the  synovial  membrane 
and  capsular  ligament  of  the  hip-joint,  ending  frequently  in  ulceration 
and  destruction  of  the  head  and  neck  of  the  thigh  bone. 

The  symptoms  are  fulness  in  the  groin  ;  pain,  which  is  increased 
by  motion  ;  aggravated  when  the  limb  hangs  without  touching  the 
ground;  is  more  felt  in  the  knee  than  in  the  hip  itself;  and  shoots 
down  along  the  inside  of  the  leg,  as  far  as  the  instep.  The  thigh 
inclines  forward,  and  the  limb  has  the  appearance  of  being  longer 
than  the  other,  —  though  in  the  latter  stages,  it  is  really  shorter. 

Treatment.  —  Before  suppuration  takes  place,  apply  leeches  and 
blisters,  and  enjoin  perfect  rest.  After  suppuration,  keep  the  patient, 
npon  his  back,  on  a  mattress,  and  mould  to  the  parts  thick  paste- 
board splints,  with  pads,  and  give  tonifjs.  Keep  the  bowels  open  with 
senna  and  bicarbonate  of  potash,  and  rub  the  parts  with  iodide  of 
potassium  ointment,  or  with  preparations  (282)  (283)  (195).  The 
disease  being  scrofulous,  the  iodide  of  potassium  (140)  may  be  taken 
with  advantage  internally. 

White  Swelling.— Synovial  Degenerations. 

There  are  several  diseases  of  the  knee-joint,  characterized  by  swell- 
ing and  white  color  from  tension  of  the  skin,  which  have  passed 
under  the  common  rame  of  white'SioeUin}>^.  The  diseases  are  not 
strictly  the  same,  but  as  they  all  affect  the  knee,  and  have  symptoms 
to  some  extent  in  common,  it  is  well  enough  to  group  them  under 
the  same  title,  —  especially  as  one  treatment  is  adapted  to  all. 

One  is  a  pulpy  disease  of  the  synovial  membrane.  It  begins  with 
a  trifling  stiffness,  and  a  slight  swelling.  TVie  swelling  increases  by 
degrees,  and  on  touching  the  part,  there  is  a  sensation  as  if  it  con- 
tained fluid.  By  and  by  the  cartilages  ulcerate.  The  disease  is  in- 
curable, as  the  synovial  membran"  is  finally  converted  into  a  pulpy  I 
substance,  and  the  limb  has  to  be  amputated. 

Another  of  these  is  inflammation  of  the  synovial  membrane,  be- 
ginning with  ulceration  of  the  cartilages.     It  begins  with  pain  in  tiie  I 


:;!J!;i 


SURGICAL  DISEASKS. 


467 


i'oint,  which  is  severe  at  one  point,  and  attains  its  height  in  a  week, 
n  a  day  or  two,  the  joint  is  swollcin  from  a  collection  of  water. 

Trcatllient. —  Splints  and  entire  rest,  as  in  all  chronic  diseases  of 
the  joints.  Also  a  generous  diet,  and  whatever  is  calculated  to  build 
up  the  health. 

Bunions. 

This  is  an  inflammation,  enlargement,  and  hardening  on  the  inside 
of  the  ball  of  the  great  toe.      It  is  frecniiMilIy  connected  wilh  a  distor- 
tion of  the  toe,  which  seems  partially  out  of  joint.     The  projection 
of  the  joint  exposes  it  to  great  irritation  from  "tlu;  shoe,  and  to  re 
peated  attacks  of  inflammation.      It  occasions  great  sufl'ering. 

Treiltllieilt. —  Remove  the  pressure  from  the  part,  and  when  there 
is  inflammation,  keep  the  foot  quiet  antl  cl(>vatcd  upon  a  chair,  apply- 
ing leeches,  poultices,  etc.  Another  method  is  to  cover  the  bunion 
with  soap  plaster,  spread  on  thick,  soft  leather,  or,  put  the  toe  in  a 
separate  apartment  of  the  stocking,  like  the  finger  of  a  glove.  Then 
enclose  it  in  a  separate  part  of  the  shoe,  which  is  contrived  by  fixing 

a  piece  of  firm  sole-leather  in 
the  bottom  of  the  shoe,  so  as 
to  make  a  separate  compart- 
ment for  the  toe.  By  this 
means  the  pressure  against 
the  side  is  removc^d.  Stick 
ing  plaster  may  be  spread  on 
wash-leather,  and  a  piece  cut  out  the  size  of  the  bunion.  This  will 
take  off  a  portion  of  the  pressure  of  the  shoe,  and  will  hasten  the 
cure. 

Fig.  166  represents  a  ganglion  or  tumor  formed  upon  the  synovial 
sheath  of  the  tendon  which  bends  the  finger. 


Fia.  166. 


Whitlow.— Felon.  —  Paronychia. 

This  is  an  abscess  of  the  fingers,  of  which  there  are  three  kinds,  — 
the  first  situated  upon  the  surface  of  the  skin,  the  second  nnfler  the 
skin,  the  third  within  the  sheath  which  contains  the  tendons  of  the 
fingers,  and  sometimes  involving  the  covering  of  the  bone. 

The  latter  form  of  the  disease  is  the  most  terrible,  and  begins  with 
redness,  swelling,  and  a  deep-seated  and  throbbing  pain,  which  grad- 
ually becomes  so  excruciating  as  to  banish  all  sleep,  and  nearly  drive 
the  patient  to  distraction.  Finally,  matter  forms  and  burrows  in  the 
deeper  parts  of  the  finger,  and  at  length  finds  an  opening,  which 
brings  relief. 

Treatment.  —  Carry  the  hand  in  a  sling ;  apply  a  leech  or  two,  and 
use  poultices.  A  poultice  made  of  equal  parts  of  powdered  slippery- 
elm  bark,  poke  root,  ground  flax-seed  and  lobelia  seeds,  mixed  with 
hot  ley,  and  changed  twice  a  day,  is  an  admirable  application. 


468 


SUUGICAL  DISEASES. 


When  these  methods  fail  to  stop  the  progress  of  the  abscess,  the 
finger  Hhould  be  laid  open  with  the  scalpel,  cutting  down  to  the  bone. 
This  will  give  vent  to  the  matter,  and  the  wound  may  be  dressed 
with  poultieos,  until  the  inflammation  is  subdued,  and  the  healing 
process  is  well  established,  when  some  simple  salve  may  be  applied. 


Pit 


Chilblains. 

This  complaint  should  have  been  spoken  of  immediately  after 
••  frost-bite,"  but  it  was  forgotten.  It  is  caused  by  exposure  to  cold, 
!ind  atl'ects  the  fingers,  toes,  and  particularly  the  heels,  with  a  painful 
iuHammatory  swelling,  of  a  red,  purple,  or  bluish  color.  The  skin 
may  be  red  in  patches,  and  slightly  swelled,  with  itching,  tingling, 
pain,  and  lameness ;  or  there  may  be  blisters,  around  which  the  skin 
is  blue  or  purple ;  or,  worse  yet,  there  may  be  ulceration  and  slough- 
"kng. 

Vreatiiieut.  —  Stimulating  liniments  are  the  remedies  usually  em- 
ployed for  this  complaint.  One  of  the  best  consists  oi'  six  parts  of 
soap  liniment,  and  one  part  of  tincture  of  Spanish  flies  ;  and  another 
excellent  one  is  prescription  (307).  If  there  is  ulceration,  use  Turner's 
cerate,  or  the  resin  ointment 


Stiff  Joint. — Anchylosis. 

This  is  of  two  kinds,  complete  and  incomplete, — complete  when  the 
bones  of  the  joint  have  become  firmly  united  by  bony  matter,  and 
incomplete  when  the  motions  of  the  joint  are  very  much  interrupted, 
but  not  entirely  destroyed.  The  first  is  the  result  of  ulcerations  of 
the  cartilages  of  the  joints,  and  of  the  heads  of  the  bon^s ;  the  latter, 
of  fractures,  sprains,  bruises,  thickening  of  the  synovial  membrane, 
and  weakening  of  the  muscles. 

Treatment. — No  treatment  is  of  much  use  in  the  first-named  form  of 
the  disease.  By  sawing  through  the  bone,  and  then  daily  moving  the 
limb  back  and  forth,  a  false  joint  may  be  made,  but  it  is  apt  to  grow 
together  again,  and  finally  defeat  the  purpose  of  the  surgeon.  When, 
however,  stiffness  arises  from  the  weakening  of  the  muscles,  and  some 
other  causes  involving  the  /igaments  and  tendons,  something  may 
be  done  by  daily  frictions  with  stimulating  liniments,  champooing, 
and  warm  fomentations ;  and  by  gently  bending  the  joint  back  and 
forth,  several  times  every  day,  as  much  as  can  be  done  without  pain. 

Tumors. 

A  TUMOR  is  a  swelling  which  consists  of  a  new  production,  not 
constituting  any  portion  of  the  original  structure  of  the  body.  There 
are  several  kinds  of  tumors;  but  it  is  sufficient  for  my  purpose  to 
follow  Mr.  Ferguson,  and  divide  them  into  the  maligtiant  and  noft* 
malign,(mt. 


SURGICAL  DISEASES. 


Cancer. 

This  belongs  to  the  class  of  malignant  tumors.  It  has  two  stages. 
The  first  is  that  of  induration  or  scirrhvs,  —  during  which  it  has, 
under  the  finger,  the  feeling  of  stony  hardness.  The  second  stage  is 
that  of  vlceratutn  or  open  cancer. 

Cancer  most  often  attacks  the  female  breast,  the  skin,  the  muccu» 
membranes,  the  tongue,  the  stomach,  the  neck  of  the  womb,  the  lips, 
etc.  It  rarely  occurs  in  subjects  under  thirty  years  of  age,  and  not 
often  in  persons  under  forty-five. 

Tlie  Symptoms  of  Cancer,  when  it  appears  in  the  breast,  arc,  a 
puckered  condition,  and  dull,  leaden  color  of  the  skin  ;  a  hard,  knotty? 
and  uneven  feel  ;   and  occasional   sharp  kio.  m. 

pains.  When  it  attacks  the  skin  and  mu- 
cous membranes,  there  is  a  hard,  warty 
lump,  which  ulcerates,  after  a  time,  pro- 
ducing an  open  sore,  with  a  hard  base. 
(Fig.  167.) 

The   sore  of  a   cancer  discharges   an       ^^ 
irritating,  excoriating  matter,  which  has    vi^H|||f|^^fii^^"  I 

a  peculiarly  fetid  odor,  so  offensive  and  "i^^''*"'*^^*'"'^- 
so  different  from  any  other  smell,  that  it 
is  seldom  forgotten.  The  bones  of  a 
cancerous  person  break  with  great  ease. 
Unmarried  females  are  much  more  liable  to  \\w  dis<'ase  than  the  mar- 
ried. The  cancerous  growth  is  composed,  in  part,  of  cells,  rounded 
or  caudate,  containing,  as  seen  under  the  microscope,  nuclei,  younger 
cells,  and  granules.     (Fig.  168.) 


■4^ 


FI0.1M. 


Fio.  109. 


na.  17& 


The  difference  between  these  cells  and  those  of  common  pus  gl'*f> 
oles  may  be  seen  by  comparing  Fig.  168  with  169,  —  the  latter  being 
pus  corpuscles  highly  magnified  by  a  powerful  microscope.  Fig.  170 
represents  pus  globules  not  so  much  magnified. 

Treatment. —  There  are  but  two  methods  of  treatment  which  prom- 
ise any  success.  The  first  is  to  extirpate  the  tumor  by  a  surgical 
operation  before  the  disease  has  so  far  invaded  the  constitution  as  to 
be  sure  of  returning.     The  other  is  that  adopted  by  Dr.  J.  W.  Fell, 


470 


SURGICAL  DISEASES. 


an  American  physician,  who  was  permitted  to  try  his  remedies  in 
one  of  the  English  hospitals,  and  who  '}  cw  from  the  surgeons  in 
charge  of  it  a  favorable  report  of  the  results, 

Dr.  Fell's  remedies  are  mainly  blotKJ-root  and  chloride  of  zinc  (336) 
made  into  a  paste.  The  skin  over  the  tumor  is  first  destroyed,  and 
this  paste,  spread  u|)on  strips  of  linen,  is  applied.  This  causes  an 
eschar,  into  which  incisions  are  made,  half  an  inch  apart,  taking  care 
to  avoid  the  living  tissue.  The  same  paste  spread  in  a  like  manner 
is  then  daily  inserted  into  the  fnrrows.  By  this  means,  which  is  orig- 
inal with  l)r.  Fell,  the  ert'ect  of  the  caustic  penetrates  through  all 
[)arts  cf  the  tumor,  causing  the  whole  diseased  mass  to  fall  oil',  and 
leave  a  liealthy,  granulating  surface. 

In  incipient  cancer,  where  the  diseiise"  has  not  made  nuu-h  progress, 
Dr.  Fell  uses  the  above,  which  he  calls  a  l)r()\vn  ointtiieiit  (-WO),  and 
in  coruM'ction  with  it  an  oiiitinent  of  the  iotiiile  of  lead  (-W?),  usini^ 
each  twelve  hours.  Witli  these,  he  claims  that  he  cnrcs  incipient 
cancers,  with  great  readiness.  He  al^io  employs,  internally,  half-grain 
doses  of  pulverized  blood-root  (1-4?J),  witli  ar^t-M' ^  and  eieuta. 

Dr.  Fell  claims  that  with  thesi;  preparation.-*,  Ik;  has  often  cured 
tvpns,  and  has  been  very  successful  with  them  in  treating  indolent 
ulcers. 


Soft  Cancer.— Bleeding  Cancer. 

Medullary  Cancer. — Enrephahiid  Tumor.  —  Fung-ua  Ilemalodes. 

This  varies  in  size  from  a  nutmeg  to  a  ehild's  head.  Its  color 
varies  from  white  to  deep  red.  At  tirfies,  it  is  soft  and  elastic  at 
nrst ;  at  other  times,  it  is  firm  and  tense.     The  patient  is  wan  and 

Eale  from  the  beginning.     The  parts  do  not  ulcerate,  as  in  scirrhus; 
ut  after  the  skin  is  broken,  a  spongy  bleeding  tumor  protrudes. 


Treji 


liiiien^ 


Dr.  Fell's  method. 


Black  Cancer. — Melanosis. 

This  is  an  organic  disease,  in  which  the  ti?.f  ae  of  the  disordered 
part  is  converted  into  a  black,  hard  substance,  which  is  converted 
into  ulcerous  caviti^'s.  This  often  appears  in  the  lungs,  and  is  met 
with  in  the  iiver  and  other  |)art!;<. 

Ifs  symptoms  are,  a  sallow  coiuplexioii,  great  debility,  and  dropsi 
cal  swelling  of  the  limbs  before  the  termination. 

Treatnieilf. —  When  it  appears  externally,  Dr.  Fell's  treatment  is 
worth  a'trial.  When  in  the  hmgs,  the  inhalation  of  tincture  of  blood- 
root  and  solution  of  chloride  of  soda  (241)  should  be  used.  Two 
teaspoonfuls  may  be  put  in  Warren's  Vapor  Inhaler,  —  the  instru- 
ment being  filled  half  full  of  hot  water,  —  and  inhaled  ten  minutes, 
three  times  a  day  ;  the  blood-root  pills  (143)  being  taken  at  the  same 
time. 


I'    ^     '  I! 


SURGICAL  DISRA8RH. 


471 


Fatty  Tumor. — Adipous  Sarcoma. 

This  is  the  most  common  of  uU  the  forms  of  tumor.  These  bodies 
generally  have  a  soft  and  doughy  feel,  or  as  if  filled  with  wool.  They 
are  the  least  inclined  to  become  malignant,  and  consequently  the  least 
dang(!rourt,  of  all  the  tumors.  Whatever  pain  there  is,  is  caused  by 
their  size,  weight,  and  pressure.  They  are  occasionally  found  a  little 
below  the  point  of  the  shoulder,  in  the  deltoid  muscle  of  females,  and 
are  caused  by  the  unreasonable  pressure  of  the  dress  at  that  point. 

Trc'UtllH'llt. —  They  should  Ix;  removed  by  an  o|)eration,  which  is 
easily  performed,  as  they  separate  very  readily  from  surrounding 
parts. 

Polypus. 

Thk  polypi  constitute  a  class  of  tumors  growing  from  mucous 
membranes.  They  are  of  two  kinds,  —  the  «>//,  jeUy-Uke  polypus, 
and  the  Jleshy  or  Jibrous  polypus. 

TllC  Soft  Polypus,  whicli  grows  from  the  nose,  has  not  much  feel- 
ing, and  is  not  particularly  di^posed  to  bleed. 

The  Fleshy  Polypus  is  firmer  and  harder  than  the  preceding,  and 
most  generally  connects  itself  with  the  womb. 

Trentiiient.  —  Both  kinds  of  polypi  are  either  twisted  off  with  a 
pair  of  forceps,  or  strangled  by  putting  a  string,  called  a  ligature, 
around  their  neck,  which  will  cause  them  to  fall  oil'  in  a  short  time. 


Wens.  —  Encysted  Tumors. 

The  most  common  situation  of  these  is  under  the  skin  of  the  head. 
A  wen  is  simply  a  sac  full  of  various  matters,  which,  when  examined 
with  a  microscope,  are  found  to  be  oil  globules,  epithelial  cells,  and 
crystals  of  stearine.  These  contents  are  secreted  by  the  internal 
surface  of  the  sac.  They  sometimes  look  like  curd  or  rice,  sometime» 
like  suet,  and  sometimes  like  honev.  In  other  instances,  they  are 
mere  water,  and  they  have  been  known  to  consist  of  hair  or  horn. 
These  tumors  are  round,  elastic,  and  movable,  and  are  without  paio. 
They  grow  slowly,  but  steadily. 

Treatment. —  The  attempt  to  excite  inflammation  and  consequently 
absorption,  by  punctures,  seatons,  or  injections,  are  dangerous,  and 
ought  not  to  be  resorted  to.  If  the  tumor  is  small,  its  opening,  indi- 
cated by  a  small  black  spot,  may  be  found,  a  probe  be  introduced 
into  it,  and  the  contents  of  the  sac  be  squeezed  out ;  and  this  may  be 
repeated  as  often  as  necessary.  But  the  |)roper  and  only  real  remedy 
for  these  tumors  is  their  removal  by  a  surgical  operation. 


1  r 


472 


SURGICAL  DISEASES 


Aneurisms. 

An  aneuriam  is  a  tumor  formed  by  arterial  blood,  and  commupl- 
cating  with  an  artery.  A  true  aneurism  is  formed  by  the  coats  of  an 
artery  getting  weakened  by  some  cause,  and  swelling  out  ^o  as  to 
form  a  pouch  or  sac.  (Fig.  171.)  There  are  other  kinds  of  aneu- 
risms, which  need  not  be  descri  bed. 

Fio.  in. 


Symptoms.  —  An  aneurism  may  be  felt  as  a  tumor  somewhere 
along  the  course  of  an  artery,  and  it  beats  under  the  finger  like  the 
pulse.  The  beating  is  caused  by  a  fresh  quantity  of  blood  being 
pushed  into  this  sac  with  every  stroke  of  the  heart.  If  it  be  small^ 
pressure  on  the  artery  above  it  will  so  far  shut  off  the  blood  from  it^ 
that  it  will  feel  flaccid  or  soft.  The  pat'ent  will  often  say  that  the 
tumor  began  to  appear  after  some  violeit  strain,  when  something 
appeared  to  give  way.  In  the  chest,  "..lourism  will  produce  an  un- 
natural pulsation  felt  by  the  patient  In  the  belly,  it  may  generally 
be  feH,  as  a  tumor  through  the  abdominal  walls. 

Distinction.  —  Tumors  which  lie  diiectly  over  arteries  are  lifted  up 
every  time  the  blood  is  driven  along  under  them,  and  hence  they 
pulsate  like  aneurisms ;  but  thej  do  not  pulsate  when  smalt,  whereas 
aneurisms  do  from  the  beginning  of  their  growth.  Aneurisms  are 
so/l  at/int,  and  hard  afterwards ;  whereas  tumors  are  generally  hard 
at  first,  and  finally  soft. 

Treatment. — In  some  few  fortunate  cases,  aneurisms  get  well  spon- 
ianeously.  If  the  flow  of  blood  through  them  can  h<:  stopped,  that 
which  is  within  them  will  coagulate,  forming  a  hard  tumor,  which 
will  (gradually  waste  away.  To  cure  them,  therefore,  we  must  stop 
Vte  circulation  through  them ;  and  this  may  be  done,  in  some  cases, 
by  compression.  The  pressure  upon  che  artery  must  of  course  be 
above  the  tumor,  and  should  not  be  so  great  as  to  stop  the  blood 
altogether,  but  only  very  materially  to  diminish  its  flow.  The  pres- 
Rure  is  applied  by  an  instrument  having  two  pads,  an  arc  of  ($teel,  a 
joint  in  the  middle,  and  a  screw  by  which  the  padded  extremities  are 
pressed  together.     (Fig.  172.) 

When  this  mode  of  treatment  is  not  practicable,  the  artery  must 
be  tied  between  the  aneurism  and  the  heart  The  patient  should  b« 
placed  in  bed,  witli  the  limb  wrapped  up  to  preserve  its  temperature^ 


Pla 


SURGICAL  DISEASES. 


473 


and  placed  in  an  easy  position.     Nothing  cold  should  be  applied 
to  it 

The  force  of  the  circulation  should  be  reduced  by  the  tincture  cf 
veratrum. 


Fio.lTl. 


Fio.  ITS. 


Bronchocele.— Derbyshire  Neck. —  Goitre. 

Bronchocele  is  what  is  called  an  endemic  disease ;  which  n'leans, 
a  disease  which  prevails  in  certain  localities.  This  complaint  is  prev. 
a^uit  in  Nottingham  and  Derbyshire,  England,  among  the  Alps,  and 
especially  in  the  Tyrol  and  valley  of  the  Rhone.  It  is  thoiight  to  be 
produced  by  the  use  of  melted  snow,  and  water  impregnated  with 
lime  and  earthy  matter. 

Symptoms. —  A  prominent,  soft,  elastic  tumor,  occupv'iig  the  front 
of  the  throat,  in  the  situation  of  the  thyroid  ,^land,  and  like  it  in  shapa 
It  is  not  tender,  and  the  skin  is  not  discolored.  In  old  cases,  the 
tumor  becomes  hard.  In  Fig  173,  the  t-jmor  is  so  large  as  to  have 
pushed  the  gullet  to  one  side. 

Treatment.  —  The  ui.aal  and  perhaps  the  best  remedy  for  this  dis- 
ease is  iodine.  It  may  be  given  as  iodide  of  potassium,  with  a  bitter 
or  Home  other  article  (138)  (145)  (101).  Ka  iodine  ointment  may  be 
applied  to  the  tumor  (185). 

The  patient  should  move  away  f.om  the  infected  district,  and  re- 
side, if  possible,  upon  the  sea  coast 

Water  in  the  Bcrotum. — Hydrocele. 

As  the  name  shows,  this  is  a  collection  cf  water  in  the  rcrotom  or 
ba^'  which  holds  the  testicles. 

Ajrmptonil.  —  It  presents  a  swelling,  shaped  like  a  pear,  smooth  oi 


474 


SURGICAL  DISEASES. 


its  surface.  flnpt".atir:g  if  pressed,  without  pain,  but  causing  a  little 
uneasiness  by  its  weight.  On  placing  a  lighted  candle  on  one  side 
of  the  scrotum,  the  'ight  may  be  seen  through  it.         . 

Distinction. —  This  complaint  may  be  distinguished  from  a  solid 
enlargement  of  the  testicle  by  its  not  being  so  heavy,  solid,  or  painful, 
and  by  its  fluctuating  and  being  transparent;  from  rupture,  by  its 
forming  slowly  instead  of  suddenly,  by  the  swelling  beginning  at  the 
lower  part  of  the  scrotum  instead  of  the  upper,  and  by  the  enlarge- 
ment not  bring  increased  by  coughing  as  it  is  in  rupture. 

Treatment. —  In  children,  strong  scattering  washes  (353)  are  some- 
times successful.  But  most  commonly,  a  number  of  ^mnctures  are 
made  with  a  large  needle,  to  cause  the  fluid  to  escape  into  the  cell 
tissue  of  the  scrotum,  whence  it  is  removed  by  absorption. 

To  effect  a  radical  cure  in  grown  persons,  the  surgeon  is  to  grasp 
the  tumor  behind,  and  introduce  a  trocar  and  canuhi  into  the  sac, — 
being  careful  to  point  the  instrument  upwards,  so  as  not  to  wound 
the  testicle.  The  trocar  is  then  withdrawn,  —  the  eanula  being  at 
the  same  time  pushed  well  into  the  sac,  so  that  none  of  the  fluid  may 
get  into  the  cell  tissue  outside  the  sac.  The  fluid  runs  oft"  through 
the  canula.  When  this  has  all  escaped,  some  stimulating  fluid,  as 
common  lime-water,  or,  still  better,  tincture  of  iodine,  is  to  be  injected 
through  the  canula  into  the  emptied  sac.  After  retaining  this  from 
two  to  five  minutes,  it  is  permitted  to  flow  out.  Inflammation  fol- 
lows, which  breaks  up  the  secretion  of  water,  and  eftects  a  cure  in 
two  or  three  weeks.  The  amount  of  fluid  thrown  in,  should  be  about 
one  or  two  teaspoonfuls  of  a  mixture  of  one  part  of  tincture  of  iodine 
and  two  parts  of  water.  If  the  first  operation  does  not  effect  a  com- 
plete cure,  it  may  be  repeated. 

Blood  in  the  ScTotnm.—  Hematocele. 

This  is  a  collection  of  blood  in  the  scrotum  from  some  injury. 

Tresitinent.  —  If  the  quantity  of  blood  effused  be  small,  cold  appli- 
cations may  cause  it  to  be  absorbed.  If  it  be  large,  make  a  puncture, 
and  apply  a  poultice  for  the  blood  to  ooze  into. 

Acute  Inflammation  of  Veins.  —  Phlebitis. 

The  veins  are  subject  to  attacks  of  acute  inflammation,  which 
constitutes  a  very  dangerous,  and  often  fatal,  diseas(>.  • 

Symptoms. —  Fits  of  shivering,  or  perhaps  fainting,  a  rapid  pulse, 
anxiety  of  counttMiance,  lowness  of  sjjirits,  cat,(;liing  pains  al)out  the 
heart,  and  srrelliri^^i  redness^  terulerness,  and  hardness  ahni^  the  course 
of  the  affected  veins.  Sometimes  the  tongue  is  furred  brown  or  black, 
the  skin  is  sallow,  there  is  bilious  vomiting,  low  delirium,  and  death. 
In  cases  less  rapid,  there  are  great  swelling  and  redness  over  the  cVnh 


:•    ili't 


SURGICAL  DISEASES. 


476 


eased  veins,  and  abscesses  form,  which,  when  opened,  reveal  clots  of 
blood,  mixed  with  pus.  Or,  the  patient,  while  remaining  low,  with  a 
sallow  countenance,  and  a  yellow  tongue,  will  complain  suddenly  of 
intense  pain  in  some  joint,  as  the  knee  or  shoulder,  —  in  which  there 
will  be  a  rapid  formation  of  pus ;  a  similar  suppuration  will  follow 
in  other  joints  as  well  as  in  the  lung^^,  etc.,  until  the  patient  sinks,  and 
dies  of  exhaustion. 

Treatment. —  Apply  leeches  freely  over  the  inflamed  veins,  —  also 
fomentations.  Every  abscess  i^huiild  be  opened  early.  Keep  the 
bowels  moderately  open  with  some  propJiration  of  salts,  and  allay 
pain  and  restlessness  by  morphia.  Hupport  the  strength  by  beef  tea, 
etc.;  and,  if  the  puLe  be  feei)l(r,  give  wine  or  quinine. 

The  suppuration  may  be  checked,  in  this  as  in  other  complaints, 
by  drliiking  freely  of  chamomile  teu.  The  power  to  control  sup- 
puraton  has  recently  been  discovered  as  belonging  io  chamouiile 
flow'Ts.  •  ' 

Chronic  Phlebitis. 

This  is  a  far  loss  serious  disease  than  the  preceding.  It  generally 
affects  the  veiii  .  of  the  legs. 

Syiliptoilis. —  Tenderness  and  hardness  of  the  aflected  vein,  with 
swelling  around  it,  and  of  the  parts  below;  a  giMieral  puinfulness  of 
the  limb.  After  the  inflamrr.ation  has  subsided,  the  vein  feels  hard, 
like  a  cord,  because  the  inflammation  causes  the  blood  within  to  co- 
agulate, and  harden,  so  that  nothing  can  pass  through  the  vessel. 

Treiltllieilt.  —  Leeches,  fomentations,  or  cold  lotions,  as  the  patient 
may  choose,  purgatives,  and  rest,  with  the  limb  elevated.  Subse* 
quently,  when  the  inflammation  seems  completely  subdued,  friction 
with  camphorate'i  oil,  and  bandages. 

EiiT   t^^^d  or  Varicose  Veins.  —  Varix. 

TriE  veins  wl.-  lie  near  the  surface,  especially  tijosc  of  the  legs, 
are  iipt,  by  exfiau;  i  4  labor  i.|)on  the  fe(!t,  and  by  strains,  to  get 
weakened,  so  that  their  valves  1  )se,  the"-  tone,  and  their  sides  stretch 
and  give  way  in  certain  places, -lettir,  ih^  blood  bulge  out,  and  form 
purple  bunches.  These  bags  of  blood,  .  ..ig  alotij;  upon  the  surface 
of  the  liml),  form  knotty  tumors,  lookirig  !'k(^  blood-boih.  Tney  oc- 
casion a  kitid  of  distress,  but  no  sharp  pain. 

Persons  of  weak,  soft,  and  relaxed  muscles  and  blood  vessels  are 
particularly  '  ible  to  this  complaint.  It  often  attacks  women  in  the 
family  wa- 

Treatment  V/httie  only  a  few  veins  are  affected,  it  may  be 
sufTicient,  in  bome  cases,  to  c^pply  firmly  over  them  a  few  strips  of 
leather,  sprerd  with  soap  plaster.  But  gerurrally  it  is  better  to  sup- 
port fhc  whol?  limb  with  a  good  calico  bandage,  or  with  a  laced  stock- 


476 


SURGICAL  DISEASES. 


ing,  which  should  be  applied  in  the  morning  before  the  patient  is  upi 
It  is  generally  well,  also,  to  use  friction,  with  some  liniment,  or  iodine 
ointment  Lead  water,  or  alum  water,  or  an  infusion  of  white  oak 
bark,  may  be  used  with  advantage.  Burdock  and  plantain  leaves, 
bound  upon  the  skin,  and  removed  before  they  are  dry,  are  useful 
Showering  with  cold  water  strengthens  the  veins. 


I 


Rupture. — Hernia. 

Hernia  signifies  a  protrusion  of  any  internal  organ  from  the  cavity 
where  it  belongs ;  but  the  term  is  generally  restricted  so  as  to  mean 
no  mora  than  a  protrusion  of  the  bovjet  through  the  walls  of  the  belly. 

When  the  abdominal  walls  are  weak,  from  any  cause,  no  mutter 
what,  —  lifting,  straining,  or  making  violent  musculav  exertion  of  any 
kind,  will  then  often  cause  the  bowel  to  force  itself  through  at  th-; 
most  debilitated  spot;  a.'  i^ushing  the  lining  of  the  belly,  the  peri- 
toneum, along  before  it,  .^  'r  sac  is  formed,  in  which  the  project- 
ing bowel  is  enclosed,  formii.-.     a  external  tumor. 

Divisions  of  Heniia.  —  Rupture  may  occur  in  several  different 
places,  and  has  accordingly  received  diiferent  names. 

Umbilical  Hernia  is  a  protrusion  of  tno  bowel  at  the  umbilicus 
or  navel.     This  is  most  common  in  children  soon  after  birth ;  and 
wonien  who  are  often  pregnant  are  liable  to  it- 
Ventral  Ileniia  is  that  which  occurs  at  any  part  of  the  belly  where 
other  forms  of  rupture  do  not  appear. 

Inguinal  Heniia  is  that  in  which  the  bowel  protrudes  at  the  groins, 
or  through  the  abdominal  rings. 

Scrotal  Hernia  is  that  in  which  the  bowel  descends  into  the  bag  or 
scrotum. 

Femoral  Hernia  is  the  dropping  down  of  the  bowel  behind  what 
is  called  Poupart's  ligament,  and  appearing  as  a  tumor  at  the  upper 
part  of  the  thigh. 

Reducible  Hernia.  —  Rupture  is  said  to  be  reducible,  when  the 
bowel  may  be  put  back  into  the  cavity  from  which  it  came. 

Irreducible  Hernia.  —  Hernia  is  called  irreducible  when  the  pro* 
trading  bowel  cannot  be  returned  into  the  belly. 

Stransfulated  Hernia  is  that  form  of  the  complaint  in  which  the 
bowel  is  so  pressed  upon  at  the  point  where  it  passes  through  the 
walls  of  the  belly  that  it  is  strangled  or  constricted  so  that  its  contents 
cannot  pass  through, 

Symptoms  of  Hernia.  —  A  soft  tumor,  which  may  be  compressed, 
appears  somewhere  ab^ut  the  belly;  and  is  increased  in  size  when 
the  patient  stands  up.  It  also  swells  when  he  coughs,  cur  makes  any 
eiertion ;  and  grows  smaller,  or  entirely  disappears,  when  he  Uei 
down 


■i-! 


^^i 


SURGICAL  DISEASES. 


477 


Treatment. —  In  a  case  of  reducible  hernia,  the  first  thing  to  be 
done  is  to  put  the  bowel  back  in  its  place,  which  is  accomplished  by 
gently  pressing  and  kneading  the  tumor,  and  swaying  it  back  and 
forth,  —  being  careful  to  use  no  violence,  —  until  it  can  be  pushed 
within  the  abdominal  walls.  It  is  then  to  be  kept  in  its  place  by  the 
use  of  a  truss,  made  expressly  to  fit  the  case.  This  instrument  should 
be  constantly  worn  by  day,  and  by  night,  too,  if  not  too  irksome  ;  but 
if  worn  by  day  only,  it  should  always  be  applied  before  rising  in  the 


mornuig. 


Irreducible  Hernia  may  be  pnllialed  by  wearing  a  truss  with  a  hol- 
tovf  pud,  which  will  so  evenly  and  firmly  embrace  the  tumor  as  neither 
to  irritate  it,  nor  permit  any  further  protrusion  or  enlargement. 

Striiug:ulated  Ilerniu.  —  If  a  person  have  worn  a  truss  for  some 
time,  and,  suddenly  leaving  it  ofi,  makes  srrrie  violent  exertion,  either 
the  bowel  or  omentum  is  liable  to  be  suddenly  forced  through  a  nar- 
row aperture,  and  to  become  strangled.  In  such  case,  the  patient  has 
flatulence,  colicky  pains,  a  sense  of  tightness  across  the  belly,  and  a 
desire  to  go  to  stool,  but  no  ability  to  pass  anything.  Then  follows 
vomiting,  first  the  contents  of  the  stomach,  then  mucous  and  bile, 
and,  lastly,  the  fecal  matters  from  the  bowels,  which  are  not  permitted 
to  pass  on  to  their  natural  outlet.  The  neck  of  the  hernial  sac  now 
becomes  swelled,  tender,  and  painful,  the  countenance  is  anxious,  and 
the  pulse  small,  hard,  and  wiry  ;  and,  after  a  time,  the  tumor  begins 
to  mortify,  the  patient  expresses  himself  free  from  all  pain,  and  soon 
after  dies. 

In  the  treatment,  the  bowel  is  to  bo  returned  if  possible.  To  do 
this,  the  bladder  should  first  be  emptied  with  a  catheter,  and  the 
patient  should  lie  down  with  his  shoulders  raised,  and  both  his  thighs 
bent  towards  the  belly,  and  placed  close  to  each  other,  so  as  to  relax 
all  the  ligaments  and  muscles  of  the  belly.  The  surgeon  me  now 
work  gently  for  half  an  hour,  if  necessary,  trying  to  put  the  bowel 
back,  but  must  be  very  careful  not  to  excite  inflammation  by  any 
violence. 

If  he  does  not  succeed,  efforts  are  next  to  be  made  still  further  to 
relax  the  muscles,  as  well  as  to  reduce  the  force  of  the  heart's  action, 
and  to  diminish  the  size  of  the  tumor.  With  the  tincture  or  fluid 
extract  of  veratrum  viride,  the  heart's  action  and  force  of  the  c;iroula- 
tion  may  be  reduced  to  any  desirable  extent.  The  muscles  may  be 
relaxed  by  injections  of  tobacco,  made  by  steeping  o\w.  dram  of  to- 
bacco in  one  pint  of  water  for  ten  minutes.  This,  however,  is  a 
somewhat  dangerous  remedy,  and  should  give  place  to  the  compound 
lobelia  injection.  Two  grains  of  tartrate  of  antimony  in  one  pint  of 
tepid  water,  make  a  suitable  injection. 

To  reduce  the  tumor,  apply  pounded  ice  in  a  bag,  or  a  freezing 
mixture  (354).  If  the  pain  be  acute,  give  large  doses  of  opium  or 
morphia. 

If  all  these  remedies  fail,  there  is  then  no  hope  but  in  relieving  the 
stricture  by  a  surgical  operation. 

General  Directions. —  Rupture  is  an  exceedingly  common  affection, 


^  i 


Ill"  ' 
1 

i 

1 

V 

1 

1 

1' 

: 

( 

478 


SCTRGICAL  DISEASES. 


Perhaps  every  third  or  fourth  person  suffers  from  it  more  or  less. 
Females,  from  motives  of  delicacy,  are  apt  to  conceal  the  misfortune, 
and  not  seek  advice.  This  exposes  them  to  danger.  Queen  Caro- 
line, wife  of  Georn^f*  II.,  lost  her  life  by  such  concealment. 

A  swelling  coming  on  sudflenly  in  the  groin  or  at  the  navel,  after 
considerable  exertion,  may  be  taken  to  be  a  rupture  without  much 
fear  of  mistake. 

The  complaint  being  discovered,  the  bowel  should  be  put  back 
in  its  place,  and  a  truss  be  put  on  at  once.  In  the  case  of  young 
persons,  a  truss  may  frequently  effect  a  cure,  but,  that  it  may  do  lliis, 
it  should  not  be  taken  oH",  night  or  day,  (,'xcept  to  cleanse  it,  and  then 
orily  when  the  wearer  is  in  bed. 

Those  who  can  afford  it,  should  have  two  trusses  of  the  same  size 
and  strength,  so  that  if  one  g(!t  out  of  order,  the  other  may  take  its 
place  while  it  is  being  repaired ;  for,  an  hour's  absence  of  the  truss 
might  occasion  a  mischief  which  it  would  require  months  to  repair. 

Persons  having  a  rupture  must  be  very  careful  to  keep  costivenesa 
at  a  distance  ;  for  straining  at  stool  is  highly  injurious. 

Varicocele.— Cirsocele. 

This  is  an  enlargement  or  varicose  state  of  the  spermatic  veins, 
and  may  be  mistaken  for  hernia,  inasmuch  as  standing  and  coughing 
increase  it.  But  it  feels  like  a  bag  of  worms ;  and  by  this  peculiarity, 
may  be  distinguish(!d  from  rupture.. 

Treatment. —  Wear  a  suspensary  bandage. 

Deformities  and  Irritations  of  the  Spine. 

Lateral  Curvature.  —  There  ^re  several  varieties  of  curvature  of  the 
spine;  Some  of  them  are  caused  by  the  destruction  of  some  portion 
of  the  spinal  column  by  disease.  It  will  not  be  necessary  for  me  to 
treat  of  these  forms  of  curvature,  as  they  can  only  be  investigated  and 
treated  by  the  most  skilful  surgeons.  Those  who  will  use  this  book 
chiefly,  would  hardly  think  of  meddling  with  them. 

The  curvature  which  arises  from  debility  of  the  bones,  ligaments, 
and  muscles,  and  which  is  very  common  among  females,  has  the 
following 

Symptoms.  —  At  first  there  is  a  projection  of  one  collar-bone,  or  one 
side  of  the  chest,  or  one  shoulder  is  considerably  elevated,  and  ir^ 
popularly  thought  to  be  ^^g-rowin^  out."  On  examination,  the  right 
shoulder  and  the  right  side  of  the  chest  will  be  found,  generally,  to 
be  rounded  and  lifted  up,  while  the  other  is  sunk  down  and  concave. 
At  the  same  time,  the  left  hip  sticks  out,  and  the  loins  on  the  right 
side  have  an  inward  curve.  The  spinal  column  will  have  a  curve,  as 
in  Fig.  174. 

Causes.  —  This  affection  is  caused  by  occupations  which  keep  tho 
body  in  a  laterally  distorted  position,  and  tax  one  side  of  the  body 


SURGICAL  DISEASES. 


479 


more  than  the  other. 


lessons  at  school   with   one    elbow   resting  on 


Ficj.  174. 


It  is  produced  in  children  who  study  their 

a  high  desk.  The 
muscles,  too,  get  so  weakened  in  many 
females  of  luxurious,  sedentary,  and  indo- 
lent habits,  that  tlu^y  cannot  hold  the  bony 
frame  of  the  body  in  an  upright  position, 
and  the  jointed  cohunn  of  bones,  ealled 
the  spine,  sags  down  to  one  side,  and 
draws  the  whole  skeleton  of  the  trunk  out 
of  shape. 

Treiitriipuf. —  The  first  thini?  to  be  done 
is  to  learn  what  particular  attitude  of  the 
body  has  occasioned  tiie  distortion.  This 
discov(!red,  every  possible  ('llort  is  to  be 
made  to  break  up  the  habit,  whatever  it 
may  be.  If  it  be  standing  on  one  foot,  or 
sleepir)<i;  on  one  side,  or  reading  or  writ- 
ing with  the  elbow  high,  keep  a  constant 
watch  and  strict  rule  over  the  patient. 

Exercise  in  the  open  air  should  be  free, 
and  taken  daily.  The  use  of  the  dumb 
bells  is  excellent  for  both  sexes;  bat  girls 
should,  in  addition,  have  all  the  variety  of  elegant  exercise  furnished 
by  calisthenics.  Wealthy  parents,  whose  daughters  are  tenderly  bred, 
should  tiever  let  them  grow  up  without  the  invigoration  which  these 
e\ercises  impart. 

When  the  curvature  is  marked,  and  the  debility  conslflerable,  these 
vigorous  exercises  should  be  taken  for  a  time  with  moderation,  and 
the  patient  should  lie  down  and  rest  immediately  after  taking  them. 

In  many  cases  considerable  benefit  is  derived  from  the  mechanical 
support  afforded  by  supporters  of  various  kinds.  These  are  now  con- 
structed and  adapted  to  the  body,  with  considerable  skill,  by  those 
who  make  their  construction  a  study  and  a  business. 

Spinal  Irritation.  —  The  spinal  column  is  liable  at  certain  points, 
to  become  congested,  and  consequently  sore  and  irritable. 

Syinptunis.  -  The  symptoms  of  this  state  of  things  are  very  varia- 
ble and  numerous,  as  all  sorts  of  sensation  of  the  skin,  from  utter 
numbness  and  insensibility  up  to  the  most  acute  sensitiveness,  des- 
cribed as  creeping,  shooting,  coldness,  tingling,  and  the  crawling  of 
ants.  There  may  be  neuralgic  pains,  spasm,  cramp,  trembling,  or 
palsy  of  the  voluntary  muscles ;  or  a  fixed  pain  and  tenderness  in 
some  joint  or  other  part ;  or  palpitation  of  the  heart,  dizziness,  and 
wind  and  pain  in  the  stomach. 

When  any  of  these  symptoms  appear,  and  cannot  be  traced  to  any 
other  cause,  we  are  to  suspect  some  irritability  of  the  spitial  column, 
and  to  search,  accordingly,  in  that  direction.  The  proper  method  of 
search  is,  to  make  firm  pressure  on  each  of  the  projections  of  the 
Bpine,  and  to  pass  pver  the  projections  a  sponge  wrung  out  of  hot 


^vate^.  If  there  be  trouble  here,  the  patient  will  now  bo  likely  to 
complain  of  severe  pain  at  some  one  point.  Or,  the  tender  place 
will  generally  be  found  sooner,  by  tapping  with  the  ends  of  the  fin- 
gers, with  (luick  and  sharp  strokes  along  upon  the  projecting  bones 
of  the  spine.  The  patient  will  be  pretty  sure  to  wince  when  the 
tender  point  is  reached. 

Tresitnieiit. —  Apply  leeches,  and  follow  them  with  a  blister,  or 
stimulating  liniment,  or  some  strong,  slightly  irritating  plaster,  and 
the  tenderness  will  be  very  likely  to  disappear,  as  if  by  magic. 


ill  ''^■:^' 


Wry  Neck. —  Caput  Obstipum. 

In  this  complaint,  the  head  is  drawn  over  towards  one  of  the  shoul- 
ders, with  the  face  generally  turned  towards  the  opposite  side.  This 
is  caused  by  the  rigid  contraction  of  a  particular  muscle.  In  some 
instances,  however,  other  muscles  are  affected,  and  the  head  may  be 
drawn  in  other  directions,  or  be  twitched  about  in  various  ways. 

I  had  a  singular  case  from  Now  Hampshire,  which,  though  not 
exactly  wry  neck,  was  a  kindred  disease,  and  is  worthy  of  being  men- 
tioned. The  subject  of  it  was  a  young  lady  of  good  physical  develop- 
ment, but  inclined  to  nervous  complaints.  Her  head  was  chiefly  drawn 
over  backwards,  sometimes  so  as  to  lie  for  a  short  time  flat  upon  the 
back,  with  no  power  to  raise  it.  She  was  obliged,  ordinarily,  to  let 
her  head  lean  a  little  to  one  side,  and  rest  upon  the  hand,  in  order  to 
keep  it  steady.  When  walking,  with  the  head  erect,  without  this 
support,  it  was  every  few  moments  jerked  over  backward  and  a  little 
to  one  side,  the  chin  being  thrown  up  in  a  most  unseemly  way.  The 
case  partook  of  the  nature  of  chorea. 

Treatment.  —  For  the  genuine  wry  neck,  where  the  muscle  which 
draws  the  head  to  one  side  is  rigid  and  inflamed,  the  treatment 
should  consist  of  leeches,  poultices,  purgatives,  blisters,  and  alteratives. 
When  the  muscles  causing  the  distortion  are  not  rigid,  electro-mag- 
netism, or  the  shower  bath  may  have  a  good  eftect.  In  some  cases, 
Mtrychnine  will  do  well. 

T^he  peculiar  case  mentioned  above,  completely  recovered,  under  the 
Vises  of  the  extract  of  St.  Ignatius's  bean  (95),  one  pill  three  times  a 
day,  and  gradually  increased  to  nine  pills  <i  day.  She  also  took  iron, 
and  was  put  upon  a  most  energetic  system  of  out-door  exercise. 
Considering  the  stubborn  and  severe  nature  of  the  complaint,  her 
complete  recovery  was  as  unexpected  to  her  friends  as  it  was  grati' 
fying. 

Foreign  Bodies  in  the  Eye. 

When  a  person  complains  of  some  substance  in  the  eye,  the  mside 
of  the  lower  eyelid,  and  lower  portion  of  the  ball,  should  first  be  ex- 
am ed,  the  person  being  directed  at  the  same  time  to  look  up.  If 
not  iitiQ  be  discovered  there,  the  patient  is  then  to  be  directed  to  looil 


SURGICAL  DISEASES. 


481 


downward.  This  will  exjxjse  to  view  the  upper  part  of  the  globe. 
At  the  same  time,  the  eyelashes  should  be  taken  between  the  thumb 
and  finger,  and  tlie  lid  turned  upward  over  some  round  smooth  thing, 
as  a  bodkin,  which  will  turn  the  lid  wrong  side  out,  and  bring  to  view 
whatever  is  on  the  inner  surface.  Any  foreign  body  discovered  may 
be  removed  by  wiping  it  off  with  the  iiead  of  a  pin,  having  a  silk 
handkerchief  turned  over  it.  If  this  fails  to  detach  it,  it  may  be  care- 
fully picked  up  by  running  under  it  the  point  of  a  lancet,  tooth-pick^ 
or  pen-knife. 

Stye. — Hordeolum. 

A  STYE  is  nothing  more  nor  less  than  a  small  painful  boil  at  the 
edge  of  the  eyelid. 

Treatment.  —  In  severe  cases,  apply  a  poultice ;  and  open  it  as  soon 
as  it  begins  to  point.  After  it  has  discharged  all  it  is  likely  to,  apply, 
on  going  to  bed,  for  two  or  three  nights,  a  little  diluted  nitrate  of 
mercury  ointment.  Tonics  and  alteratives  are  frequently  required  to 
break  up  the  formation  of  styes. 


Inflammation  of  the  Edge  of  the  Eyelids. 

Ophthalmia  Tarsi. 

This  inflammation  often  involves  the  Meibomian  glands,  which 
then  secrete  a  sticky  mucus,  which,  not  being  wiped  away  during 
sleep,  glues  the  lids  together,  so  that,  on  waking  in  the  morning,  the 
patient  cannot  get  his  eyes  open.  The  complaint  is  generally  chronic 
and  obstinate,  lasting  a  long  time.  Weakly  persons,  with  disordered 
digestion,  are  most  subject  to  it.  In  some  cases  the  lids  ulcerate,  and 
the  lashes  fall  out.  Generally  the  lids  are  considerably  inflamed  for 
a  few  days,  and  then,  the  inflammation  subsiding,  branny  scales, 
which  may  be  brushed  off,  form  along  the  borders  of  the  lids,  at  the 
roots  of  the  lashes. 

Treatment.  —  The  health  being  generally  disordered,  needs  first  to 
be  improved  by  all  possible  means,  as  by  alteratives,  tonics,  bathing, 
exercise  in  the  open  air,  travelling  if  practicable,  and  a  generous  diet 

While  the  lids  are  inflamed,  they  should  be  bathed  by  a  wash  com- 
posed of  sulphate  of  zinc,  twelve  grains;  laudanum,  two  drams;  and 
tioft  water,  twelve  ounces.  The  redness  and  heat  having  subsided, 
and  the  bowels  beirjg  opened  by  a  gentle  dose  of  physic,  an  astrin- 
gent wash  should  be  applied  once  or  twice  during  the  day  (208) 
(209),  and  a  small  piece  of  the  diluted  nitrate  of  mercury  ointment 
be  rubbed  along  the  borders  of  the  lid,  with  a  pencil-brush  at  night. 
This  will  generally  eftect  an  imniediate  improvement,  and  in  time 
will  bring  about  a  cure. 

61 


;1    I 


wr 


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1,  '■ 

1  • 

1  ' 

".m 

482 


SURGICAL  DISEASES. 


Disorder  of  the  Lashes. 

Trichiasis.  —  This  signifies  a  growing  inward  of  the  eyelashes. 

Dystricllinsis.  —  This  is  a  doublo  row  of  eyelashes,  one  of  which 
grows  inward. 

Treatment.  —  Pull  out  the  misplaced  hairs,  and  continue  to  do  so 
as  fast  as  they  appear. 

Ptosis. 

This  is  a  falling  down  of  the  upper  eyelid,  from  palsy  of  the  third 
nerve.  It  is  sometimes  attended  with  headache,  and  dizziness,  and 
may  be  the  forerunner  of  apoplexy. 

Treutment.  —  Begin  the  treatment  with  purgatives,  and  then  use 
every  means  to  improve  tlie  health,  especially  exercise  out  of  doors. 

Chronic  Inflammation  of  the  Lachrymal  Sac. 

When  the  mucous  lining  of  the  nasal  duct  gets  thickened  and 
obstructed,  the  patient  complains  of  great  weakness  of  the  eye,  which 
is  constantly  weeping,  —  the  nostril  on  the  same  side  having  a  corres- 
ponding dryness.  The  tears  not  passing  down  through  the  obstructed 
duct,  collect  in  the  lachrymal  sac,  and  form  a  small  tumor  by  the  side 
of  the  nose.  By  pressing  the  finger  upon  this,  the  tears  may  be 
squeezed  out  through  the  upward  passage,  and  glairy  mucus  along 
with  them.  There  is  generally  tenderness  of  the  sac,  and  sometimes 
redness  of  the  skin.  There  is  commonly  inflammation  of  the  mucous 
membrane  lining  the  eyelids,  etc. 

Treatment.  —  The  acute  inflammation  of  the  sac  must  be  treated 
by  leeches,  purgatives,  and  cold  washes. 

Chronic  inflammation  of  the  sac  requires  a  special  attention  to  the 
general  health.  The  diet  should  be  carefully  regulated,  and  the  alka- 
line sponge  bath  used  every  day,  with  brisk  rubbing  after  it.  When 
the  sac  gets  very  full,  the  patient  shoukl  try  gently  to  force  the  con- 
tents down  into  the  nose  by  pressing  upon  the  upper  side  of  the 
tumor ;  and  he  may  promote  the  same  object  by  strongly  drawing  in 
his  breath  often  with  his  mouth  and  nostrils  both  tightly  shut.  The 
diluted  nitrate  of  mercury  ointment  may  be  applied  to  the  eyelids  at 
bed-time,  and  a  little  of  prescription  (211)  may  be  dropped  once  dur« 
ing  the  day  into  the  inner  corner  of  ^he  eye. 

Purulent  Ophthalmia. — Egyptian  Ophthalmia. 

Owing  to  the  glaring  sunshine,  and  the  particles  of  sand  with 
which  the  air  is  loaded,  this  disease  is  endemic  in  Egypt.  Hence  its 
name  Egyptian  bpthalmia. 


m 


SURGICAL  DISEASES. 


48:) 


Symptoms.  —  It  begins  with  stifTness,  itching,  and  watering  of  the 
eyt's,  and  a  feeling  as  if  there  were  dust  in  them.  The  lids  are  a 
little  swelled,  and  become  glued  together  during  sleep.  The  mucous 
metubrfne  which  lines  the  lids  and  covers  the  bull,  is  int«'nsely  red 
and  swollen,  and  discharges  a  copious  quantity  of  pus.  There  is  a 
Bcvere  burning  pain  extending  to  the  cheek  and  temple,  with  head- 
ache and  fevc*.  The  eyes  cannot  be  opened.  Jt  is  both  contagious 
and  infectious. 

Trfatm<'nt. —  At  the  very  beginning,  apply  a  nitrattr  of  silver  wash 
(211),  twice  a  day.  Willi  this  application,  a  low  diet,  and  five  to 
ten-drop  doses  of  llnid  extract  or  tincture  of  veratrum  viride,  every 
hour,  this  terrible  complaint  may  often  be  broken  up. 

If  the  disease  have  reached  its  height,  arid  there  is  great  fever  and 
headache,  the  patient  may  be  freely  purged  (31),  and  the  pain  be 
allayed  by  full  doses  of  Dov(!r's  powder. 

The  patient  must  be  kept  in  bed,  in  a  dark  room,  with  the  head 
elevated. 

The  eyes  should  be  frequently  washed  out  gently  with  warm  water, 
or  a  decoction  of  poppi<!s,  containing  one  grain  of  alum  to  an  ounce. 
This  must  be  done  with  a  piece  of  fine  sponge,  or  with  a  small 
syringe.  Once  or  twice  a  day,  a  few  drops  of  solution  of  nitrate  of 
silver,  two  grains  to  the  ounce  of  soft  water,  may  be  dropped  in 
the  eyes  from  a  camel's-hair  pencil.  As  soon  as  the  disease  begins 
to  give  way,  the  alum  in  the  poppy  decoction  may  be  increased  a 
little. 

Purulent  Ophthalmia  of  Children. 

This  always  begins  within  a  short  time  after  birth,  —  generally 
on  the  third  day. 

Symptoms.  —  The  edges  of  the  lids  at  first  become  red,  and  glued 

I  together,  and  the  membrane  lining  them  is  red  and  rough.     The  eye 

i  remains  closed.      The  conjunctiva  or  membrane  which  covers  the 

globe,  next  becomes  intensely  scarlet,  and  so  much  swelled,  at  times, 

that  the  lids  turn  out;  and  it  dischaiges  a  thick  purulent  matter. 

The  child  is  feverish  and  restless. 

Causes.  —  Exposure  to  cold  and  damp,  bad  nursing,  omitting  to 
I  wash  away  from  the  eyes  the  cheesy  secretions  of  the  skin,  and  the 
contact  of  gonorrhoeal  and  leucorrhceal  secretions  of  the  vagina  at 

I  birth. 

Treatment.  —  Wash  out  the  eye  frequently,  and  gently,  with  a 

[weak  astringent  wash  (207)  (203),  or  put  between  the  lids  once  a 

[day,  a  large  drop,  with  a  camel's-hair  pencil,  of  prescription  (208). 

I  When  the  disease  is  declining,  apply  to  the  lids,  with  a  camel's-hair 

pencil,  diluted  nitrate  of  mercury  ointment. 


n^ 


# 


F 


A^ 


SUUUICAL  mSKASES. 


Catarrhal  Ophthalmia. 

Symptoms. —  In  this  complaint,  the  white  of  the  eye  becomes  in. 
flamed  and  very  red,  tlie  rednea.s  being  superficial,  ho  that  the  veBsel 
can  be  moved  by  pulling  the  eyelids;  generally  there  is  a  thin  mucous 
discharge,  which,  in  severe  cases,  becomea  thick  and  purulent.  It  is 
caused  by  cold  and  damp. 

TreiitiiU'iif. —  If  there  be  considerable  pain  and  headache,  give  pu^ 
gatives  (31)  (19),  and  continue  them,  once  a  day,  till  the  symptonia 
of  active  inflammation  subside.  Apply  to  the  eyes  a  poultice  of 
slippery  elm,  and  bathe  them  frequently  with  a  decoction  of  poppy 
leaves,  lukewarm  or  cold,  according  to  the  choice  of  the  patient, 
Smear  the  edges  of  the  lids  at  night  with  fresh  lard ;  and  when  the 
inflammation  begins  to  decline,  use  diluted  nitrate  of  mercury  oint- 
ment instead.  KcM-p  the  eyes  well  protected  from  the  light  with  a 
shade.  A  large  drop  of  a  solution  of  nitrate  of  silver,  two  to  four 
grains  to  the  ounce  of  water,  may  be  put  into  the  eye  two  or  three 
times  a  day.  Sometimes  sulphate  of  zinc,  four  grains  to  tlrib  ounce 
of  water,  will  do  well. 

When  the  disease  reaches  the  chronic  stage,  —  the  pain  and  head- 
ache having  passed  ofl",  —  some  astringent  applications  will  be  re- 
quired, as  a  very  weak  solution  of  nitrate  of  silver  (208),  or  a  dram 
each  of  powdered  witchhazel  leaves  and  golden  seal,  stC'C|>od  for  ten 
minutes  in  a  gill  of  boiling  watery  and  strained  when  co^d. 


Scrofulous  Ophthalmia. 

Th's  disease  is  chiefly  confined  to  children  undci  w«^ht  years  of 
age. 

Symptoms.  —  Entire  inability  to  bear  light ;  the  lidv  are  spasmodi- 
cally closed,  and  the  head  constantly  turn.  '.  away  frori  vhe  light  The 
blood  vessels  of  the  conjunctiva  are  not  particulavly  injected,  with 
the  exception  of  one  or  two  large  ones  which  run  tf.warJa  the  cornea, 
and  terminate  in  one  or  more  small  opaque  pinvples.  The  cornea 
frequently  ulcerates,  and  the  complaint  is  very  obstinate,  —  beiog 
Jiable  often  to  recur. 

Tre^tmept  —  As  in  all  scrofulous  complaints^  tt  is  important  in 
this  to  look  after  the  general  health.  No  more  physic  is  required 
than  to  keep  the  bowels  open  ;  and  ':ven  this,  ir  costiveness  exist, 
had  better  be  done  by  bread  made  from  unbolted  wheat  flour,  by 
injections  of  cool  or  tepid  water,  and  by  exercise.  The  health  must 
be  supported  by  iron,  sarsaparilla,  stillingia,  and  qumine. 

The  eye  is  to  be  .strengthened  by  cold  water  applitd  to  the  lids,  the 
forehead,  and  the  temples.  The  eyes  may  be  bathed  likewise  with  a 
warm  decoction  of  poppies,  or  of  chamomile  flowers. 

But  one  of  the  best  applications  is  a  solution  of  nitrate  of  silver, 
one  or  two  grains  to  the  ounce  of  water,  a  few  drops  being  put  into 


SURGICAL  DISEASES. 


485 


the  eye  once  or  twice  a  day.     Occasionally  a  solution  of  sulphate  of 
copper,  of  the  same  strength,  may  be  used  with  decided  advantage. 
Both  eyes  should  be  protected  by  a  shade. 

Inflammation  of  the  Cornea. — Comeitis,        > 

Symptoiiix.  —  The  corncii  is  rough,  red,  oprKiuc,  and  g<'nerally  prom- 
inent. ThiTt!  is  soine  p.iin  and  inability  to  bear  light,  but  not  great. 
The  pulse  is  frequent,  and  the  skin  dry. 

TreiltllH'llt. —  If  the  inflammation  be  acute,  use  leeches,  emetics, 
purgatives,  tincture  of  veratrum.  Apply  fomentations,  and  siiu-ai 
bclladornia  ointment  o\i  the  eyebrows. 

For  the  elironie  form,  give  quinine  and  other  bitters,  and  put  blis- 
ters upon  the  nape  of  the  neck,  and  behind  the  ears.  The  wine  of 
opium,  and  the  diluted  nitrate  of  mercury  ointment,  must  be  applied 
to  the  lids. 

Inflammation  of  the  Iris. — Intis. 

TuE  iris  is  covered  with  a  serous  membrane,  and  is  very  liabl<-  to 
adhesive  inflammation, 

Syi  ♦oilis. —  In  the  first  stage,  the  iris  changes  its  color,  and  the 
puj)  ontracted.     In  the  next  stage,  lymph  is  poured  out  upon  the 

surf  .  a  thin  layer,  sometimes,  which  looks  rusty,  and  sometimes 

ill  larger  quantities,  filling  the  whole  cavity  of  the  acjuc'ous  humor. 

CiUlses. —  Injuries,  or  overworking  the  eye,  but  more  frecpiently  a 
taint  of  the  system  from  gout  or  syphilis. 

Treutllieilt. —  If  there  be  considerable  inflammation,  apply  leeches 
to  the  temples,  and  keep  down  the  circulation  by  tim-ture  of  vera- 
trum. To  relieve  pain,  if  any,  give  Dover's  powder,  or  morphia. 
The  strength  is  generally  to  be  supported  by<|uinine;  and  in  many 
instances,  iodide  of  potassium  is  to  be  given  as  an  alterativi-.  A  little 
solution  of  atropia,  one  grain  to  the  ounce  of  water,  is  to  be  dropped 
into  the  eye  once  or  twice  a  day,  and  a  warm  infusion  of  slippery 
eltn  bark,  or  of  marshmallow,  to  be  used  as  a  wash.  The  bowels  to 
be  kept  open  by  gentle  physic. 

Weakness  of  Sight. — Muscee  VoUtantes. 

This  is  an  affection  to  which  persons  of  weakly  constitution  are 
liable,  and  those  who  write  much,  or  examine  very  small  objects. 

Syiiiptonis.  —  Dimness  of  sight;  uneasiness  on  exposure  to  a  strong 
light;  and  specks  floating  before  the  eyes,  —  often  looking  like  flies. 

Treatment. —  The  complaint  depends  on  debility,  natural  or  ac- 
quired ;  and  tonics,  as  quinine  and  iron,  and  the  shower  or  sponge 
bath,  and  out-:*loor  exercise,  are  the  proper  remedies. 


:il! 


486 


SURGICAL  DISEASES. 


Imperfect  Vision. — Amaurosis. 

The  complaint  here  referred  +o  if  dependent  on  some  change  in 
the  optic  nerve  or  the  brain,  —  most  commonly  the  former. 

Sjmptoiiis. —  In  some  cases  the  sight  becomes  suddenly  dini,  and 
i?  perhaps  soon  lost  altogether ;  but  more  often  it  is  impaired  by  slow 
degrr«;3,  —  being  only  defective  at  inter v^als,  as  when  the  stomach  is 
out  Oi  order,  or  the  eyes  have  been  /atigued.  At  one  time,  it  will 
begin  with  objects  appearing  dim ;  at  another,  with  their  being 
double  ;  at  still  another,  with  the  ability  to  see  only  one  half  of 
obj(!cts.  In  some  instances,  the  complaint  begins  with  a  crooked, 
or  disfigured,  or  discolored  appearance  of  things  looked  at.  Again 
it  will  begin  as  near-sightedness,  or  far-sightedness ;  or  the  patient 
cannot  measure  distances,  and  will  miss  his  aim  in  pouring  water 
into  a  glass,  or  in  putting  a  match  to  the  wick  of  a  lamp.  The  flame 
of  a  lamp  will  appear  split.  At  times  the  eye  does  not  bear  light ; 
at  other  times  it  longs  for  it,  and  objects  do  not  appear  illuminated 
enough. 

Distinction.  —  Amaurosis  may  be  distinguished  from  cataract  by 
there  being  no  opaque  body  to  be  seen  behind  the  pupil ;  and  by  the 
light  of  a  candle  appearing  discolored,  split,  or  lengthened,  or  iride- 
scent, whereas  in  cataract,  vision  is  only  clouded,  and  a  lig'.ited  candle 
looks  as  if  surrounded  with  a  m.ist. 

Chances  of  Cure.  —  These  are  generally  not  very  favorable,  unless 
the  remedies  employed  very  soon  produce  good  effects. 

Treatment.  —  Electro-galvanism  is  one  of  the  most  promi^jing  reme- 
dies. Bayberry  root,  dried  and  reduced  to  an  impalpable  power,  and 
taken  as  a  snuff,  is  occasionally  useful.  Cayenne,  steeped  in  water, 
one  grain  to  one  ounce  of  water,  and  a  little  of  it  dropped  into  the 
eye,  may  stimulate  the  palsied  nerve,  and  in  some  cases  restore  sight. 

Blisters  may  be  applied  behind  the  ears,  or  a  seton  may  be  tried 
upon  the  back  of  the  neck,  with  some  promise  of  .success. 

But  probably  nothing  will  do  better  than  cold  bathing,  —  a  shower 
bath  if  it  can  be  borne,  —  out-door  exercise  vigorously  puisued,  and 
an  adherence  for  a  lorig  time,  — perhaps  a  year,  —  to  a  strictly  vege* 
table  diet,  —  at  the  same  time  using  nervine  tonics,  ecc.  (3iC). 


Short  and  Long  Sight. 

Short  k^ij^iit,  o.'dhxl  mi/opia,  depends  on  too  'j^rcal,  a  conrrxitij  of  the 
cornea,  or  crystaline  lens,  or  vitreous  liuinor,  —  one  or  all,  —  and  the 
consetjiient  format  ion  of  the  image  of  the  object  inspected  a  liltle  in 
front  of  the  optic  nerve,  or  retina,  —  as  at  a,  Fig.  173,  instead  of  at  b, 
where  it  should  be  formed.  The  rays  of  light  are  brought  to  a  focus 
before  they  reach  th(;  retina. 

Children  are  either  born  with  this  defect,  or  it  is  brought  on  by  too 
close  study,  or  by  long  application  of  the  eyes  to  minute  objects. 


SURGICAL  DISEASES. 


487 


It  may  be  remedied  frequently  by  exercising  the  eyes  in  looking  at 
distant  objects.  Children  afflicted  in  this  way  should  have  their 
studies  abridged,  and  their  exercise  in  the  open  air  increased.  "While 
atudyiiig  they  should  have  some  apparatus  applied  to  them  which 
p'.iall  keep  the  chin  elevated,  so  that  the  head  cannot  be  dropped  too 
low,  and  the  eyes  brought  too  near  the  book.  And  the  book  should 
( ach  day  be  placed  a  very  little  further  from  the  eyes. 

Fio.  173. 


Glasses  worn  by  persons  having  this  defect  of  vision  should  be 
concave,  as  a*  c. 

liOn^  Sij?l>t,  or  prc.slf/opia,  depends  on  the  humors  of  the  eye  not 
being  convex  enon';!..  In  this  c;is(*,  llic  itnfige  of  the  inspected  object 
is  formed  beyond  the  optic  ncnr,  as  nt  ft.  Fig.  174.  This  is  one  of  the 
earliest  signs  of  advancing  ugc. 


Fio.  174. 


This  defect  is  to  be  remedied  by  glasses  which  are  convex,  e.  Per- 
sons in  the  early  autumn  of  life,  must  not  resort  to  glasses  too  hastily, 
or,  indeed,  until  they  are  compelled  to,  nor  should  they  change  those 
first  used  too  soon.  Glasses  should  make  objects  look  distinct  and 
bright,  but  not  larger  than  natural. 

Squinting. — Strabismus. 

In  strabismus,  the  eyes  are  not  parallel  in  their  position  an' I  mo- 
tion- 
It  is  supposed  tliat  one  eye  may  beeoiiie  weaker  than  the  other,  or 
that  the  visual  a.\is  of  the  two  may  not  be  a<!justed  alike,  so  that  one 
eye, —  perhaps  the  more  defective  one,  —  turns  aside  to  escape  the 
distorted  vision,  or  possibly  tlie  injury  to  itself  wliieli  would  follow 
the  attempt  to  make  eyes  of  um'([ij;il  power  work  evenly  together. 
The  opposing  muscles  lose  their  counttTbalanciiig  force,  and  the  in- 
ternal rectus,  gaining  th<  picponderaiiee,  draws  the  eye  iitiranl,  —  for 
the  squint  is  more  often  conctri^cnl  tliun  dircr^-c/U ;  that  is,  the  eye 
turns  in  more  often  than  out.     Both  ey<!s  sometimes  squint. 


■nff^T 


'km 


;  «■ 


488 


=1' 


SURGICAL  DISEASES. 


Treatment.  —  In  recent  cases,  there  is  some  chance  of  curing  this 
complaint  without  a  surgical  operation.  The  patient  should  not  be  in 
the  society  of  other  squinting  persons,  so  as  to  learn  it  by  imitation. 

In  the  first  place  care  should  be  taken  that  the  bowels  are  kept  in 
good  condition,  and  that  the  general  health  is  well  fortified  by  bath- 
ing, tonics,  and  exercise.  The  patient  should  be  made  to  stand 
before  a  glass,  and  while  he  closes  the  sound  eye,  look  steadily  at 
some  object  with  the  squinting  cyo.  Let  him  do  this  till  the  eye  is  a 
little  tired ;  then  let  him  open  the  sound  eye,  whcMi  the  squinting  one 
will  turn  aside.  But  by  compelling  it,  in  ihis  way,  several  times  a 
day,  to  work  in  a  straight  line,  it  may,  perhaps,  be  taught  to  remain 
parallel  with  the  other. 

Nervine  tonics,  as  strychnine  (86)  (94)  (9o)  (316),  will  sometimes 
do  good  service ;  and  electro-galvanism  has  been  found  useful  in 
many  cases. 

But  in  old  and  obstinate  cases,  the  only  cure  is  found  in  dividing 
the  muscle  which  pulls  the  eye  to  one  side,  —  the  internal  rectus,  if 
the  eye  is  drawn  in,  —  the  external  rectus,  if  it  is  drawn  out 

Affections  of  the  Ear. 

These  are  so  common,  that,  in  almost  every  family,  they  require 
attention,  at  one  time  or  another.  And  deafness,  which  so  often 
results  from  these  disorders,  is-  so  serious  a  misfortune,  that  every 
affection  of  the  ear  should  receive  early  attention. 

Examination  of  the  Neatns.  —  For  examining  the  meatus,  or  ex- 
ternal passage  of  the  ear,  there  is  perhaps  no  better  instrument  than 
a  simple  silver  or  glass  tube,  of  the  si^je  fio.  175. 

and  shape  represented  in  Fig.  175. 

To  make  the  examination  properly,  place 
the  patient  either  in  a  sitting,  kneeling,  or 
standing  posture,  as  may  be  most  conven- 
ient, with  the  ear  directly  under  a  good  -^ 
stream  of  gas,  or  lamp,  or  sun-light.  Then  take  hold  of  the  ear  with 
the  thumb  and  finger,  and  gently  draw  it  outward  and  backward,  and 
with  the  other  hand  introduce  the  small  end  of  the  tube  or  speculum, 
and  carry  it  forward  as  far  as  it  will  go  without  producing  pain. 
Then  by  gently  swaying  the  large  end  of  the  tube  back  and  forth,  a 
stream  of  light  may  be  made  to  illuminate  all  sides  of  the  passage. 
If  the  lining  of  this  passage  is  smooth,  dry,  pearly-white,  and  shining, 
and  is  without  wax,  it  may  be  regarded  as  healthy.  At  the  close  of 
the  passage,  the  tympanum  may  be  seen,  and  should  be  semi-trans- 
parent, dry,  and  grayish-white.  Within  this,  may  be  seen  the  handle 
of  the  malleus,  coming  from  above  downward  and  forward.  This 
bone  rviHS  about  half  way  across  the  tympanum,  and  divides  it  into  an 
upper  front,  and  a  lower  back  part.  This  lower  back  portion,  when 
viewed  through  the  speculum,  is  more  glistening  than  the  upper  and 
front  part,  and  a  bright  spot  of  light  is  seen  on  its  most  rounded 
nortion,  which  is  just  below  and  behind  the  point  of  the  malleua 


fM 


SURGICAL  DISEASES. 


489 


Inflammation  causes  this  innermost  part  of  the  meatus  to  become 
thickened,  vascular,  or  granular,  —  like  the  conjunctiva  of  the  eye 
when  it  is  inflamed ;  it  also  causes  it  to  secrete  and  discharge 
matter. 

Inflammation  of  the  Meatus. — Otorrhcea. 

This  is  quite  a  common  complaint  among  delicate  children  ;  and 
may  occur  as  the  result  of  scarlet  fever,  or  be  excited  by  currents  of 
cold  air,  by  rotten  teeth,  or  .by  deranged  stomach  and  bowels. 

Symptoms. —  Fever,  headache,  intense  pain  in  the  ear,  and  swelling 
of  the  glands  of  the  neck.  After  a  iiuw,  a  reddish,  watery  discharge 
comes  on,  which  soon  grows  thicker  and  mattery.  The  fever  dis- 
appears with  the  appearance  o'"  the  thick  matter.  An  examination 
with  the  speculum  shows  the  whole  meatus  to  be  swollen,  vascular, 
and  covered  with  a  slimy  matter. 

Unless  great  attention  be  given  to  cleanliness,  the  discharge  be- 
comes very  abundant  and  fetid,  and  lasts  for  a  long  time ;  and  if 
neglected,  will  be  likely  to  lead  to  very  serious  consequences,  even 
the  decay  of  some  of  the  bones  of  the  head. 

Treatment. —  While  the  inflammation  is  acute,  and  there  is  fever 
and  pain,  the  diet  should  be  confined  to  mere  liquids,  —  as  rice-water, 
gruel,  etc.,  and  the  bowels  should  be  opened  with  some  preparation  of 
salts,  —  the  ear  being  gently  syringed,  occasionally,  with  warm  water, 
or  decoction  of  poppies,  and  being  covered  with  a  warm  poultice  of 
flax-sefid,  or  bread  and  milk.  In  place  of  a  poultice,  a  soft  linen  ba<,r, 
filled  with  bran,  and  dipped  in  hot  water,  may  be  kept  on  ''e  ear. 
If  there  be  great  pain  and  headache,  put  leeches  behind  the 

The  pain  and  fever  being  gone,  and  the  mattery  discharge  li  iving 
come  on,  the  case  is  to  be  treated  like  other  chronic  diseases  of  mu- 
cous membranes  in  scrofulous  constitutions,  by  tonics,  alteratives, 
warm  baths,  and  out-door  exercise. 

The  ear  may  now  be  gently  syringed  out  with  castile  soap  and 
water,  and  inunediately  after  with  a  weak  solution  of  alum,  or  sul- 
phate of  zinc,  one  grain  to  a  dram.  This  may  be  done  twice  a  day. 
Or,  a  little  of  a  mixture  of  two  drams  of  solution  of  sugar  of  lead 
and  half  a  pint  of  water,  may  be  dropped  into  th(;  meatus,  and,  after 
remaining  two  or  three  minutes,  be  allowed  to  run  out.  If  the  dis- 
charge be  very  fetid,  two  drams  of  solution  of  chloride  of  lime,  with 
half  a  pint  of  water,  will  njake  a  suitable  wash  with  which  to  syringe 
it,  —  applying,  once  a  day,  a  solution  of  nitrate  of  silver,  five  grains 
to  the  ounce  of  water. 

Should  the  discharge  stop,  at  any  time,  and  pain  and  fever  come 
on,  lay  aside  these  astringent  applications,  and  fi*^  back  at  once  to  the 
leeches,  purgatives,  poultices,  and  fomentation 


izrtij 


490 


SUBGICAL  DISEASES. 


Wax  in  the  Ear. 

Thk  ear  sometimes  becomes  completely  filled  with  wax,  mixed 
with  hairs  and  (lakes  of  scarf-skin. 

Treatment  —  Let  the  ear  be  gently  syringed  from  time  to  time 
with  warm  soap  suds,  so  as  thoroughly  to  clear  out  the  vhole  mass 
of  matter.  The  water  may  be  quite  warm,  and  a  little  cotton  should 
be  loosely  inserted  after  the  syringing. 

Earache.  —  Otalgia. 

Symptoms.  —  This  is  simply  neuralgia  of  the  ear,  and  comes  on  in 
fits  of  excruciating  pain,  which  shoots  over  the  head  and  face.  It 
may  be  distinguished  from  inflammation  of  the  ear,  by  the  sudden- 
ness and  intensity  of  the  pain ;  by  its  not  throbbing,  not  increasing 
in  intensity,  not  being  attended  by  fever,  and  not  coming  and  going 
without  apparent  cause. 

Treatment.  —  Fill  or  remove  all  rotten  teeth,  which  may  be  sus- 
pected as  the  cause  of  the  suffering.  Give  iron,  particularly  the 
citrate  combined  with  strychnine  (316). 

Inflammation  of  the  Tympanam.— Deafness. — Otitis. 

Symptoms.  —  In  the  acute  form  of  the  disease,  there  is  violent  pain, 
ringing  noises  in  the  ear,  and  delirium.'  When  the  suppuration  take* 
place,  there  is  a  chill,  and  a  heavy,  tensive  pain. 

In  the  chronic  form  of  the  complaint,  the  lining  membrane  of  the 
tympanic  cavity,  has  its  vessels  a  little  enlarged,  with  blood  some- 
times effused  into  its  substance,  or  lymph  upon  its  surface,  or  the 
membrane  is  thickened,  and  sometimes  covered  with  tuberculous 
concretions,  or  there  are  fibrous  bands  occupying  nearly  the  whole 
of  the  cavity. 

Symptoms. —  These  are  slight,  —  the  first  perceptible  change  being 
generally,  deafness  in  one  or  both  ears.  Then  may  be  a  woolly  sen 
Bation,  with  noises  or  ringing,  and  slight  aching  pains. 

Treatment.  —  As  the  deafness  in  these  cases  generally  depends  on  • 
chronic  inflammation  of  the  tympanic  membrane,  the  best  remedies  are 
those  which  improve  the  condition  of  the  digestive  organs  and  gen- 
eral health,  as  regular  diet,  bathing,  pure  air,  and  exercise,  with  tonics 
and  alteratives.  Occasionally,  a  leech  or  two,  or  a  blister  behind  the 
ear,  will  be  serviceable.  But  generally  dry  cupping  belli nd  and  in 
front  of  the  ear  will  ansv/er  the  purpose  for  calling  the  blood  away 
from  the  thickened  membrane. 

If  the  inflammation  be  acute,  it  must  b«  combatted  with  purging, 
blisters,  poultices,  and  fomentations. 


:  -■  I 


SURGICAL  DISEASES. 


491 


When  deafness  is  caused  by  inflammation  in  the  eustachian  tubes, 
or  from  enlargement  of  the  tonsils,  etc.,  the  tonsils  must  be  cut  off, 
and  a  solution  of  nitrate  of  silver,  twenty  grains  to  the  ounce,  must 
be  thrown  upon  the  mouths  of  the  tubes  with  a  shower  syringe. 

Bleeding  from  the  Nose. — Epistaxis. 

Treatment.  —  In  full-blocJrd  persons,  with  redness  of  face,  and  sub- 
ject to  h(>adache,  and  dizziness,  bleeding  from  the  nose  may  be  salu- 
tary, and  necessary  to  ward  oft'  apoplexy,  and  should  not  be  too  s.id- 
denly  stopped. 

When  the  bleeding  is  such  as  to  require  to  have  it  arrested,  plug 
the  nostrils  with  the  scraping  from  a  fur  hat,  or  with  lint,  dipped  in  a 
strong  solution  of  alum,  or  tannin,  or  Monsel's  persalt  of  iron,  one 
part  to  ten  parts  of  water. 


I,  ;  I  ; 


Fio.  ITS. 


Ingrowing  Toe-Nail. 

To  most  persons,  the  above  words  will  suggest  some  unpleasant 
associations,  for  there  are  few  but  have  had  some  ])ainful  experience 
with  this  aftection.  It  is  generally,  like  corns  and  some  other  trouble- 
some things,  the  penaUy  inflicted  for  wearing  tight  shoes.  It  gener- 
ally appears  upon  the  great  toe.  The  constant  pressure  of  a  narrow 
boot  or  shoe  against  the  side  of  the  toe,  causes  the  edge  of  the  nail 
to  sink  luto  the  flesh,  and  cause  inflammation  and  pain,  and  finally 
ulceration.  Nature,  attempting  to  repair  the  mis- 
chief, sends  out  granulations,  which,  being  perpet- 
ually irritated,  shoot  up  into  unhealthy  growths, 
c&Weii  jrraud  Jiesh.  Thenceforward,  the  suflferings 
of  the  patient  become  incessant;  and  he  cannot 
now  even  compromise,  as  he  would  be  glad  to  do, 
by  putting  on  shoes  of  ample  dimensions,  but  is 
obliged  to  negotiate  a  peace  by  putting  away  the 
shoe  altogether,  or  by  cutting  a  hole  through  it  to 
take  ofT  the  pressure.  At  the  risk  of  giving  the 
reader  a  few  dismal  twinges  every  time  he  looks 
upon  this  page,  we  place  here,  in  Fig.  17G,  a  good 
representation  oi  this  tormenting  disorder,  as  a 
Buitable  warning  against,  the  folly  of  giving  the  toes  narrow  quarter* 

Treatment.  —  Make  a  lye  by  putting  half  a  pint  of  hard-wood  ashes 
into  a  quart  of  hot  water;  bathe  the  toe  in  this,  wiiile  warm,  twenty 
minutes,  every  day.  Innnudiately  after  ea(-h  batliing  apply  a  poultice, 
made  of  ground  slippery  elm  and  weak  ly(>,  changing  the  poultice 
twice  a  day.  As  fast  as  the  innainmation  is  subdued  by  this,  press  a 
little  fine  lint  gently  under  the  edge  of  the  nail.  At  each  subsequent 
dressing,  cut  oft"  as  much  of  the  nail  as  is  raised  out  of  the  tcndcv^ 
tlesh,  with  the  keen  point  of  a  penknife.  Continue  to  do  this  till  the 
whole  offending  portion  is  cut  away. 

If  the  above  treatment  does  not  reduce  ii.'\  inllammatioii  and  great 


r=iJ 


492 


SURGICAL  DISEASES. 


tenderness,  spread  some  extract  of  belladonna  upon  lint,  —  lay  this 
upon  the  diseased  part,  and  put  a  poultice  over  it. 

When  the  disorder  begins  to  make  its  appearance,  it  is  a  good  plan 
to  scrape  the  nail  very  thin  on  top ;  this  will  cause  it  to  grow  upon 
the  upper  surface,  and  to  give  way  at  the  tender  part,  so  as  to  obvi- 
ate,  sometimes,  the  nettessity  of  any  other  treatment. 

The  following  is  the  best  treatment.  Wash  the  toe  in  warm  watiT, 
and  make  the  parts  dry  with  cotton  wool.  Then  gently  press  cotton 
wool  in  between  the  toe  nail  and  the  tt^nder  projecting  flesh,  and  ex- 
tend it  along  the  groov«;  back  between  the  skin  and  nail.  Next,  wet 
the  end  of  a  piece  of  nitrate  of  silver,  and  rub  it  tlioroughiy  upon  tho 
nail,  close  to  the  cotton,  not  a''owing  it  to  touch  the  tender  flesh;! 
then  put  on  a  thin  layer  of  cottt>n  wool,  and,  in  two  or  three  hours,  a 
poultice  around  the  toe. 

In  two  days,  the  nail  will  be  perfectly  black,  and,  as  far  as  the  ni- 
trate was  well  applied,  will  be  separated  from  the  parts  underneath,  and 
may  be  taken  ofl'  without  piiin. 

If  the  nail  is  verif  thick,  scrape  ofl'  the  black  and  deadened  part  in 
two  days,  and  apply  the  nitratt;  again.  This  treatment  is  a  vast  im- 
provement on  the  old  and  cruel  practice  of  tearing  ofl'  the  live  nail. 

Chafing  and  Excoriation. 

WnEN  the  neck,  arm-pits,  thighs,  etc.,  of  children,  get  chafed  or 
excoriated,  a  remedy  may  be  found  by  keeping  the  parts  clean,  and 
by  dusting  them  with  powdered  slippc^ry  elm,  starch,  or  hair-powder. 
If  this  docs  not  effect  a  cure,  apply  Turner's  cerate,  or  wash  the  parts 
with  a  solution  of  sulphate  of  zinc,  or  nitrate  of  silver,  five  grains  to 
the  ounce  of  soft  water. 

Grown  j>ersons  may  treat  these  troubles  very  much  in  the  same 
way,  or  by  wearing  cotton  between  parts  which  rub  together. 

Foreign  Substances  in  the  Nosa. 


Whkn  any  foreign  substance 


gets 


lodged  in 


the  nose,  close  the 
mouth  and  the  opposite  nostril,  and  then  blow  forcibly  through  the 
obstructed  side.  Jf  this  is  not  successful,  press  the  thumb  against  the 
nose  above  the  obstructing  body,  and  then  make  a  hook  of  a  piece 
of  wire  or  knitting  needle,  and  pressing  it  up  over  the  ortending  sub- 
stance, pull  it  down. 

• 

Foreign  Substances  in  the  Ear. 

If  flies  and  other  insects  get  into  the  ear,  fill  the  ear  with  sweet 
oil,  and  then  syringe  it  out  with  warm  water.  Sometimes  it  will  be 
Buiitcient  to  hold  the  head  down  on  one  side,  and  have  the  ear  filled 
with  water,  —  remaining  (juiet  in  this  position  for  a  short  time,  when 
the  insect  will  rise  to  the  surface.  If  any  hard,  substance  be  got  into 
the  ear,  lie  down  quietly  upon  the  affected  side,  and  send  for  a  phy- 
Ncian. 


Foreign  Substances  in  the  Gullet. 

If  the  substance  have  lot  gone  beyond  the  reach  of  the  thumb  and 
finger,  thrust  them  down  as  far  as  possible,  and  try  to  pull  it  out ;  or, 
a  small  curved  pair  of  forceps  will  reach  still  lower  than  the  fingers. 
Or,  this  failing,  let  some  otic  place  one  hand  firmly  on  the  chest  of 
the  choking  person,  and  give  him  a  smart  blow  or  two  between  the 
shoulders  with  the  other  hand.  If  the  substance  be  down  some  way 
in  the  gullet,  it  may  be  pushed  along  into  the  stomach  by  some 
smooth,  blunt  instrument. 

Foreign  Bodies  in  the  Windpipe. 

Sometimes  foreign  bodies  will  remain  a  long  time  in  the  windpipe, 
and  will  only  create  some  inflammation  and  cough,  but  not  any  im- 
mediately dangerous  symptoms.  When  the  body  has  gone  entirely 
below  the  epiglottis,  but  little  can  be  done,  except  to  give  a  oinch  of 
enuff  to  cause  sneezing,  and  to  direct  the  patient  to  expel  the  air  ex- 
plosively from  the  lungs  by  a  few  energetic  and  sudden  coughs.  Th«a 
may  drive  the  oflfending  body  out. 

Bleeding  from  Wounds. 

If  bleeding  occur  from  any  part  where  a  bone  lies  near  the  surface, 
as  Ihe  head  or  face,  it  may  generally  be  stopped  by  pressing  firmly 
against  the  bone  with  a  finger,  or  a  piece  of  cork,  or  by  binding  on 
tightly  a  hard  pad.  If  this  does  not  succeed,  lift  up  each  edge  of  the 
wound,  and  examine  carefully  to  see  if  any  small  stream  of  blood  is 
spouting'  out  in  jets.  If  so,  an  artery  is  wounded,  and  the  point  of 
Rmall  forceps  or  tweezers  must  be  dipped  in  where  the  jets  come 
from  ;  the  spouting  mouth  taken  hold  of  and  drawn  out ;  and  a 
strong  silk  thread  passed  around  it,  and  tied  below  the  forceps.  The 
white  and  gaping  mouth  of  the  vessel  may  then  be  seen. 

If  the  bleeding  be  profuse  from  an  arm,  the  whole  current  c  ?.  blood 
to  that  limb  must  be  cut  oft',  which  may  be  done  by  some  person 
pressing  a  thumb  firmly  into  the  neck  behind  the  middle  of  the  collar- 
bone. This  will  dam  up  the  blood  in  the  great  artery  of  the  arm,  as 
it  comes  out  of  the  chest.  The  handle  of  a  door-key,  wrapped  in 
several  folds  of  linen,  may  be  pressed  upon  this  j)lace  for  a  long  time 
until  medical  assistance  can  be  had. 

Dangerous  bleeding  from  the  thigh  or  leg,  may  often  be  stopped  by 
pressing  the  great  artery  just  below  the  crease  of  the  groin. 

If  the  bleeding  be  below  the  middle  of  the  upp»^r  arm,  or  middle 
of  the  thigh,  pass  a  handkerchief  once  or  twice  around  the  limb,  as 
far  above  the  wound  as  possible,  and  tie  it  tightly.  Slip  a  stifl'  stick 
under  this,  and  turn  it  round,  like  the  handle  of  an  auger,  until  the 
handkerchief  becomes  so  tight  as  to  stop  the  bleeding.  This  arrange- 
ment is  called  a  stick-tourniquet,  and  is  intended  to  answer  the  same 
purpose  with  the  instrument  represented  by  Fig.  146.    (See  p.  878.) 


i 


ITT 


4M 


SURGICAL  DISEASES. 


Apparent  Death  from  Noxious  Vapors. 

When  persons  become  insensible  from  breathing  foul  air  in  a  deep 
well  or  other  place  where  it  collects,  let  them  be  immediately  exposed 
to  the  open  air,  and  cold  water  be  sprinkled  upon  the  face  and  head, 
and  strong  vinegar  be  rubbed  about  the  nostrils.  As  soon  as  there  is 
ability  to  swallow,  give  some  drinks,  as  lemonade,  or  a  few  drops  of 
aromatic  sulphuric  acid,  dropped  into  a  tumblerful  of  water,  and 
slightly  sweetened.     A  stimulating  injection  (246)  may  be  given. 

Apparent  Death  from  Burning  Charcoal. 

Some  persons  very  thoughtlessly  attempt  to  warm  their  sleeping  or 
sitting  rooms  with  a  portable  furnace,  or  open  pan  tilled  with  burning 
charcoal,  or  live  coals  from  a  wood  fire.  This  is  very  wrong,  as  such 
coals  while  burning  throw  off  large  quantities  of  carbonic  acid  gas,  a 
deadly  poison.  This  being  heavier  than  atmospheric  air,  falls  tc  the 
bottom  of  the  room,  and  for  a  time  may  do  no  damage ;  but,  if  there 
be  no  chimney-draught,  or  open  door  or  window,  it  will  rise  above 
the  heads  of  those  in  the  room,  and  bring  on  asphyxia  and  death. 

Let  such  cases  be  treated  the  same  as  the  preceding,  with  the  addi- 
tional measure  of  attempting  to  excite  breathing,  as  in  the  case  of 
persons  apparently  dead  from  drowning. 

To  Recover  Persons  Apparently  Drowned. 

Drowning  persons  die  by  what  is  called  asphyxia.  The  air  being 
(shut  off  from  the  lungs,  breathing  stops,  and  the  immediate  accumu- 
lation of  carbonic  acid  in  the  blood,  paralyzes  the  nervous  system,  and 
insensibility  immediately  follows.  The  heart  continues  to  beat,  how- 
ever, from  five  to  twenty  minutes  after  the  occurrence  of  insensibility 
and  apparent  death. 

Recovery  may  take  place  at  any  time  before  the  heart  ceases  to 
beat,  and  has  been  brought  about  in  some  cases  even  after  this  organ 
has  become  still.  It  has  taken  place,  in  some  few  instances,  as  late  as 
half  an  hour  after  being  under  water,  but  it  can  scarcely  be  expected, 
even  under  the  best  treatment,  later  than  twenty  minutes  from  tin- 
time  of  submersion  ;  and  even  as  late  as  this,  the  chances  are  much 
against  restoration. 

Treatment.  —  The  best  treatment  is  that  recommended  by  Dr.  Mar- 
shall Hall. 

Treat  the  patient  instantly,  on  the  spot,  in  the  open  air,  and,  except 
in  severe  weather,  expose  the  face  and  chest  to  the  breeze. 

Then,  to  Clear  the  Throat,  place  the  patient  gently  on  the  face,  with 
one  wrist  under  the  forehead.  All  the  fluids,  and  the  tongue  now 
fall  forward,  leaving  the  passage  to  the  windpipe  free.  If  there  be 
breathing,  wait  and  watch.  If  there  be  no  breathing,  or,  if  there  have 
been,  and  it  has  failed, 


l;; 
ii' 


+  ■-» 


SURGICAL  DISEASES. 


495 


Then,  to  Excite  Breathing,  turn  the  patient  well  and  instantly  on 
his  side,  and  excite  the  nostrils  with  snuff,  or  the  throat  with  a  feather, 
and  dash  cold  water  on  the  face,  previously  rubbed  warm.  If  there 
be  no  success,  lose  not  a  moment,  but,  instantly, 

Next,  to  Iiiiitiite  Breathiii^,  replace  the  patient  on  his  face,  raising 
and  supporting  the  chest  well  on  a  folded  coat  or  other  article  of 
dress.  Now  very  gently  turn  the  body  on  the  side,  and  a  little  be- 
yond, and  then  quickly  back  upon  the  face,  and  repeat  these  turnings, 
ba(;k  and  forth,  deliberately,  cliiciently,  and  persevcriiigly,  fifteen  times 
ill  a  minute,  occasionally  varying  the  side.  These  motions  will  cause 
a  kind  of  artificial  breathing;  for  while  the  patient  rests  upon  the 
breast,  the  weight  of  the  body  compresses  this  cavity,  and  expels  the 
air,  which  is  the  same  as  the  outgoing  breath,  or  expiration  ;  when 
he  is  turned  on  the  side,  the  pressure  is  removed,  and  the  air  rushes 
in  as  in  natural  inspiration,  or  the  ingoing  of  the  breath.  When  the 
patient  is  on  the  face,  make  even  and  efficient  pressure  along  up  the 
back  of  the  chest,  discontinuing  it  immediately  before  turning  the 
body  upon  the  side.  This  upward  gliding  pressure  helps  expel  the 
air.  Of  course  it  must  be  stopped  the  moment  the  body  is  in  a  posi- 
tion upon  the  side  to  let  it  in.  The  result  of  these  movements  is 
breathing;  and,  if  not  too  late,  life. 

Then,  to  Induce  Circulation  and  Warmth,  mb  the  limbs  upwards 
(and  of  course  this  should  be  done  during  the  previous  measures) 
with  firm  grasping  pressure,  and  with  energy,  using  handkerchiefs, 
and  warm  soft  flannels  if  at  hand.  This  pushes  the  blood  along  up 
towards  the  heart  through  the  veins.  In  this  way,  too,  the  limbs  are 
wanned  and  dried,  and  may  be  now  clothed,  —  the  bystanders  sup- 
plying the  garments.  Avoid  the  continuous  warm  bath,  and  the 
position  on  or  inclined  to  the  back.  Beside  the  above,  pour  into  the 
nostrils  a  teaspoonful  of  aromatic  spirit  of  ammonia,  and  thrust  a 
feather  into  the  nostrils,  dipped  in  water  of  ammonia.  Give  also  a 
.itimulatinff  injection,  composed  of  a  pint  of  water  with  a  tablespoon- 
ful  of  ground  mustard,  and  a  teaspoonful  of  pulverized  cayenne,  and 
put  a  mustard  poultice  upon  the  perineum  and  anus. 

Apparent  Death  from  Lightning. 

A  STROKE  of  lightning  wiU  frequently  produce  asphyxia  by  par- 
alyzing the  muscles  of  resp. -ation.  In  such  case,  the  same  means 
for  recovery  should  be  used  as  in  apparent  death  from  drowning.  Or, 
the  apparently  dead  person  may  be  placed  in  a  current  of  fresh  air, 
and  cold  water  dashed  upon  the  face,  neck,  and  breast,  and  warm 
friction  he  applied  if  the  body  is  cold. 

Apparent  Death  from  Hanging. 

Persons  found  hanging,  who  have  committed  suicide,  are  to  be  cut 
down  instantly,  and  the  same  means  employed  to  reestablish  breath- 


U*     I' 


^■^ 


il 


496 


SURGICAL  DISEASES. 


ing  as  in  cases  of  drowning.  It  may  help  to  restore  the  breathing,  to 
bathe  the  forehead  and  face  with  vinegar,  or  1'  cture  of  camphor,  and 
to  pass  hartshorn  frequently  under  the  nostrils. 

Clothes  Catching  Fire. 

It  is  perhaps  u.ireasonable  to  look  for  presence  of  mind  when  this 
frightful  accident  occurs,  yet  it  is  never  more  needed  than  at  such  r 
time. 

The  instant  a  lady  i  erceives  her  clothes  to  be  on  fire,  and  in  a  blaze, 
she  should  seize  the  u^virest  large  rug,  doakC,  blanket,  coverlet,  or  any 
ecjuivalcnt  article,  and,  wrapping  it  tiffht  around  her,  throw  hersi-lf 
Hat  upon  the  floor,  taking  care  to  keep  the  protecting  covering  close 
to  her  until  the  fire  is  completely  smothered.  If  she  does  this  with 
energy,  and  effectually,  she  will  put  out  the  fire  instantly. 

If  she  continue  on  her  feet,  the  blaze  will  rapidly  ascend,  and  burn 
her  vital  parts.  If  she  run  to  seek  relief  from  others  not  present,  the 
motion  of  the  air  will  fan  the  (lame  into  a  swifter  work  of  destruc^ 
tion. 

If  it  be  a  child  that  is  on  fire,  let  any  person  present  treat  it  as 
above.  If  it  be  badly  burned  before  the  fire  is  extinguished,  put  it 
instantly  into  a  tub  of  cold  water,  or  daj  h  cold  water  upon  it,  to 
prevent  the  burn  from  becoming  deep. 

Accidents  on  the  Water. 

If  upset  in  a  boat,  or  otherwise  thrown  into  the  water,  and  are  not 
able  to  swim,  draw  the  breath  in<  well,  and  keep  the  mouth  shut  tight 
Do  not  struggle  and  throw  the  arms  up ;  but  yield  quietly  to  the 
water,  hold  the  head  well  up,  and  stretch  out  the  hands  only  below 
the  water.  To  throw  the  hands  or  the  feet  «/?,  will  pitch  the  head 
down,  and  cause  the  whole  person  to  go  immediately  under  water. 
Keep  the  head  above,  and  everything  else  under  water. 

Poisoning  Accidents.— Antidotes  of  Poisons. 

Accidents  from  poisons  are  of  such  common  occurrence,  that 
every  person  should  know  the  proper  remedies,  and  not  be  obliged  to 
wait  the  arrival  of  a  physician  before  the  proper  corrective  is  applied. 
The  most  common  remedies,  with  the  methods  of  applying  them, 
will  be  given  under  the  proper  heads  below.  The  mineral  poisons 
will  be  spoken  of  first.     (Sec  p.  880.) 

Poisoning  by  Ammonia. 

Water  of  ammonia,  or  hartshorn,  if  taken  in  an  undiluted  state, 
acts  as  a  violent  poison. 

When  this  accident  happens,  give  vinegar  instantly,  mixed  with  a 
little  water.  Vinegar  is  an  acid,  and  ammonia  is  an  alkali  \  and  acids 
and  alkalies  neutralize  each  other. 


'Hm 


SURGICAL  DISEASES. 


497 


Poisoning  by  Antimony. 

Tartar  emetic,  and  wine  of  antimony,  are  sometimes  taken  by 
accident  in  large  doses,  so  as  to  act  as  poisons,  and  cause  dangerous 
vomiting  and  prostration. 

Give  a  tea  of  slippery  elm,  flax-seed,  marshmallow,  etc.;  also  syrup 
of  poppies,  paragoric,  or  laudanum  in  twenty-drop  (loses.  To  neu" 
trali/e  the  poison,  give  a  strong  solution  of  tannin,  or  an  infusion  of 
oak  bark,  or  nutgalls. 

Poisoning  by  Arsenic. 

UsK  the  stomach  pump  instantly,  if  one  is  to  be  had;  if  not,  give 
twenty  grains  of  sulphate  of  zinc  (white  vitriol)  in  a  little  warm 
wuti'r;  and  promote  the  vomiting  by  filling  the  stomach  with  large 
dnuights  of  warm  or  cold  milk,  sweetened  water,  or  flax-seed  tea. 
Or,  vomiting  may  be  induced  still  mpre  quickly,  by  giving  a  large 
tabiespoonful  of  strong  ground-mustard,  mixed  with  a  teacupful  of 
water. 

But  thfe  best  antidote  for  arsenic  is  hydrated  sesquioxide  of  iron. 
Mix  a  tivblespoonful  of  this  with  water,  and  give  this  amount  every 
live  or  ten  minutes,  until  half  a  dozen  doses  are  taken. 

Treat  the  inflammation  of  the  stomach  which  follows,  by  blisters, 
a  bland  liquid  diet,  mucilaginous  drinks,  etc. 


Poisoning  by  Verdigris,  or  Acetate  of  Copper. 

Cooking  utensils  made  of  copper  never  ought  to  be  tolerated  ;  yet 
they  are  used ;  and  it  is  from  the  verdigris  which  forms  upon  them 
that  most  of  the  cases  of  poisoning  by  copper  happen. 

Give  an  emetic  instantly,  and  then  two  teaspoonfuls  of  carbonate 
of  soda  (bread  soda)  in  a  tumblerful  of  water,  to  be  repeated  in  ten 
minutes.  White  of  eggs,  diffused  in  water,  and  mucilaginous  drinks 
are  proper. 

Poisoning  by  Corrosive  Snblimate. 

This  is  the  common   bed-bug  poison,  and  is  often  taken  by 
mistake. 

Mix  up  quickly  the  whites  of  a  dozen  eggs,  with  two  pints  of  cold 
water,  and  give  a  glassful  of  the  mixture  every  two  minutes  till  the 
stomach  can  contain  no  more.  If  there  are  not  eggs  enough  at  hand, 
take  what  there  are,  and  make  up  the  deficiency  with  milk.  Wheat 
flour,  mixed  with  water,  is  a  good  remedy.  Use  the  stomach  pump, 
if  it  is  at  hand.  Treat  the  resulting  inflammation  with  leeches  and 
fomentations. 

63 


w 


498 


SURGICAL  DISEASES. 


Poisoning  by  Sugar  of  Lead,  or  Aoetate  of  Lead. 

Give  a  ground-mustard,  or  a  sulphate  of  zinc  emetic;  then,  give 
diluted  sulphuric  acid,  or,  either  epsuiu  or  gluuber's  suits. 

Poisoning  by  Strong  Lye. 

Strono  lye  Is  sometiriK^s  swallowed  by  children.  The  remedy  ii 
vinegar,  or  oil.  Vinegar  will  convert  the  lyt;  into  acetate  of  potash, 
and  any  of  the  oils*  will  unite  with  it,  and  form  soap;  and  neither 
the  acetate  of  potash,  nor  soap,  will  materially  injure  the  stomach. 

Poisoning  by  Nitric,  Muriatic,  or  Sulphuric  Acid. 

When  either  one  of  i''  "se  acids  is  swallowed,  not  a  moment  of 
time  is  to  be  lost.  Fill  thi;  pitient  full  of  calcined  magnesia  stirred 
up  in  water.  This  is  the  bent  remedy ;  but  if  it  is  not  to  be  had, 
give  half  an  ounce  of  soap  in  a  pint  of  water.  If  neither  are  at 
hand,  give  chalk,  or  whiting,  in  water,  or  even  pound  fine  some  of  the 
plastering  of  the  room,  and  give  it  in  water. 


11 


r. 


n 


Poisoning  by  Nitrate  of  Potash,  called  Nitre,  or  Saltpetre. 

Induce  vomiting  by  luke-warm  water,  and  by  tickling  the  throat 
with  a  feather;  but  avoid  irritating  the  stomach  with  the  ordinary 
emetics. 

Poisoning  by  White  Vitriol. 

Prcvok  3  vomiting  by  warm  drinks,  and  by  tickling  the  throat,  and 
give  freely  carbonate  of  soda,  in  water. 


Poisoning  by  Oxalic  Acid. 

This  resenibles  epsom  salts,  and  is  liable  to  be  taken  for  salts  by 
mistake.  The  two  can  always  be  distinguished  by  touching  a  little 
to  the  tongue.     Epsom  salts  taste  bitter ;  oxalic  acid,  very  sour. 

In  cases  of  poison  from  oxalic  acid,  give  magnesia  in  water  as 
quickly  as  possible.  When  this  is  not  at  hand,  give  chalk,  or  liine^ 
or  saleratus.     Use  the  stomach  pump,  if  it  is  to  be  had. 


■■r/t. 


Vegetable  Poisons. 


The  vegetable  poisons  are  quite  numerous,  and  many  of  them 
quite  as  virulemt  and  rapid  as  any  in  the  mineral  kingdom. 


•*^^ 


.■^^. 


•    !■ 


8UU(UCAI-  DISKASKS. 


499 


Poisoning  by  Acouite. 

GivK  an  ctnctic  of  f^ronnd-iiiustarcl  or  Miipliiitc  of  zinc,  or  use  the 
!»toiiiiuli  pump,  instantly,  and  then  give;  stiinuhmts,  a»  brandy,  gin, 
whiskey,  rum,  ete. 

Poisoning  by  Opium,  Morphine,  and  Laudanum. 

UsK  the  stomach  puinp,  if  at  hand ;  if  not,  a  powerful  emetic  of 
sulph!it<!  of  /ine,  or  sulphate  of  copper;  or,  if  these  ar»*  not  at  hand, 
a  tahlcspoonful  of  ground-mustard  in  a  teacupful  of  warm  vvatei. 
If  VDiuiling  is  not  induced  at  once,  tickh;  the  thrt)at  with  a  feather,  or 
with  the  finger.  If  sleep  is  impending,  take  the  patient  into  the  optMi 
air,  an«l  keep  hiiu  walking;  dash  water  upon  his  face,  etc.  If  he 
still  falls  into  sleep,  and  appears  to  be  near  dying,  a|)ply  ujeans  for 
artificial  bret';l)ing  as  for  persons  apparently  dead  from  drowning. 

Poisoning  from  Belladonna,  Hyoscyamus,  Stramo- 
nium, and  Conium. 

These  are  all  narcotics,  and  when  accidentally  taken  in  poisonous 
doses,  the  treatment  is  to  be  the  same  as  for  poisoning  by  opiuia 
Strong  coflfee  is  said  to  counteract  the  effect  of  these  articles. 


■o 


.^soning  by  Dogwood,  Ivy,  etc. 


Give  some  of  the  salts  as  a  cathartic,  and  apply  a  solution  of  sugar 
of  lead,  or,  still  better,  a  decoction  of  witchhazel  bark. 

Poisoniag  by  Spanish  Flies. 

Give  large  draughts  of  sweet  oil,  sugar  and  water,  milk,  or  flax- 
seed tea.  For  the  inflammation  of  the  bladder,  which  is  produced 
by  it,  apply  leeches,  and  a  liniment  composed  of  camphor  and  sweet 
oil.  To  relieve  the  strangury  or  scalding  of  the  water,  give  camphor 
internally.  , 

Poisoning  by  Prnssic  Acid. 

This  is  the  most  deadly  of  all  known  poisons.  One  drop  of  the 
pure  acid  wiil  cause  immediate  death.  Give  water  of  ammonia  oi 
hartshorn,  one  part  diluted  with  six  parts  of  water,  freely. 

Poisoning  by  Strychnine. 

The  same  treatment  as  for  poisoning  by  opium,  excepting  that 
sweet  mill:  should  be  freely  admini»tered.     This  has  been  recom* 


'I 

i 


1 


SURGICAL  DISEASES. 


mended  by  one  respectable  physician,  at  least,  who  says  he  has  found 
it  to  be  a  specific.  Camphor,  two  ounces  dissolvecf  in  a  quart  of 
whiskey,  and  given /ree/y,  is  also  said  to  be  an  antidote. 

Care  of  the  Teeth. 

A  DECAY  and  lo."^  of  the  teeth  is  common  even  among  the  yomig. 
Few  persons  at  th )  age  of  twenty  have  sound  teeth. 

Rotting  of  the  Teeth. — Caries. 

This  is  not  confined  to  any  age,  temperament,  or  condition  of 
society. 

The  teeth  become  diseased,  die,  and  drop  nway^  while  all  the  other 
organs  are  sound  and  active. 

The  Creator  doubtless  intended  that  all  the  members  of  the  same 
body  Hhouid  be  eciually  dural;)le ;  but  eertain  laws  of  nature,  violated 
by  us  habitually,  turn  upon  us,  as  it  were,  iii  anger,  and  smite  us  full 
in  the  face,  breaking  our  teeth,  and  robbing  us  of  the  means  of  pre- 
serving the  health  which  we  do  not  apjH;ar  to  pri/o. 

When  rotting  begins  in  the  ti^eth,  its  progress  is  more  or  less  rapid, 
and  their  destruction  is  certain,  unless  it  is  arrested  by  artificial 
means. 

The  enatnel  is  nature's  fortification  to  protect  the  teeth  against  ex- 
ternal injuries.  When  this  is  broken,  or  worn  away,  the  bone  of  the 
tooth  becomes  exposed,  and  rotting  begins  immediately.  Whatcjver 
has  a  t«;n(lency  to  crack,  break  up,  or  destroy  the  enamel,  therefore, !» 
to  be  carefully  avoided. 

Hot  Drinks,  or  hot  food,  coming  suddenly  in  contact  with  the  en- 
amel, art!  liabh'  to  crack  it,  and  expose  the  bony  substance  of  the 
tooth.  The  enamel  is  exceedingly  brittle,  much  like  glass  in  its  struc- 
ture, and  is  easily  cracked  when  expo.sed  to  sudden  transitiojis  from 
heat  to  cold,  and  from  cold  to  heat 

Luiui*lou8  Livju«r  often  deranges  the  general  health,  and  causes 
acid  and  unhealthy  secretions  in  the  mouth,  which  act  injuriously 
upon  the  enamel. 

Acids  are  injurious  to  the  enamel ;  and  when  taken  as  medicine, 
should  be  well  diluted,  and  in  some  cases,  drank  through  a  tube,  so 
as  not  to  coiTu?  in  conta(!t  with  the  teeth.  Sugar  is  not  directly  inju- 
rious to  the  teeth,  as  iuany  suppose  ;  but  if  allowed  to  reman  about 
and  between  Ihem,  it  may  generate  an  acid  which  i«  dfst;uctive  to 
the  enamel. 

A  €rmv(hMl  Omidition  of  the  teeth  in  the  month  causes  the  enamel 
to  wear  away,  and  leads  to  rotting;  in  which  case,  early  attention 
and  advice  from  a  dentist,  is  quite  important. 

Ftwd  Lodjii^ed  lletween  the  Teeth,  and  in  their  depre:..-*ions,  is  a  cause 
or  cxiensive  decay.     Animal  and  vegetable  matter,  when  exposed  f>o 


--flrn 


warmth  and  moisture,  soon  generate  an  acid  which  corrodes  the  en- 
amel. The  teeth,  conseciuently,  often  begin  to  decay  in  parts  where 
oiK^  presses  upon  an  other,  and  in  depressions,  where  food  lodges  and 
reiiiiiiiis.  This  shows  Ihe  necessity  of  cleansing  the  mouth  and  teeth 
often,  —  ])articniarly  after  meals. 

Wercary,  when  taken  to  the  extent  of  salivation,  —  whether  it  be 
calomel,  (•orn)sive  snblimati',  blue  pill,  or  any  other  form  of  it, — 
causes  indammation  of  the  membranes  about  the  teeth,  and  indi- 
rectly produces  caries. 

Acidity  of  the  stomach,  the  contact  of  decaying  teeth  and  dead 
sliiiiijjs  with  sound  ones,  diseas«'d  and  ulcerated  gums,  and,  abuv«' 
all,  a  filthy,  uncU'an,  and  unwholesome  condition  of  the  moulh,  are 
active  causes  of  diseased  teeth. 

Iiiipropcr  Toutli  Powders,  as  those  containing  gritty  particles,  are 

to  be  avoided. 

T«bn('('0,  by  deranging  the  general  health,  may  be  indirectly  inju- 
rious to  the  teeth.  Smoking  blackens  th(^  teeth  ;  and  though  ('hewing 
may  be  useful  in  deadening  the  sensibility  of  the  uvrvv  of  a  de.ayirig 
tooth,  this  alotic  is  not  a  sullicient  reason  for  so  imcieanly  and  disa- 
grceai)Ie  a  habit,  wliile  so  many  agents  may  be  found  to  produce  the 
name  rlleet. 

T;irt.ir. —  This  is  derived  from  the  saliva,  and  is  found,  when  ex- 


amined 


bv 


the    microscope,   to   be   cotii| 


)ose 


ol    mvri.Kis 


yi 


nvmsr 


aniinals.  When  first  <i<'|)osite(l  aroend  llic  teeth,  it  is  in  a  soft  siat(>; 
bill,  when  not  !)riished  away,  i(  s«-on  hardens,  and  elinnges  from  a 
yellow  to  a  l)r(iwn,  and  sometinu's  to  a  black  color;  ami  ol'tcn  i.i 
childicii,  it  becnuies  a  dark  green.  It  deslniys  the  beauty  oi'  the 
Icftli,  giving  th(Mii  a  lillhy  and  revolting  look;  tin;  setting  of  tim 
teeth  ill  iln'i<-  so<'k''ty  is  weakened;  their  appearamre  is  elongafeil ; 
the  p' rio>lenin  or  covering  of  the  fang  beeonics  iiillaiiied  and  tender; 
and,  if  the  proper  rcnn'dy  be  not  applied,  tlu;  ti'eth  will  become  loos- 
ened, and  linally  fall  from  thi-ir  soekels.  It  causes  the  gums  to  be- 
coiue  inl!;mi"d,  swollen,  l"nd(>r,  and  id. (rated,  an<l  loads  the  breath 
with  a  disagre(;<ble  fetor.  Its  (/irccf  inlhiciief^  on  the  tccih  is  not 
};reat  ;  but.  it  vitiaN-s  all  the  .secretions  of  the  moiilh,  and  i;^  thus  a 
very  eHi<;ient,  tliongi,  an  indi-eet  cause  of  decaying  teeth.  In  all 
cases,  it  simuld  b<'  iii.iiu'diately  and  earel'iillv  removed,  and  some 
islniigent   wash,   made    from    pernvian    or   oak    bark,    b<:    a|»plieo   to 


'•educe  the  inlianwnatioM  and  swellini'  of  th 


Tooth-Ache. 


gui 


US. 


This  is  generally  caused  by  an  exposure  of  the  nerve  which  fills 
th(!  internal  cavity  of  the  tooth.  This  exposure  is  caused  by  a  frac- 
ture, or,  more  eommonlv,  by  the  rotting  aw-.iy  t)f  a  part.  v{  the  tooth. 
This  n(.'rve  is  extremely  sensitivt^;  and,  by  coming  in  cont'-act  with 
the  air  and  acrimonious  .subsfances,  inflammation  is  excited,  and 
tooth-ache  is  the  consetjuenco. 


1 , 


I! 


Teeth  sometimes  ache  when  they  are,  to  appearance,  perfectly 
i<ound.  This  may  be  caused  by  bony  enlargements  of  the  ends  of 
the  fangs,  inflammation  of  the  periosteum,  u  peculiar  irritability  and 
ague  of  the  face,  which  excite  neuralgia,  etc. 

Pain  of  a  sound  tooth  is  sometitriea  caused  by  sympathy  with  a 
d(K'.aying  one,  by  a  disordered  stomach,  or  by  scurvy,  pregnancy,  tar- 
tar, or  whatever  excites  painful  sympathetic  action  in  the  nerves  of 
the  fac(\ 

Treatment.-  -Tooth-ache  may  be  (|uie<ed  by  placing  a  drop  of  oil 
of  cloves,  or  cjijeput,  or  a  drop  of  creosote  upon  a  piece  of  cotton, 
and  inserting  it  into  th<'  cavity  of  the  tooth,  and  bringing  it  into  con- 
tact with  the    xjiosed  nerve. 

Paiiisof  the  face  and  jaw,  wlu'n  not  tiie  consecpiene»;  of  rotten 
teeth,  may  be  relieved  l)y  holding  brandy,  or  whiskey,  or  rum,  or 
diluted  tincture  of  eayetnie,  or  hot  water,  in  (he  mouth,  and  i)y  ex- 
ternal applieat  ons  of  laudtuumi,  Oliver's  plaster,  a  nuistard  |)laster, 
or  hops  ste(!ped  in  alcohol,  or  a  blister  behind  the  ear.  But  for  teeth 
too  much  decayed  to  be  saved  by  filling,  there  is  no  remedy  so  proper 
as  extraction. 

Pilling  Teeth. 

TuKUK  is  no  operation  of  the  dentist  of  more  real  and  lastin<^ 
benefit  to  the  patient  than  that  of  filling  rotten  teeth. 

A  tooth  that  is  well  fdled  before  its  n(!rve  is  exposed,  is  as  servicea- 
ble as  a  sound  one,  and  nearly  as  durable.  Its  preservation  for  many 
years  is  perfect  and  complete. 

It  is  necessary,  in  the  performance  of  this  operation,  to  remove 
very  carefully  all  rotten  and  foreign  matter  lodged  in  th(^  oavity;  to 
make  the  cavity  of  a  dovetail  sha|)e,  so  as  to  retain  the  filling  ;  to  wipe 
it  perfectly  dry ;  and  to  press  tin;  gold  in  so  as  to  make  the  cavity 
perfectly  water  and  air  tight.  A  tooth  filled  in  this  way  may  be  pre- 
served many  years,  and  in  many  cases^  during  life. 

When  dei-ay  has  gone  so  far  as  to  expt)se  the  nerve  and  render  a 
tooth  painful,  the  nerve,  in  all  cases,  should  be  destroyed  before  the 
<'avity  i-' filled  ;  otherwise  thert;  maybe,  soreness,  anil  sometimes  ex- 
treme pain,  making  the  extraction  of  the  tooth  absolutely  neees.sary. 

A  tooth  lllli'd  alter  the  nerve  is  destroyed  is  not  as  good  as  if  filled 
bel'or(^  the  nerve  was  exposed  ;  th«!  walls  of  the  cavity  are  thinner  and 
weak<'r,  and  eonsetpiently  are  more  liable  to  break  and  ermubli»  away 
when  brought  into  «-ontaetvNith  hard  sul)stanees  ;  and  the  filling  will 
be  more  likely  io  l)e  loosenevl.  Thert;  is  likewise  some  danger  of 
nleeratiun  and  absorption  at  tiie  root  of  a  tooth,  when  filled  in  this 
eondilion,  which  makes  it  very  iin|)ortant  that  teeth  should  bo  liUed 
early. 

Hold  fnU  is  |)referable  to  all  other  substances  for  filling  teeth.  If  it 
is  properly  pressed  and  polished,  it  will  remain  in  the  mouth  for  many 
years  without  any  sensible  lo.ss  of  its  aubstanuu. 


SURGICAL  DISEASES. 


503 


The  First  Teeth. 

It  is  an  imperative  duty  of  parents  to  see  that  their  children's  teeth 
1  avc  early  and  careful  attention. 

Tlie  health  and  durability  of  the  permanent  teeth  depend  materi- 
ally on  the  healthy  condition,  regularity,  and  durability  of  the  tempo- 
rary ones.  It  may  sotMU  strange  that  diseases  of  the  lirst  set  of  teeth 
shoukl  influence  the;  set  which  is  to  follow;  but  when  we  consider  that 
the  rudiments  of  the  second  set  already  exist  when  the  first  are  cut, 
it  is  not  unreasonable  to  suppose  they  may  iidierit  disease  from  their 
predecessors. 

Cleaning  the  Teeth. 

The  most  important  rule  to  be  observed  in  the  preservation  of  tho 
teeth,  is  to  keep  them  perfectly  clean,  and  never  to  allow  any  foreign 
siil)f:tance  to  remain  on  or  about  them.  A  decaying  tooth  should 
never  be  allowed  to  rinnain  in  the  mouth  ;  it  causes  t)iiiers  to  decay. 

If  tartar  have  be(>n  allowed  to  collect,  have  it  removed  immedi- 
ately. The  teeth  should  be  (rarefully  and  thoroughly  brushed  daily 
with  warm  water,  and  th(i  occasional  use  of  a  detifrice  that  is  impal- 
pably  tine,  and  that  contains  no  acid. 

A  Bnisll  has  no  bad  effect  upon  the  teeth,  as  some  suppose,  for  the 
parts  of  the  teeth  most  exposed  to  the  friction  of  a  brush  are  never 
the  first  to  begin  to  decay.  1'liis  beginning  of  decay  takes  place  in 
their  depressed  surfaces,  and  where  they  touch  each  other.  A  soft 
brush  is  better  for  the  teeth  than  a  still"  oik*,  i)ecause  the  latter  ia 
apt  to  fret  the  gums,  and  ciuisc^  Ihem  to  recede,  which  gives  the 
teeth  a  lengthened  appearanc(\ 

Teeth  in  a  crowded  condition  should  never  be  filed,  unless  they 
begin  to  decay. 

Toot!l-l*urks,  made  of  quill,  or  wood,  or  ivory,  should  be  used  after 
mrals,  and  all  particles  of  food  lodged  betwoen  the  teeth  should  bo 
renioved. 

In  Si'ihness,  the  ndes  for  cleaidiness  of  the  teeth  should  be  mor(* 
rigiilly  <'nr()rced  than  at  any  other  tinu',  as  then  they  an;  mon;  ex- 
ptiscd  to  destructive  agents,  ind  are  liable  to  participate  in  the  gen» 
oral  d(!bility  and  disease  of  the  system. 


Influence  of  Diseased  Teeth  upon  the  Health. 

The  bad  eflt'cta  of  a  diseased  and  unclean  nu*uth  upon  the  general 
health,  an;  of  more  serious  conseciuence  than  most  people  are  aware. 
In  twenty-four  hours,  we  breathe  twenty  thousand  time;* ;  and  what 
nnist  be  the  cfiect  upon  the  delicate  structure  of  the  lungs,  wher),  for 
days,  months  and  years,  the  air  we  breathe  is  drawn  through  a  di'pos- 


004 


SURGICAL  DISEASES. 


itory  of  filth,  and  is  poisoned  by  being  mixed  with  effluvia  arising 
from  decayed  and  diseased  matter  in  the  mouth. 

The  intermittent  fevers  of  the  West  are  caused  by  the  effluvia  aris- 
ing from  the  decaying  matter  of  low  grounds  and  marshes,  which 
can  hardly  be  more  pernicious  than  the  effluvia  from  the  impurity 
and  corruption  generated  in  an  unclean  mouth,  filled  with  decaying 
teeth.  Dr.  Hays  says  "  no  species  of  animal  matter  is  so  offensive  to 
the  health  and  vitality  of  the  adjoining  substance,  whether  nerve,  or 
membrane,  or  any  part  or  portion  of  the  living  body,  as  decaying 
bone." 

Fumigation  of  Infected  Chambers  and  Other  Places. 

Nitric  Acid  Fiimipition. —  The  efficiency  of  nitric  acid  in  the  form 
of  gas,  in  arresting  contagion,  and  in  cleansing  infected  rooms,  ships, 
and  other  olaces,  .'s  W^ell  established.  To  obtain  the  gas,  pour  one 
cunce  of  sulphuric  acid  upon  two  ounces  of  nitrate  of  potash  in  a 
large  tea  cup, — the  cup  being  placed  in  a  basin  containing  hot  water. 
Th'i  gas  or  vapor  will  be»inmiediately  disengaged. 

TJilo  -^'uantity  will  thoroughly  cleanse  a  small  apartment,  but  if 
used  in  v.  sick  room,  should  be  placed  at  some  distance  from  the 
patient.  In  a  large  room,  two  cups  will  be  required  ;  and  if  a  whole 
houpj  is  to  be  fumigated,  let  several  be  placed  in  various  apartments, 
and  the  doors  and  windows  be  closed  for  half  an  hour. 

Chloride  of  KillC. —  A  solution  of  the  chloride;  of  zinc  has  great 
power  in  arresting  contagion,  and  in  cleansing  infected  places.  A 
small  {juantity  of  it  will,  in  a  few  minutes,  cleanse,  the  most  offensive 
apartments. 

Chloride  of  Lime. —  This  is  one  of  the  most  powerful  disinfecting 
or  cleansing  agents  known.  To  prepare  it  for  use,  add  four  gallons 
of  water  to  a  pound  of  the  chloride  of  lime;  stir  the  mixture  well, 
and  after  allowing  it  to  settle  for  a  short  time,  pour  oif  the  clear 
solution,  and  keep  it  in  well-eorked  bottles. 

Cliloride  of  Sodsi, —  This,  in  disinfecting  power,  is  about  equal  to 
the  chloride  of  lime.  In  order  that  it  may  retain  its  properties,  it 
must  be  ke|)t  from  the  light,  in  a  well-stopped  glass  bottle.  When 
used,  it  rrust  be  mixed  in  the  proportion  of  one  ounce,  or  two  large 
spoonfuls,  to  the  pint  of  water.  It  is  excellent  for  cleansing  car- 
buncles, gangrenous  sores,  bad  ulcers,  ulcerated  sore  throat,  and  fetid 
discharges  of  every  kind.  A  weak  solution  should  be  frequently  ap- 
plied. 

Uses  of  Clilorides  of  Lime  nnd  Soda.  —  These  articles  almost  in- 
stantly destroy  every  bad  smell,  and  all  effluvia  arising  from  animal 
and  vegetable  decomposition,  and  entirely  prevent  their  bad  influ- 
ence. 

While  infectious  or  contagious  diseases  prevail  in  large  towns  or 
aities,  the  rooms  should  be  sprinkled^  morning  and  evening,  with 


H 

some  of 

H 

different 

H 

ticularly 

^1 

In  hot 

H 

complair 

^H 

rooms,  a 

H 

should  b 

^H 

vessel  or 

H 

Before 

H 

mersed, 

H 

washing 

^1 

be  imme< 

H 

to  dry  wi 

H 

By  poi 

^1 

water,  in 

H 

as  may  b 

^1 

Meat  > 

H 

molestati 

^1 

stant,  an( 

H 

rendered  i 

H 

To  pui 

L^M 

to  every  c 

H 

The  w; 

H 

it  into  all 

H 

A  rooit 

H 

he  sprinkl 

^1 

Stables, 

H 

which  oil" 

^1      mixtures. 

^H          J^ein^  li; 

of  so  .'re a 

^^H 

In  treat 

H 

to  have  ic 

H 

According 

^1 

TIk!  sal 

H 

in  them  a 

H 

pulverized 

H 

a  basin,  or 

H 

inclosed  in 

^5 

ohtain  ext 

H 

1)0  cooled 

H 

To  five 

iH 

•Iram-i  of 

IH 

water,  in  a 

H 

f'ca-water. 

^1 

niometer  1 

1 

degrees. 

^1 


SURGICAL  DISEASES. 


505 


some  of  one  of  these  solutions.  Some  of  it  should  be  placed  in  the 
dirterent  rooms,  in  shallow  dishes,  —  the  small  bed-rooms  being  par- 
ticularly remembered. 

In  houses  where  there  are  typhoid  and  putrid  fevers,  and  infectious 
complaints,  it  is  highly  proper  to  sprinkle  the  solution  about  the 
roomiji,  and  occasionally  upon  the  bed-linen  ;  and  the  air  of  the  room 
tshoiild  be  frequently  renewed.  A  wincglassful  added  to  the  chamber- 
vessel  or  the  bed-pan  will  prevent  all  smell. 

Before  sending  the  bed  and  other  linen  to  the  wash,  let  it  be  im- 
mersed, five  or  six  minutes,  in  one  of  these  solutions,  diluted,  as  mere 
washing  will  not  always  remove  the  infection.  But  the  linen  should 
bo  immediately  rinsed  in  pure  water  after  the  immersion  ;  to  allow  it 
to  dry  without  such  rinsing  might  injure  it. 

By  pouring  a  quart  of  one  of  these  mixtures,  added  to  a  pailful  of 
water,  into  drains,  sewers,  or  cesspools,  and  repeating  the  application 
as  may  be  required,  will  destroy  all  their  offensive  ellluvia. 

Meat  will  keep  for  some  time,  without  any  taint,  and  without  the 
molestation  of  flies,  if  immersed  in  one  of  these  solutions  for  an  in- 
stant, and  hung  up ;  and  all  tainted  meat,  fish,  game,  etc.,  will  be 
rendered  sweet  by  a  little  sprinkling  of  the  same. 

To  purify  water  in  cisterns,  and  destroy  the  animalcules  in  it,  add 
to  every  one  hundred  gallons,  about  a  pint  of  one  of  the  solutions. 

The  washing  of  bedstciuls  with  one  of  the  solutions,  and  putting 
it  into  all  the  crevices,  will  destroy  bugs. 

A  room  just  painted  may  be  .sle|)t  in  safely,  if  one  of  the  mixtures 
ho  sprinkled  about,  and  loft  in  shallow  dishes. 

iStables,  slaughter-lK)ns(>s,  hog-styes,  |)rivies,  and  nil  places  from 
which  oilensive  smells  arise,  may  be  tlioroiiglily  purified  by  these 
mixtures. 

Being  guardians  of  the  public,  jiealtli  of  such  wide  application,  :uiU 
of  so  !T"eat  utility,  it  is  surj)rizing  that  they  are  not  more  used. 

Freezing  Mixtures. 

In  treating  wounds,  inflammations,  etc.,  it  is  often  quite  important 
to  have  ice,  which  is  not  to  be  obtained  without  manufacturing  it 
Accordingly,  I  give  here  a  few  dircctioiis  for  its  immediate  production. 

The  salts  used  should  be  in  a  crystiilized  state,  with  as  much  water 
in  Ihcrn  as  po.-.nble  without  being  damp.  Tlu^y  should  be  coarsely 
pulverized  at  the  time  of  using,  and  put  into  the  water  contained  in 
a  basin,  or  other  suitable  vessel.  The  water  to  be  frozen  should  be 
inclosed  in  a  thin  vessel,  and  immersed  in  the  freezing  mixture.  To 
obtain  extreme  degrees  of  cold,  the  ingredients  and  the  vessel  should 
be  cooled  by  one  mixture,  before  being  mixed  for  another. 

To  five  drams  of  pulverized  hydroehlorate  of  ammonia,  and  five 
ilram-i  of  pulverized  nitrate  of  potash  (nitre),  add  two  ounces  of 
water,  in  a  tin,  stone-ware,  or  glass  vessel,  and  you  may  freeze  water, 
j'cii-watcr,  milk,  vinegar,  or  oil  of  turpentine.  It  will  cause  the  ther- 
iiH)meter  to  sink  from  50°  above  zero,  to  10°  above;  that  is,  fort]f 
degrees. 


wi 


ITT: 


!!'   .'-li* 


506 


SURGICAL  DISEASES. 


A  mixture  of  five  drams  of  sulphate  of  soda,  and  four  drams  of 
diluted  sulphuric  acid,  will  sink  the  thermometer  seven  degrees  lower 
than  the  above,  namely,  down  to  3°  above  zero,  or  twenty-nine  degrees 
below  the  freezing- point. 

If  six  dratns  of  sulphate  of  soda,  four  drams  of  hydrochlorate  of 
ammonia,  two  drams  of  nitrate  of  potash,  and  four  drams  of  dilutt^d 
nitric  acid  be  put  together,  the  n)ixture  will  lower  the  thermometer 
60°;  that  is,  to  10°  below  zero,  or  4:2°    below  the  freezing  point. 

Beside  the  above,  the  following  combinations  may  be  used : 

Muriate  of  ammonia,  live  ounces;  nitrate  of  not  ash,  five  ounces; 
water,  sixteen  ounces.     Mix. 

Nitrate  of  ammonia,  four  ounces  ;  crystalized  carbonate  of  soda. 
four  ounces  ;  water,  four  ounces.     Mix. 

Nitrate  of  ammonia  and  water,  equal  parts.     Mix. 

Nitrate  of  ammonia,  and  nitrate  of  ))otash,  fi.ve  parts  each  ;  sul- 
phate of  soda,  eight  parts;  and  water,  sixteen  parts.      Mix. 

Phosphate  of  soda,  nine  parts  ;  liiluted  nitric  acid,  four  parts.     Mix. 

Sulphate  of  soi'-»,  eight  parts;  muriatic  acid,  live  [)urts.     Mix. 

Sulphate  of  soda,  six  parts;  nitrate  of  ammonia,  live  parts;  di- 
luted nitric  acid,  four  parts.     Mix, 

Freezing  Mixtures  with  let". —  Snow  or  pounded  ice,  two  parts; 
salt,  one  part.  Mix.  This  will  sink  the  thermometer  to  5°  below 
zero. 

Snow  or  pounded  ice,  four  parts ;  salt,  two  parts ;  muriate  of  am- 
monia, one  part.  In  this  mixture  the  thermometer  will  go  down  to 
12°  below  zero. 

Snow  or  pounded  ice,  twenty-four  parts;  common  salt,  ten  parts; 
muriate  of  ammonia,  five  parts ;  nitrate  of  potassa,  five  parts.  Mix. 
Gives  18°  below  zero. 

Snow  or  pounded  ice,  twelve  parts;  common  salt,  five  parts;  nitrate 
of  ammonia,  five  parts.     Mix.     Gives  2o°  below  zero. 

Snow,  eight  parts;  muriatic  acid,  five  parts.  Mix.  Gives  27°  below 
zero. 

Snow,  seven  parts ;  diluted  nitric  acid,  four  parts, 
below  zero. 

Snow,  four  parts ;  chloride  of  calcium,  five  parts, 
below  zero. 

Snow,  t  hree   parts ;   potassa,  four  parts.     Mix. 
zero,  or  b3°  below  the  freezing  point. 


Mix.    Gives  30» 

Mix.     Gives  40" 

Gives  51°  below 


Dr.  Ira  Warren's  Paracentesic  Instrument. 

PuNcnjuiNG  the  chest  for  drawing  ofi'  water  in  extensive  j)leuritic 
efi'usion,  as  practised  of  late,  has  proved  one  of  the  most  valuable 
operations  in  modern  surgt^ry.  Like  most  new  operations,  however, 
it  has  been  embarrassed  by  imperfect  instruments. 

The  annexed  cut  represents  an  improved  instrument  which  I  have 
just  invented,  by  which  this  operation  is  made  extremely  simple  and 
easy.     At  the  right  hand  is  the  puncturing  instrument,  including  the 


external  canula,  and  the  trochar  inserted  in  it.  At  the  letter  i  is  a  slid- 
ing guard  whifh  moves  back  and  forth,  and  may  be  set  at  the  point  of 
desired  depth  to  which  it  is  desirable  to  puncture,  and  made  fast  by 
a  screw.  By  this  arrangement  it  may  be  driven  home  to  the  desired 
depth,  without  any  fear  of  going  too  far,  or  of  falling  short  of  the 
mark.  The  guard  also  serves  in  u  measure  to  keep  the  instrument 
steady  during  the  operation,  and  to  prevent  indicting  pain  by  having 
it  oscillate  about  At  b  is  a  tubular  attachment,  opening  into  the 
canuia ;  to  this  an  India-rubber  hose  is  attached,  whi(^h  coimects,  at 
tht;  other  <mkI,  with  the  cock,  a,  upon  the  exhausted  receiver,  o.  To  a 
cock,  6",  on  the  other  side  of  the  rt^ceiver,  another  rubber  hose  is  fast- 
oued,  which  connects  at  the  other  end  with  an  air-pump. 

Fio.  177. 


The  mode  of  operating  is  exceedingly  simple.  First,  exhaust  the 
receiver;  then  quickly,  yet  gently,  plunge  in  the  instrument,  and,  leav- 
ing the  canula,  withdraw  the  trocar  till  the  point  passes  the  connect- 
ing tube  at  h,  when  the  water  will  irnmediiit(>ly  How,  in  a  full  stream, 
into  the  exhausted  receiver,  o.  The  working  of  the  apparatus  is  ex- 
tremely beautiful.  Five  pints  of  water  may  be  taken  away  with  it  in 
five  minutes,  —  an  amount  which  cannot  be  got  with  the  old  instru- 
ment in  much  less  than  half  an  hour.  If  the  patient  c-.iimot  bear  to 
have  it  drawn  so  rapidly,  the  stream  may  be  wholly  or  partially  ar- 
rested, at  any  moment,  by  entirely  or  partly  closing  the  cock,  a. 

The  reader  will  see  that  the  app;\ratus  is  so  arranged  that  the  ad- 
mission of  air  into  +l<e  chest  is  entirely  impossible. 

The  artist,  in  making  the  drawing  for  me,  has  inserted  the  instru- 
ment much  further  forward  than  the  point  usually  se'.edea. 

My  apparatus  has  a  second  puncturing  instrumeiu,  a  little  larger  ia 
■ize,  for  the  purpose  of  operating  ia  ascites,  or  dropsy  of  the  belly. 


E{    I 


h. 


Iv.-^ 


▲  BRIEI*^  TREATISE  ON   THB 

HOMOEOPATHIC  TREATMENT  OF  DISEASES. 

BT  A.   E.   SHALL,  M.D. 

In  the  following  pages  will  be  found  a  reliable  guide  in  the  administra- 
tion of  homoeopathic  remedies  for  tlie  various  ills  known  to  occur  in  almost 
every-day  life.  Nearly  every  disease  incident  to  the  liuman  family  is  briefly 
considered,  and  the  corresponding  treatment  explicitly  stated.  It  must  be 
borne  in  mind,  that  liomoeopathlc  remedies  are  addressed  to  vital  forces, 
whose  derangement  may  be  seen  in  the  manifold  forms  of  disease.  But,  in 
order  to  obtain  the  desired  effect  from  the  administration  of  any  remedy  for 
a  given  case,  a  certain  principle  must  be  observed  in  its  selection.  Thia 
principle  is  believed  to  be  a  competent  guide  in  affiliating  remedies  to  dis- 
eased conditions.  The  discovery  of  a  universal  hiw  of  cure,  which  points 
out  the  direct  relationship  between  all  diseases  and  tlieir  remedies,  is  as- 
cribed to  Ilalinemann,  the  founder  of  the  homoeopathic  system  f  medicine. 
By  numerous  experiments  with  drugs  upon  healthy  individu.  s,  he  ascer- 
tained that  diseases  are  curable  by  such  medicines  as  are  caj).able  of  pro- 
ducing similar  characteristics:  as,  for  instance,  chamomile  will  ))roduce  a 
colic,  and  will  cure  a  similar  one  from  some  morbiHc  cause ;  lience,  tlie 
formula,  ^'■/Similia  similibus  curantur,^^  is  the  principle  that  guides  in  tlie 
administration  of  remedies.  Every  medicine  has  a  specific  range  of  action 
in  the  body :  one  will  act  on  one  set  of  organs,  and  another  on  another 
set ;  some  will  direct  their  energies  so  as  to  affect  one  locality,  and  others 
to  another.  Tiie  only  way,  therefore,  of  ascertaining  how  a  remedy  will 
direct  its  action  to  any  local  or  general  disease  is  by  trying  it  first  u))on 
healthy  persons  in  order  to  ascertain  its  range  of  action.  As  disease  mani- 
fests '♦s  action  by  symptoms,  so  remedies  show  their  action  by  symptomB, 
in  a  similar  manner ;  and,  when  a  disease  presents  itself  for  treatment,  a 
remedy  must  be  selected  whose  pathogenetic  eflfects  upon  those  in  health 
resemble  the  phenomena  of  the  disease.  The  homoeopathic  materia  medica 
u  made  up  of  a  collection  of  remedies  that  have  been  thas  tried.  Those 
508    . 


employee 

fl 

the  folios 

i^^l 

1.  Aconite 

!^B 

a.  AioM.  i 

^^1 

t3.  Alnmin 

^H 

t4.  Ammoi 

I^H 

tS.  Antimo 

^H 

6.  Apii  m 

7.  Arnica 

8.  Arsenic 

ti).  Aurum 

^^1 

10.  Anacar 

i^H 

11.  Bsiptisii 

>^B 

12.  Bellado 

1^1 

tl3.  Bismatl 

iH 

14.  Bryoniu 

:^H 

tl5.  Calcarei 

i^^H 

16.  Calendi 

^H 

17.  Ciiinpht 

^B 

18.  Capsicu 

^H 

1!).  Cantbai 

^H 

20.  Caiinab 

^H 

t21.  Ciirbo  n; 

^H 

T'.'2.  Carbo  v 

^H 

23.  Caiutici 

^H 

24.  Cliamoii 

^1 

25.  Cliiiia.  S 

^1 

26.  Chelidoi 

^B 

27.  Cimicifu 

^m 

28.  Cicuta  V 

^H 

29.  Cina.  3. 

^^^H 

30.  Cucculu 

^H 

31.  Co£Feac 

^1 

32.  Colchioa 

^H 

33.  Golooyn 

^^B 

34.  Coniam 

^H 

35.  Crooiut 

■ 

86.  Coprnni 

1 

1.  Aconite. 

^H      2.  Arnloft. 

^H       3.  Baptiaia. 

1 

4.  Calenduli 

•  The  rerao 

^H 

tl)  on  the  docl 

^^H 

r  email  powdei 

1 

tMipoonflilakc 

HOmSOPATHIC  TREATMENT  OF   DISEASES. 


509 


employed  in  this  treatise  are  of  this  character,  and  are  comprised  ia 
tlie  following 

•  LIST  OF  REMEDIES. 


1.  Aconite.  3. 

37.  DifflUlia.  3. 

73.  Nitram.  6. 

2.  Aloes.  6. 

t3R.  nioscorea  TllIoBa.  2. 

74.  Nitric  aoid.  6. 

t3.  Alamina.  6. 

39.  Droflera  rotundifolia.  3. 

75.  Nnx  vomica.  6. 

t4.  Ammuniuni  oarb.  6. 

40.  Dulcamara.  3. 

76.  Nux  moscbata.  8. 

fS.  Antimoniuincrad.  6. 

t41.  Elaterium.  .1. 

77.  Opium.  3. 

6.  Apia  mellifioa.  6. 

42.  Eupborbium.  3. 

78.  Oleander.  3. 

7.  Arnica  montanft.  8. 

43.  Euphrasia.  3. 

79.  Petroleum.  6. 

8.  Anenionm  albom.  6. 

t44.  Ferrum  redact.  3. 

80.  rbospborus.  6. 

ti).  Auriini  metallicum.  6. 

46.  Oaniliogia.  3. 

81.  Pbospborlo  acid.  6. 

10.  Anacardiam.  3. 

46.  Oelsemium.  1. 

t82.  Platina.  6. 

11.  Baptisia.  1. 

t47.  Graphites.  6. 

83.  Pbytolacca  decandra.  1 

l-j.  neliodoDna.  3. 

48.  Gloniiinum.  G. 

84.  Pulsatilla.  6. 

tl3.  Bismath  Bubnit.  8. 

49,  Helleborus  nig.  6. 

85.  Podophyllum  pelt  3. 

14.  Bryoniu  alba.  3. 

tSO.  Hepar  Hulpb.  6. 

86.  Rhus  tox.  3. 

tU.  Calcarea  carb.  6, 

61.  Hyoscyamus  nig.  3. 

87.  Ruta  graveolens.  3. 

16.  Calendnla.  1. 

62.  Hanmmelis.  1. 

88.  Sabina.  3. 

17.  Ciiinphora.  3. 

63.  Ignatia  amara.  3. 

89.  Saiiibucus  nig.  3. 

18.  Capsicum.  3. 

64.  lodium.  6. 

00.  Sanjuinaria.  3. 

19.  Cantbaris.  3. 

66.  Ipecacuaulia.  3. 

91.  Secale  curnutum.  8. 

20.  Cannabis  sat.  3. 

60.  Iris  versicolor.  3. 

92.  SencRa.  3. 

t21.  Carbo  unlmalis.  6. 

tS7.  Kali  carb.  6. 

93.  Sepia  ruccub.  6L 

T'.'2.  Carbo  veg.  6. 

tr>8.  Kali  bicbromioum.  3. 

t94.  Silicca.  6. 

23.  Caiuticuin.  6. 

69.  Laobesis  trig.  G. 

95.  Spiitelia.  3. 

24.  Cliamoiiiilla.  3. 

tiO.  I^dnm  piilustre.  3. 

96.  Spongia.  3. 

25.  China.  3. 

01.  Laiirocer:iBUS.  3. 

t97.  Stannuin.  6. 

26.  Chelidonium  maj.  3. 

t(>2.  Leptandria.  3. 

98.  Staphysagria.  3. 

27.  Cimicifuga  raoeui.  1. 

t63.  I.ycopodium  clav.  6. 

99.  Stramonium.  3. 

28.  Cicuta  Tirosa.  3. 

lA.  Lobelia  inflata.  3. 

tlOO,  Sulpliur.  6. 

29.  Cina.  3. 

6.5.  Mercurius  currosivus.  6. 

101.  Sulphuric  acid.  8. 

30i  CocculuR  indicus.  i. 

t66.  Mercurius  vivus.  6. 

102.  Tartar  eniet  6. 

31.  Cuffea  crada.  6. 

t67.  Mercurius  iod.  3. 

103.  Uva  ursi.  1. 

32.  Colchicam.  3. 

t6A.  Mercurius  biniod.  3. 

104.  Urtica  urens.  3. 

33.  Golooyntbia.  i. 

60.  Mercurioa  aol.  6. 

105.  Veratrum  album.  & 

34.  Conlam  mao.  & 

70.  Mezerium.  3. 

106.  Veratram  viride.  L 

35.  Crooiu  MtiTm.  X 

71.  Mosofaua.  6. 

tlOS.  Zinoum  mat.  & 

86.  Cnpnua  aoet^  6. 

72.  Natrum  mariat.  6. 

TINCTURES  FOR   EXTERNAIi  USB. 


1.  Aoonlta. 

2.  Arnica. 

3.  Baptiaia. 

4.  Calendula. 


6.  Gantharla. 

6.  Gonium. 

7.  Gaustioum. 

8.  Hypericum. 


9.  Ruta  graveolana. 

10.  Staphyaagria. 

11.  Urtica  urena. 


*  The  remcdie*  marked  f  should  be  bought  a*  triturationt.  Ask  the  pharmaclat  to  prepare  thera 
til  on  the  decimal  scale,  and  so,  also,  the  dilutioni.  The  trlturatlona  may  be  given  dry  un  the  tongue, 
r  email  powder  the  size  of  a  pea;  or  the  Hamo  amount  or  more  dUitolved  In  half  a  tumblcrfUI  of  water,  ■ 
UaipoonAil  at  one  doa«k  when  It  ia  daalrable  to  repeat  the  medicine  at  siiort  lnt4)rvala. 


rr-r 


RULES    KOK   TIIK    AIlMINISTItATION    OK    KKMKDIKS. 

As  specific  directions  will  be  found  in  the  treatment  of  each  disease 
treated  of  in  this  work,  only  a  few  general  rules  are  ueces!sar\ . 

1 .  In  acute  cases,  the  elioscn  remedy  ma}'  bo  repeated  every  hour  or 
two  hours,  until  a  change  occurs  ;  then  it  is  prudent  to  wait  awiiile  for  the 
result. 

2.  If  there  is  no  favorable  reaction  within  a  few  hours,  or,  in  very  acute 
pain,  within  half  an  hour,  select  another  remedy  according  to  the  indica- 
tions; and,  should  no  iavorublo  reaction  follow  the  administration  of  this. 
select  another,  and  so  on. 

3.  AVhen  convalescence  follows  the  administration  of  a  remedy,  it  need 
not  bo  repeated  uuU^ss  the  recuperation  reaches  a  certain  point  and  tliiu 
ceases  ;  in  which  event,  select  a  remedy  according  to  indications. 

4.  The  same  remedy  may  be  repeated  in  case  of  continued  convalescence 
becoming  interrupted,  provided  there  is  no  change  other  than  amelioration 
of  symptoms. 

5.  A  change  of  remedies  is  admissible  in  obstinate  cases,  when  one  has 
been  employed  for  some  time  without  the  desired  effect.  In  chronic  cases 
it  is  well  to  try  the  remedy  at  least  a  week  before  changing. 

6.  In  chronic  diseases,  the  remedies  need  not  be  repeated  oftencr  tha 
once  or  twice  in  twenty-four  hours,  and  even  at  longer  intervals. 


KORM3   OK    MEDI0INK3    KOIl   ADMINISTRATION. 

There  are  four  forms  in  which  honKcopathic  medicines  are  prepared  for 
use:  1 .  Mother  tinctures  prepared  from  fresh  plants  ;  2.  Triturations  pre- 
pared from  metals,  salts,  earths,  and  herbs-;  •  3.  Dilutions  prepared  from 
the  tinctures  ;  and,  4.  (ilobules  medicated  with  the  solutions.  The  last  two 
are  generally  employed,  and  the  first  two  occasionally,  in  household  prac- 
tice. When  water  is  employed  as  a  medium  for  the  administration  of  eitliir 
form,  five  drops  of  the  tincture  or  dilution,  or  ten  globules,  or  three  or  four 
grains  of  the  trituration,  may  be  thoroughly  mixed  in  half  a  tumbler  of 
water,  and  a  dessertspoonful  of  this  mixture  will  suffice  for  a  dose.  Tl.t 
tumbler  containing  the  medicine  should  be  carefully  covered,  and  kc; ' 
away  from  the  light  and  from  any  corrupting  odor ;  and  all  ottier  medicines, 
teas,  tonics,  and  stimulants  are  strictly  prohibited  during  its  administration : 
and  all  medicated  po*  'tices,  lotions,  and  the  like,  must  be  avoided,  becausi; 
of  their  interference  with  the  medicinal  action  of  the  remedy. 

RULES    FOK   PRESERVING  THE   PURITY   OF   MEDICINES. 

1.  The  medicines  should  be  kept  in  a  small  box  or  chest,  exclusively  for 
this  use,  carefully  closed,  and  in  a  cool  place.  Examine  the  corks  often  tu 
see  that  they  are  perfectly  tight. 

•DUutioni  are  noommeBdedto  be  prepared  on  the  d$iUmal  eeolfc 


2.  Be  carcftll  to  keep  the  vials  corked  always  with  tlic  .sanio  cork,  or  one 
that  has  never  been  used  for  any  otiier  purpose  ;  and  l»e  particularly  careful 
not  to  miaplaee  the  corks,  or  fail  to  rei)laee  tlu;  identical  one  each  time  when 
a  vial  is  uncorked  for  uses 

.T.  Never  put  inediciue  into  a  vial  that  has  been  already  used  for  one  of 
ft  dilferent  kind,  unless  it  be  thoroughly  washed  and  baked. 

■1.  Every  vial  should  be;  labelled,  to  prev'  lit  mistakes  ;  and  «!very  glass, 
spoon,  or  cup  should  be  carefuily  tlcumscd  before  usiiijj  it  in  the  prepuratioa 
of  a  remedy. 

5.  Never  use  the  same  spoon  in  giving  medicines  of  a  different  kind  to 
different  {kirsons  sick  in  the  same  house. 

ANTIDOTES   TO   MKUICINES. 

In  some  exceeding  impressil)le  conditions,  the  remedy  chosen  may  pro- 
duce  intense  aggravation  of  suffering,  which  may  be  relieved  by  the  admin- 
istration of  a  drop  of  the  Spirits  of  camphor.  If  Belladonna  should  pro- 
voke an  aggravation.  Aconite  will  antidote  its  effect,  anil  so  will  Camphor f 
and  tills  latter  is  regarded  the  general  antidote  of  homu'opathic  reme- 
dies, two  of  which  should  seldcmi  be  given  in  alternation,  because  of  the 
liability  of  their  neutralizing  the  effects  of  eairli  other.  For  the;  same  reason 
it  will  not  do  to  change  from  one  remedy  to  another  suddenly.  A  period 
of  from  four  to  six  hours  should  intervene  in  acute  cases,  except  in  emor- 
geucies  of  great  pain,  and  from  one  to  two  days  in  chronic  aii'ectiona. 

EXTERNAL    APPLICATIONS. 

Compresses  wet  with  cold  water,  coveri'd  with  a  dry  bandage,  arc  always 
a  convenient  and  successful  resort  for  bruises,  sprains,  and  injuries  in  gen- 
eral. Tepid  applications,  or  cold  when  agreeable,  in  the  same  way,  may 
be  applied  to  local  iuflammatoiy  affections.  Warm  poultices,  to  hot  and 
inflamed  surfaces,  will  often  exert  a  salutary  influence .  The  tinctures 
named  for  external  use  may  at  times  be  employed  in  full  strength ;  but 
lotions  made  of  a  teaspoonful  of  any  one  of  them,  to  a  cupful  of  cold  water, 
is  the  usual  form  of  applying  them.  Mustard  poultices  may  be  employed, 
either  in  full  strength,  or  tempered  by  adding  to  the  ground  mustard  a  due 
proportion  of  meal.  Simple  cerate,  cold  cream,  and  healing  salves  may  be 
employed  when  needed ;  but  any  strongly  medicated  poultice,  plaster,  salvo, 
or  ointment  must  not  be  used  when  taking  homa'opathic  remedies. 

BATHINO. 

Persons  of  debilitated  constitutions  should  not  bathe  too  frequently ;  for 
those  of  robust  constitutions,  this  luxury  may  be  indulged  in  to  almost  any 
extent.  Bathing  in  very  cold  water  is  not  recommended.  Tepid  baths  are 
the  moat  benefloial,  aad  shoold  be  takea  regularly  throughoat  the  year. 


tvi 


"(F-r 


Hot  baths  are  weakening  and  relaxing.  They  may  be  employed  for  childrcQ 
in  convulsions,  and  to  overcome  rigidity  of  the  skin.  Sulphur  baths  are 
sometimes  recommended  for  rheumatism ;  but  they  should  be  taken  with 
caution  ;  and  this  remark  is  applicable  to  all  vapor-baths.  Sea-bathing  u 
good  for  dyspepsia,  and  those  inclined  to  biliary  derangements.  Consump- 
tives derive  but  little  benefit  ftom  any  kind  of  bathing  aside  from  necessary 
ablutions.  The  addition  of  salt  to  the  water  is  recommended  in  cases  of 
debility. 

DIET  AND  REGIBTEN. 

But  little  need  be  said  about  diet  here,  as  that  which  is  appropriate  U 
pointed  out  in  the  following  pages,  as  a  part  of  the  treatment  for  each  indi- 
vidual case.  It  may  be  romnrkcd  simply  that  no  medicinal  condiment  or 
food,  no  stimulant  or  other  medicinal  beverage,  can  be  emplo3'cd  when 
taking  homoeopathic  remedies  ;  and,  further,  all  patients  must  be  placed  in 
the  best  possible  condition  for  recovery.  They  must  have  clean  and  well- 
ventilated  apartments,  and  plenty  of  fresh  air.  They  must  have  clean  and 
well-aired  bedding.  They  must  have  proper  clothes  and  food  to  correspond 
with  the  appetite  and  wants  of  the  system.  An  experienced  nurse  is  of 
great  importance,  especially  in  feven. 


DISEASES  INVOLVING  THE  VARIOUS  ORGANS. 


Simple  Fever. 

TiiiB  disease  is  a  simple  acceleration  of  the  pulse,  with  flushes  of 
heat ;  and  when  brought  on  by  fatigue,  give  four  gh)l)ulc8  of  Arnica; 
if  from  cold,  Aconite;  if  from  grief,  Ignatia;  if  from  indigostiou, 
Belladonna;  if  from  dampness  and  chill,  Gelsemium,  or  Rhus  tox. 

Inflammatory  Fever. 

In  most  cases  this  disease  commences  with  pain  in  the  head  and 
full  pulse,  more  or  less  thirst,  loss  of  nppotito,  constipation  of  the 
bowels,  and  dry,  hot  skin.  One  drop  of  the  dilution,  or  four  globules, 
o(  Aconite  may  be  given  in  the  first  stage,  every  hour,  until  the  skin 
boromes  moist,  and  the  pulse  somewhat  reduced.  Belladonna  may 
follow  Aconite,  and  be  given  in  the  same  doses  and  intervals,  until 
tlicro  is  a  mitigation  of  the  pain  in  the  head  ;  or  if  the  pationt  becomes 
weak,  and  sulijeet  to  aggravation  of  suffering  from  the  slightost  mo- 
tion, give  a  drop,  or  four  globules,  of  lin/onia,  every  hour,  until  there 
is  a  change  ;  with  restlessness,  and  when  fiom  checked  perspiration, 
Uhm  tox.y  same  dose  as  Bryonia.  In  the  case  of  urinary  obstruction, 
give  four  globules  of  Cantharis;  or  of  flatulent  colic,  four  globulea 
of  (Jhamomilla.     The  diet  should  bo  farinaceous  gruol  or  toast. 

Typhoid  Fever. 

In  general,  the  commencement  of  this  disease  is  denoted  by  las- 
situde, headache,  and  considerable  acceleration  of  the  pulse.  Then 
follow  stupor  or  delirium,  coldness  of  the  surface,  nnd  great  prostra- 
tion. Four  globules,  or  one  drop,  of  Aconite  may  be  given  at  first, 
every  two  hours ;  to  reduce  the  pulse  and  moisten  the  skin  (by  many 
Baptisia,  m  drop  doses,  hourly,  of  the  tincture  is  preferred  to  Aco- 
nite), Bryonia  may  be  used  after  Aconite,  a  dose  every  three  hours. 
If  the  patient  becomes  drowsy,  give  Rhus  tox. ;  cleanse  the  surface 
of  the  patient  daily  with  a  towel  wet  with  topid  water;  and,  if  he 
will  take  any  nourishment,  give  him  beef-tea  or  mutton-broth  ;  milk 
is  allowable,  and  rice  gruel.  When  convalescent,  allow  some  light 
wine  throe  times  a  day.  For  the  diarrho?a  of  Typhoid,  Arsenicumt 
four  globules,  after  each  discharge,  is  good. 

Bilious  Remittent  Fever. 

This  disease  is  so  named  because  it  comes  on  by  considerable  gastric 
derangement,  headache,  and  fever,  which  appears  to  be  subject  to  eleva- 
tions and  depressions,  without  any  distinct  intermissions.    In  the  first 


m 


514 


DIHKASES    INVOLVINO    THK    VA1UOU8   ORGANS. 


or  infiumniatx>ry  stage,  give  four  j^lobulcs,  or  a  drop,  of  the  dilution  of 
AcojiitPs  and  Ibllow  it  with  a  lik(;  vlose  of  Ipecaaianlia,  and  repeat  every 
hour,  until  the  nausea  and  vomiting  are  better.  If  the  bowels  are  consti- 
pated, give  Niix  vorniai  ft  night,  —  a  single  dose  of  four  globules,  if 
there  is  colic,  give  Coiocynth.  If  there  is  vomiting  of  greenish  bilious 
xnatter.  give  limjonia  or  Pulaat<'la.     Diet  samt;  as  in  intlannrmtory  fever. 

Intermittent  Fever. 

The  8ymf>tomf5  'oy  wlucli  this  fever  is  sJi;:tinguishod  are  yawning,  stretch- 
ing, shiiddi-niig.  and  cliiiliness,  followed  by  beat,  p.-iin  in  the  back,  limbs, 
thcad,  rtc.  ;  and  allerwards  a  copious  porspiralion,  and  then  an  interim 
of  coinpletc  intcrniission.  xirsenicioai  wliere  tlic  ehilliuess  and  heat  are 
eimultaiH'ous,  and  where,  during  the  eold  stage,  there  is  intense  tliirst  for 
cold  drinks;  Araiat,  wiiere  there  is  s<)reness  of  the  tlesh,  as  if  bruised; 
JBtdlddonna,  where  headache  and  chilliness  down  tiie  l)aek  ;  China.,  where 
there  is  ringiiv?  in  the  ears ;  Sulphur,  in  cases  of  long  standing,  where 
niiici)  Qninim'  has  b<-c»  given  ;  fin/onia,  where  tliere  an;  glairy  voniitinjrs 
during  the  chill  and  fever,  and  where  all  the  sulferingH  are  aggravated 
by  motion.  Apis,  attacks  ehronie,  and  jjreeeded  by  nettle-rash.  —  followed 
well  by  Nf.U.  mur.,  either  to  lie  given  three  timis  daily.  All  the  mediciuci) 
may  be  administered  in  drop  doses  of  the  dilutions,  or  four  globules ;  and 
repeated  every  two  hours  between  the  paroxysms. 

Yellow  Fever, 

Common  to  the  'southern  States  during  the  warm  season.  Nearly  all 
the  symptoms  of  an  ordinary  bilious  fever,  in  an  aggravatecl  form,  char- 
acterize this  dis«'ase  ;  and  the  victims  become  so  sallow,  and  the  surface 
so  yello  V,  as  to  give  rise  to  tlie  name  "  Yellow  Fever."  When  the  stiige 
of  febrile  excitement  exists,  give  Aconite.  When  tlie  nose  bleeds,  give 
Bdladonna.  When  vomiting  of  bla<!k  or-  dark  bibous  nuatters  occurs, 
give  Arf!Pnicum.  For  the  prostration,  or  diarrlKv^i.  giv»!  Cnrbo  vegtia- 
hilis.  and  when  the  most  otlensive  odc^r  comes  from  the  bn.'ath,  give 
JDaptisia.  Arsenicum  and  Carbo  veget.abili»  are  the  most  pronniient  rem- 
edies. The  tisua!  drop  or  four  globule  doses  may  l)e  repeated  every  two 
hours,  Hnd  sometimes  every  houro     Diet,  —  barley-water  and  gruel. 

Eruptive  Fevers. 

Nettle-Ilash  is  a  pale-red.  stinging  eruption,  tliat  sometimes  is  attended 
with  vomiting,  and  sometimes  with  some  other  derarrgeinent  of  the  stom- 
ach. Ipecor.  and  Nux  vomica  ar«  indicated  for  the  vomiting,  and  A^n^ 
ttidUfica^  Mints  tax.,  and  /Sulphur  for  t!>e  buruir  .,  itching,  and  stinging; 
Croton  tig.  cures  nearly  nil  cases,  a  favorite  remedy  with  physicians.  Doses 
an  usual,  and  repeated  eviiry  hour  or  two  hours  until  ndieved. 

Scarlet*.RttSh  is  Ihe  roseola,  or  red  eruption,  and  is  nuich  like  the 
uettle-ras'-i.  only  less  annoying.  Bryonia,  I^laatilla^  are  the  ordin;  ry 
remedies  ;  and  either  may  be  given  in  doses  of  four  globules  every  two 
hours  ;  Aeon  .  if  waheful  and  restless. 

Scarlet-Pover  usually  begiina  wi<h  vomiting,  quick  pulse,  aorethro't, 
headache,  and  great  restlessness.     JkUnidonnat  when  there  ia  »  biigbt 


DI8EA8KS    IXVOLVINO    TIIK    vAUIOUS    OKOAN8. 


515 


give 
cure, 

rgrld- 

{live 

roin- 

two 


scarlet  eruption  ;  Calcarea  carbonica,  when  tlie  child  is  of  a  scrofulous 
habit;  Arseuiriim,  when  tliere  is  great  piostnition  :  li'llcboruH,  when  tiiere 
arc  <lroi»sical  symptoms  ;  Iir>/(»ti<i,  when  liie  cniptiou  is  slow  coniin<j;  out. 
Repeat  the  medieiues  in  the  usual  doses  t-vi-ry  hour.  Diet,  —  nourishing 
drinks,  toast,  and  tea. 

Measles  come  on  with  couuli,  pain  in  the  lit'ad.  sneezing,  redness  of 
the  eyes,  and  soMU-tinies  attended  with  nausea  and  voiuitinji.  liryonUi 
will  liasten  the  a[)pi':inin((>  of  the  eruption  ;  Jpi'inc,  should  it  disappear 
too  suddenly,  with  eonHe(|Uent  inerease  of  eoinjh,  or  vomiting;  I'/w'sphonm 
will  obviate  tlie  iiillamuiatory  efleet  upon  the  hnigs  :  and  Ifrosera  will  euro 
the  entailed  cough.     Diet,  simple  ;iiid  light. 

Erysipelas,  either  vesieular  or  phlegmonous,  is  denoted  by  a  n'd, 
burning,  and  lieiy  appeaianci'  of  the  face,  and  sometimes  l)y  a  Ihillar 
eruption,  resemliling  tly-l)listers.  li/uis  /d.i:.,  llc/htduuiid,  and  firyotiia^iiv 
prominent  remedies.  —  Jiclldihniiui.  when  (lie  head  and  fat"  are  most 
iinplieated ;  Jilms  ^u•.,  when  theve  is  eruption  on  llie  extremities,  and 
ijreat  weakness  ;  and  Jirf/miia,  when  the  suH\'ring  seems  greatly  aggravated 
by  motion  ;  Arsctiicuin,  should  there  be  great  prostration,  thirst,  and  rest- 
lesiiesH. —  one  of  the  best  remedies  in  severe  eases.  Any  of  these  remedies 
may  be  re[)eated  every  hour.  Diet.  —  barley-gruel,  rice-watisr,  beef-tea, 
uiiiltou-broth,  toast,  and  tea. 

rhicken-Po.\.  —  A  pustular  eruption,  .attended  with  slight  fever  and 
giVi^ric  (lerapgeinent.  One  or  two  doses  of  I'ldttatilla  will  generally  remove 
!ill  the  sutleriug  attendant  on  tliis  disease. 

Varioloid  is  anotlier  pustuhir  disease,  more  severe,  as  it  comes  on  with 
[min  in  th'-  head  and  back,  as  if  the  latter  would  break  ;  and,  being  a  near 
relation  to  Small- Pox,  both  may  be  considered  under  the  sanm  head. 

Siuall-Pox,  of  which  varioloid  is  a  modilieation,  comes  on  with  inttnise 
fever,  spitting,  pain  in  the  heail  and  back  and  lower  «'xtremities.  All 
the  suti'orings  ai'c  intense,  Ni'.c  voniiiu  will  removt^  the  pain  in  the 
back  ;  lin/iinla  will  hasten  the  eruption  :  PnlxdillUi  will  aid  in  carrying 
it  utT.  As  soon  as  the  appetite  returns,  feed  the  patituit  (piite  gener- 
ously. In  the  small-pox  delirium,  you  can  give  Strnmouuon ;  and, 
to  [)revent  pitting,  break  the  pustules,  and  cover  theiu  with  Styptic 
Collodit/n. 

Bhenmatio  Fevers. 

Inflammatory  Rtieiiniatisni  is  accompanied  by  pain  in  the  lir.ibs,  in- 
flammation of  the  joint.s,  swelling  of  the  same,  and  great  pain  and  dilH- 
cu'ty  in  moving  about.  Aconite  reduces  the  fever ;  Bryonia  nilievcs  the 
pain  in  mcving  al)Out ;  Pulsatilla,  the  intl.'imniation  of  the  knee-joints; 
Colonjnth,  that  of  the  hi|)-joints  ;  Nxx  ifmniai,  the  pain  and  rheumatism 
of  the  back;  and  iSiilphur  and  Rhus,  the  stiffne.sji  that  ensues  during 
convalescence  ;  Ithus  is  indicat»'d  if  the  cause  be  check  of  perapiration, 
or  exposure  to  wet.     Diet,  — bread  and  butter,  steak,  and  other  meats. 

Ohroilic  llheumatism  is  more  confmed  to  the  umscles  than  tlu;  joints, 
ami  is  oft(!n  the  sequel  of  the  acute  form.  Sniphur  is  one  of  the  reme- 
dies much  relied  njion  in  curing  this  disease.  Nitx  vomica  nniy  hv.  given 
after  Sulpiinr,  wh»'n  there  is  pain  in  the  back  or  sciatic  rerve,  and  Ithua 
tox.  when  there  is  a  general  stiffness  of  the  limbs.  The  medicines,  in  tho 
usual  doses  J  may  be  repcaU^d  every  two  hours. 


J 


516 


DISEASES  INVOLVINQ  THE  VABIOUS  OBOAHS. 


Lambngo  is  simply  rheumatism  of  the  back,  in  the  lumber  region,  and 
su  stiffens  one  that  ite  cannot  stand  erect.  Sulphur^  four  globules  at 
night,  and  Pulsatilla,  four  globules  in  the  morning,  will  generally  cure 
this  trouble.  Cimicifuga  is  a  very  valuable  remedy,  given  hourly, 
in  water. 

Sciatica  is  simply  neuriilgiu  of  the  sciatic  nerve,  and  may  be  cured 
in  a  short  time  by  u  galvanic  battery.  Rhus  is  often  useful.  Bel- 
ladonna, or  its  active  principle,  Atropine,  is  a  valuable  remedy  to 
administer  internally.  The  diet  m  all  forms  of  rheumatism,  whether 
acute  or  chronic,  may  be  generous. 

Toothache. 

When  caused  by  a  cold,  Niix  vomica ;  when  from  caries  of  the  tooth, 
Merouriua  viv.;  at  the  menstrual  period,  Puhatllla;  neuralgic,  Bella- 
donna, or  ChamomiUa;  Aconite  when  there  is  heat  in  the  gums. 
Dose  as  usual,  repeated  csvery  hour. 

Diseases  of  the  Alimentary  Canal. 

lufliiminiitiun  of  the  Tonsils  is  tlie  result  of  a  cold  which  affects  this 
locality,  and  causes  a  swelling  and  sometimes  a  suppuration  of  these  parts. 
When  they  first  begin  to  inflame,  give  Aconite,  and  follow  with  Bella- 
donna :  repeat  every  two  hours.  Mercuriav  viv.,  Lacheiis,  and  Mercurim 
lodatus  are  also  good  remedies. 

<(uiiisy  is  the  same  as  Tonsillitis,  and  requires  the  same  treatment. 

IHltrid  Sore  Tliroat  comes  on  by  little  vesicles  making  their  appear- 
ance in  the  mouth  and  fauces,  or  throat,  which  soon,  by  reason  of  a  low, 
constitutional  fever,  change  color,  run  together,  and  constitute  the  offen- 
sive sore  mouth  which  we  denominate  putrid.  Araenicum,  Mercunut 
vivus,  Nitric  acid,  and  Sulphur,  or  Stuph.  acid,  will  generally  cure. 
Dose  and  repetition  as  before. 

Canker  of  the  Mouth. 

This  troublesome  disorder  is  caused  by  a  disordered  condition  of  the 
stomach,  and  requires  Arsenicum  when  the  breath  is  foul,  the  throat 
dry,  and  attended  with  much  thirst ;  Carbo  vegetabilis,  when  the  system 
is  'a  a  low  condition,  and  there  is  much  coldness  on  the  surface  of  the 
body  ;  Dulcamara,  when  produced  by  a  cold ;  Hepar  aulph.,  when  the 
canker  seems  indolent,  and  slow  in  coming  to  a  crisis ;  Natrum  muriaticum, 
when  it  assumes  the  chai'acter  of  Scurvy,  or  Mercurius  rio. 

Dose  and  Adminixtration.  —  Dissolve  from  two  to  five  dro[)s  of  the 
dilution  in  half  a  tumbler  of  water,  and  give  a  teaspoonful  every  two 
hours.     Diet,  —  avoid  salt  provisions;  use  meat-broths,  toast  and  tea. 

Inflammation  of  the  Tongue. 

The  first  indications  of  this  difficulty  are  soreness  and  difficulty  in 
using  the  tongue  in  deglutition  or  eating.  VVIicn  caused  by  mochanjcal 
injury,  or  fr)m  accidental  biting  with  tlw  teifth,j;ive  J^rwtpa,  jour  glob- 


DISEASES  INVOLVINO  TBE  VABIOUS  ORGANS. 


517 


nles,  and  wwh  the  mouth  with  a  dihition  of  ten  drops  of  tincture  of 
Arnica  in  half  a  tumbler  of  water.  If  from  otiier  causes,  give  Aconite  or 
Belladonna  in  the  same  way.  Wiien  inflammation  of  the  tongue  takes  the 
form  of  ulcers,  give  Arsenioum ;  of  biisti-rs,  Mercurius  or  Laches Ig ; 
when  the  tongue  inflames  and  crack'',  give  Nitric  or  Sulphuric  acid. 


!  f' 


t  ;:i& 


Pharyngeal  Sore  Throat. 

This  isan  inflaminatioti  of  the  phaiyiix,  or  of  the  opening  into  the  upper 
pnrlioii  of  tlie  passage  iVom  the  niciith  into  the  stomach.  It  is  sometimes 
qtiiie  serious,  and  is  usu;slly  lermed  "  Quinsy  Sore  Throat."  AaniKu 
iiiav  he  given  at  first,  and  this  may  l»e  followed  l»y  Bii/lddouud,  ami  tliir* 
iv^iuw  hy  Mercurius  vio.  Should  it  become  evident  that  ri'.ippurati(Ui 
must  take  place,  give  Hcpar  salph.  Whichever  remedy  is  given,  let  it  be 
repeated  every  hotir  until  anudi«)ration  or  ehiin^o.  Baryta  curb,  is 
often  tin-  speeirte. 

Dyspepsia,  Indigestion. 

Difiicult  digestion,  whatever  form  it  assumes,  is  termed  Dyspepsia, 
and  must  be  treat'd  in  accordance  with  tlie  symptoms,  and  the  cause  that 
lias  produced  tliem.  Dyspepsia  brougiit  on  by  intemperance  in  drinking 
intoxicating  iiipiors  requn-i-s  Nu.c  voni. ;  if  from  a  cold,  ami  the  patient 
is  chilly  and  leverisli,  y^c//(/(io/j«rt,  or  perhaps  Brijonla ;  if  from  eating 
iiit  meat  or  "•ch  food,  Pulsatilla ;  if  from  gi  ief,  Ignatia.  Dose,  «me 
drop,  or  foi  •  ules,  repeated  every  three  or  six  hours,  according  to  the 
'Icifrce  of  sulle.  .^^\l. 

llniitlturii,  or  Waterhrash.  —  A  burning  at  the  pit  of  the  stomach, 
aiiii  ;i  cDii^tiint  ineliiiati<tii  to  rc:',urgitate  sonr,  acrid,  or  bilious  matter, 
is  termed  Waterbrash,  and  is  Ijut  a  form  of  Dyspepsia,  and  indicates 
Aferfurins,  Nux  vomica,  PulftatUfa,  Arsenicum,  Cimicifwja,  &c., 
given  as  above. 

Cardialsna,  or  (iiiNfralgin.  is  nearly  alli(^«l  to  the  above,  only  at- 
tended with  [)ain  in  the  st<Miia«li,  as  wcl  sis  iMirning,  sour,  or  acrid 
risings.  Ai.senieuin,  Nux  rotnini,  lii't/ml'i,  Calcaren.  Chamnmllln, 
i'nffi'a,  Cofofynfh.,  And  /'uhatiHa  are  .'rncdii's  indicated  in  this 
diliiitdty ;  and  each  may  be  given  and  re^vjated  every  hour,  in  Iho 
usual  doses,  uutil  relieved. 

Ihspcptif  Headache  is  simpfy  a  s>m|>«thetie  action  of  th.  >iom:i(  h 
i.lM.ii  tiie  h.v*. I,  causing  (niisiderable  pain.  Br>j»nia.  Btllidonna,  ('oc- 
culux.  Nu^  r,nniat,  and  Ar.srnii-uni,  roUKfitute  the  group  ot  remedu-s  to 
jlivo  relief  or  cm-e.  When  cold  water,  tak-n  into  the  stom.icli.  is  ionnd 
IN)  (lisaiiree  with  the  stomach,  <itber  A/r  oumica,  Ari»-iilt;ii„>,  Palmtdld, 
or  Vhhia  wiAl  aflord  relief      When  any  kiod   of  U»x^  disagrees  with  the 


» y  k 
stomach,  catising  distress  and   lipadaehe.  tfive  either  Ferrum.  Cnup/ior, 
Chainomilla.  Pulsatilla,  or  Sulphur,  in   the 


usual  i\im'  >4  one  drop  or 
lour  nlobules.  If  caused  by  l)eer,  Colocynth  ;  by  nnlk,  ^alcarm,  Pulna- 
miii^'Nux  vomien.  When"  animal  food  proves  difficult  of  dijrv^iion,  or 
lilt  meat  or  gravi-^,  drawn  butter,  Puhatdla,  Jfmafi'^^  ^«**  9^mica,  Coo- 
mhis,  &c.  Dy»]>n*«'a  '•''  «"  common  a  disease,  and  afflicts  so  great  a  va- 
riety of  temp^raittwifi  and  habits,  wc  will  U-  exj/licit  in  pointing  to  specdie 


1 


518 


DISEASES  INVOLVING  THE  VABIOUS  OBQANS. 


treatment.  For  hypochondriacal  persons,  Sulphur,  Nux  vomica,  Ignatia, 
for  liysterical  persons,  Sepia,  Pulsatilla,  Myoscyamus,  and  Lacht»i», 
for  those  of  a  sanguine  temperament,  Nhx  vomica  ;  for  the  sympathetic, 
Puhatilla ;  for  the  bihous,  Mercurius  viv. ;  and  for  the  niuhinchohc, 
Nitric  and  Phosphoric  acid,  Aurum  metallicum,  &c.  When  those  of  a  D'jr- 
•VOU3  temperament  are  afflicted  with  Dyspepsia,  we  find  Valerian,  Hy^i' 
lyamus,  Pulsatilla,  Ignatia,  and  Mosohus  good  remedies ;  ^hose  of  a 
8crofuh)us  habit  require  Oalcarca,  Arsenicum,  and  Sulpfiur ,  students 
afflicted  with  Dyspepsia  require  Nax  vomica,  China,  and  JFerrum.  Doyo 
and  repetition  as  before. 

Sea-Sickness. 

There  is  no  remedy  that  will  prevent  sea-sickness,  and  no  condition  ot 
neaith  capable  of  always  resisting  it.  But  the  effects  of  tiie  sicknt'ss, 
which  lUM  often  distressing,  can  be  removed  by  Cocculus,  Nux  vomica, 
and  Ignatia.  If  th.;re  remains  an  inclination  to  retch  after  the  sickness 
has  passed,  give  Ipecac.  Petroleum  is  often  taken  as  a  preventive 
with  success. 

Mucous  VomitiDg. 

This  is  simply  sickness  at  the  stomach,  which  may  arise  from  its  irrita- 
ble condition,  and  result  in  vomiting  of  slime,  or  mucus.  The  remedies 
that  will  obviate  the  difficulty  are  Ipecac,  Itheum,  Pulsatilla,  and  Vera- 
trum.     Usual  dose  and  repetition. 

Vomiting  of  Blood. 

This  may  bo  caused  by  Jiiechanical  injury  of  the  stomach,  and  requires 
Arnica;  if  caused  by  pregnancy,  Arsenicum;  if  from  retained  menses, 
PhoHph.  or  Pulsatilla;  if  from  acrid  humors,  Arsenicum  or  Ipecac; 
if  from  suppressed  eruption,  Sulphur. 

Gastritisi  or  iDflammation  of  the  Stomach. 

This  is  indicated  by  severe  pain  in  the  stoniiu'h,  continuous  vomiting, 
heat  over  the  regi(m  of  the  stomach,  quick  and  feeble  pulse,  cold  feet, 
and  pain  in  the  head.  The  remedies  lor  (lastritis  are  Aconite, 
Jiism.  Huhnit.,  Arsenicum,  lielladonna.  Ipecac,  Tart,  emetic,  Vera- 
trxim.  Lobelia,  and  Cocculus,  and  somutimcs  Nux  vomica.  Doso 
and  repetition  as  usirl. 

GastfodyDia,  or  Cramps  in  the  Stomach. 

A  |);iin  in  the  stDUiacli,  with  cnunp,  is  v»i  y  distn'Hsiiig,  and  i-annot  1 
mistaken  ;  t'ur  the  t  nnnp  is  ji  sudden  spasmodic  action   of  the  museles  oi 
the  st()in:ieli,  which  seems   like  takinij  tlie  breath  out  of  one.       Puhii- 
tilla,   JVnx  vomica,   and   Cnlorynth  are  the  r»»medios.     Any  one  o; 
thoni  will  bo  likely  to  afford  prompt  relief.     Dioscorea  is  usidul. 

Inflammation  of  the  Bowaia. 

A  severe  pain  in  the  bowels,  with  distention,  and    such  sflflHBkto 
the  touch  that  weight  or  pressure  cannot  be  borne,  betokens 


mmnm. 


m 


tion.  Aconite  may  be  given  in  the  usual  dose,  every  half-hour  at  first. 
If  perspiration  occurs,  and  the  vomiting  continues,  give  Bryonia  in  the 
same  way.  If  there  is  tympanitis,  or  distention,  so  that  percustuon  upon 
the  bowels  causes  them  to  sound  like  a  drum,  Terebinthe,  Aritenicum,  and 
Mercurias  must  be  consulted.  If  the  discliar<j;es  from  the  bowels,  wliile 
the  inflammation  lasts,  are  acrid,  give  Arsenicum,  and  follow  with  i?ry— 
onla.  If  there  is  strangury,  or  inability  to  pass  urine,  Cantharis,  It 
would  be  better,  in  treating  so  formidable  a  disease  as  tliis,  to  drop  ten 
drops  of  tlie  seltH'tcd  remedy  into  half  a  tumbler  of  water,  and  give  a 
tcas[)oonful  every  ii.iir-hour  or  hour,  until  ainoliitnition  or  change. 
Compresses  on  the  abdomen  are  indicated. 

Chronic  Inflammation  of  the  Bowels. 

Acute  inflannnation  of  the  bowels  sometimes  ])a.sses  otF,  leaving  them 
susceptible  to  entailed  inflammation  from  trivial  ';auses  ;  the  mucous  coat 
may  have  been  left  in  a  semi-ulcerated  ccmdition,  from  which  there  will 
be  occasional  vomiting,  and  muco-purulent  diarrhoea.  The  remedies  tor 
this  disease  are  iV^tfrtc  and  iSulphurio  aoid,  Arseniciiin,  Sulphur,  and  PhoS' 
j)horu8.  The  doses  may  be  as  usual ;  but  the  remedy  may  not  be  repeated 
more  than  twice  a  day. 

Inflammation  of  the  Peritoneum. 

Peritoneal  inflammation  is  often  considered  in  connection  with  inflam- 
mation of  the  bowels,  and  requires  nearly  the  same  remedial  treatment. 
The  disease  is  known  by  the  extreme  sensitiveness  of  the  abdomen  to 
touch  ;  and  the  tenderness  is  so  great  as  tt>  be  unable  to  bear  the  weight 
of  bed-clothes.  Aconite  given  in  the  usual  doses  every  halt-hour,  until 
the  skin  becomes  moist,  and  then  Jh^lUidonna,  or  Vcrat.  viriUe.  It 
there  is  thirst,  Arsenicum;  Pulmtilla,  if  in  females.  .Vux  vornica^ 
if  the  bowels  are  constipated.  If  dropsy  of  the  alxlonien  follow, 
give  Ilellehorns  nif].,  or  Apia  mellijica.  Diet,  — a  very  light  gruel 
of  corn-starch  or  farina. 

Diarrhoea. 

A  looseness  of  the  bowels,  which  may  be  watery,  bilious,  pappv,  pain- 
less or  with  pain.  A  merely  relaxed  eoiitliti'>n  ()f  the  bowels  niny  U* 
cured  by  a  single  dose  of  four  globules  o\  PuUatilhi ;  or,  it  not  arre^i«->J 
by  tliir,  give  Jlcrcurius.  A  watt'iy  iliarrlia-a  may  be  arrested  with 
('ha'iioiuHhi,  Nu.c  vomica,  or  I'cratnim;  a  bilious  diarrhiea.  with  A-»»'m''- 
cum  and  Mcntiniis ;  a  painless  and  invohnilary  diarrhiva,  with  Pht'mi'horii 
ariil.  I)ian-li(ea  witii  eolie  recpiires  ('hiiiw.inWa  aii<l  Ctlorpifh  :  tiiig<"d 
witli  l)lo()(l,  Ipecac;  with  undigested  food,  Puhalilla.  From  fruit, 
often  Chinn.  The  do^^e  and  adttiinist ration  nnist  accord  with  tho 
case.  K.ilher  of  the  ixniodies  may  bo  given  in  water,  a  teaspoonful 
every  hour;  fivt^  drops  of  t'le  dilution,  or  t(>M  globules  in  half  a 
tumbler  of  water,  may  be  the  mode  of  preparation.  Tlio  diet  for 
persons  suflering  from  diarrlmvi  may  be  mutton-broth,  beef-toa, 
boiled  uiilk,  or  toast  and  tea,  as  the  patient  may  elect. 


Dysentery. 

One  of  the  moat  formidable  and  prostrating  diaoascs  is  Dysentery.  It 
usually  begins  with  a  diurrhd'a.  thoiigii  ocuasionally  with  constipation,  after 
a  s«asou  oflassitudc.  and  iiicrcasos  until  mucous  discharges  from  the  bowels 
follow.  Tlie  disease  is  diaiacteri/.cd  liy  nmch  stniiiiiug  wlien  trying  to 
evacuate  tlie  bowels.  Tliis  stiaiuing  is  involiuitaiy  mid  i)aiiilul.  .lust  be- 
fore tliere  is  an  inclination  for  a  slool,  tluMc  is  usually  a  sharp  pain  in  the 
lower  portion  of  the  abdomen .  nyscnterie  discharges  are  umcus  mixed 
with  blood,  or  pure  blood,  or  no  bloo<l  at  all.  Kor  dysentery  with  no  blood 
in  tho  stools,  and  yd  much  tenesmus,  (fatnlmtje ;  when  the  tenesmus  is  low 
down,  Aloes;  when  the  nuicus  is  tinged  with  l)lood.  Mercnrius  con-ONiDiiti, 
the  leading  remedy,  especially  if  the  tenesmus  is  painfid.  To  arrest  a  dys- 
entery where  (ho  discharges  are  pun;  blood,  and  very  painful  straiiung  and 
thirst,  Arsenicum.  For  much  tenesmus,  and  discharge  of  nnicus  mixed 
with  blooil,  Ipeaic.  Whichever  remedy  is  administere<l,  let  the  usual  doso 
be  given  immediately  aftc^r  each  stool,  until  relit!V(!d.  The  diet  in  this  dis- 
ease is  .somewhat  important.  Water  cannot  be  allowed  in  great  quantities, 
but  small  bits  of  ice  may  be  held  in  the  mouth  of  tho  patient ;  barley-water, 
flavored  with  lemon,  may  be  allowed  as  a  drink  ;  rice-water ;  and,  if  the 
patient  has  any  appetite,  Ih;  may  be  allowed  mutton-soup,  beef-tea,  and 
lainb-broth ;  but  chicken-broth  umst  be  t;ntircly  prohibited.  Enemas  of 
cold  water  or  rice  water,  after  each  discharge,  arc  beneficial. 


Ohronio  Dysentery, 

Symptoms  much  like  those  of  the  acute,  but  occurs  frequently  a.s  a  weak- 
ness leit  afti'r  a  protracted  attac-k  of  the  acute  form.  Sulphur,  Sulph.  acid, 
Calmrea  cnrb..  Ferritin,  and  (Jiirbo  vigntahiUs  are  remeilies  emplo\'etl  to 
overcome  the  di(Iicult\ .  Sulphur  may  be  given  in  daily  doses  for  a  wliiio, 
and  then  Nitric  acid  or  Sulph.  arid,  or  Calcana,  until  a  (!ure  is  completcfl. 
Diet  in  Chronic  Dysentery  should  be  very  sustaining,  and  wine  u)ay  some- 
times be  allowed. 

Cholera  Morbus. 

This  disease  begins  with  severe  pain  in  tlie  stoma<-h  and  bowels,  and  then 
nevere  vomiting  and  purging,  until  seemingly  there  is  nothing  Idl  to  be  dis- 
liargfd  from  tlie  .syslcin.  Arncuicum  and  Vcrat.dlh.  are  the  leading  reme- 
^li*!s  ;  iVM.c  oumica  mny  be  given  t<>  stop  the  vomiting  ;  Ipecac,  Tart,  emetic, 
Podophylluvi  are  severally  good  remedies,  and  any  one  of  tliem  may  com- 
plete the  cure  ;  four  globules  may  be  given  every  iifteeu  minutes  until  relief 
is  obtained. 

Asiatic  Oholera. 

More  formidable  than  Choleia  Morbus  is  Asiatic  Cholera,  as  its  attacks 
are  insidious :  first,  by  painless  diarrluea,  whuih  seems  to  iiulicate  that  all 
the  contents  of  the  alim(aitary  canal  an'  in  a  soluble  condition.  Floods 
of  rice-water  discharges  pass  fix)m  the  bowels,  and  tho  same  matter  is 
vc)rr>it<'d  profusely.  Alter  a  time,  the  lowc^r  extremities  begin  to  cramp, 
and   then   the  cramps  come  in  the  abdomen ;   and,  if  the  disease  is  not 


biSEASES  INVOLVINO  THE  VARIOUS  ORGANS. 


521 


Arrested,  the  patient  soorv  passes  into  collapse,  and  then  to  the  grave.  The 
treatment  of  this  disease  in  the  early  stjige  is  very  important.  Very  few 
cases  need  to  prove  fatal,  if  timely  resort  to  the  proper  treatment  is 
bad.  As  soon  as  the  jtatient  is  attacked  with  diarrliocu,  let  him  <;o  to  bed, 
and  take  Verati'um  album.  If  lie  has  grt-at  tiiirst,  let  liiin  take  Arseni- 
cum. If  witliout  puin,  P/iosphorio  acid.  If  with  voinitinj;  and  pui'j;iti^, 
;\nd  ^reat  prostration,  7m  wr«/c'w/wr.  Oflicr  renu-dies,  such  as  UlcUeruin, 
Secale  cormdum,  Catnphor.  and  Mercuriiis  rir.  may  l)o  consulted. 
Cuprum  acet.,  if  with  vi(dent  cramps.  The  inediciiios  may  l)o  ad- 
ministei'cd  every  thirty  minutes.  In  the  collapse  stage,  givo  Muri- 
atic acid,  —  ten  drops  in  half  u  tuml)ler  of  water,  a  teaspoonful  (!very 
twenty  minutes.  But  little  time  can  run  to  waste  at  any  stage  of  tho 
disease  ;  every  moment  recjuires  vigilance  and  attention.  Should  the 
disease  pass  over,  and  tho  patient  is  left,  he  mast  first  have  a  stiuui- 
lutiiig  diet,  and  then  more  and  more  geniu'ous,  as  he  can  bejir  it. 

GonstipatioD,  Costiveness. 

A  confined  condition  of  the  bowels  is  scarcely  a  disease  by  itself,  but  a 
symptom  that  attends  many  maladies.  In  a  torpid  state  of  the  livcr,  it  is 
generally  manifest,  and  requires  a  treatment  tending  primarily  to  allect 
tills  (U-gan,  and  thence  tlie  bowels.  VVlii'ii  tliere  is  a  sense  oi  fulness  in 
die  rectum,  Bryonia;  when  a  teilious  coiisti|iation,  that  indicates  great 
ior|)idity  of  the  bowels,  Lycopodium  ;  a  constipation  following  a  diarrhoea 
re'.|uires  Merairius  viv.  or  iSulphiir  ;  a  constipation  resulting  from  a  col- 
lection of  hardened  faiccs  recpiircs  Sulphur  '.\\\<\  N'ux,  vomica,  or  Sili~ 
cea.  Two  doses  a  day,  of  any  of  the  remeclies,  will  be  siilKeient. 
A  diet  for  those  addicted  to  habitual  constipation  is  important:  corn- 
lueal  mush,  brown  bread  or  bran  bread,  prunes,  apples,  and  other 
kinds  of  fruit  are  reconnnended. 

Invermination,  Worms. 

This  trouble  is  indicated  by  tlie  cliiid  iiickliig  its  nose,  and  by  vora- 
cious ajmerite,  restlessness  at  niglit,  colic,  and  souu'times  diarrlia-a  and 
jiale  exp.'ession  of  the  face.  Tlu.'  reineclies  for  this  ditliculty  are  iSantn- 
/(///,  Ci/ia,  Spiyclla,  China,  and  Sulphur.  Santuuln  will  suit  bettei  tor 
(111  long  round  worms,  and  Ciua,  Calrana,  and  Nar.  vomica  for  the  pin- 
'vorui3.     Dose  and  administration  as  usual,  three  times  a  dav. 

Protrusion  of  the  Intestine. 

Falling  of  the  bowels,  as  tho  [)rotrusion  is  usually  termed,  is  caused  by 
protracted  diarrhoea,  and  straining  at  stool,  while  the  intestine  is  weak  and 
relaxed.  Podophyllum,  Mercurius  viv.,  Tgnalia,  and  Aloes  are  reme- 
dies that  will  euro  the  difficulty.  Either  maybe  given  three  times  a  day. 

Aoute  and  Ghronio  Inflammation  of  the  Liver. 

Denoted  by  ])ain  in  the  right  side,  below  tho  ribs,  sometimes  se- 
vere and  at  others  iluU.     If  there  is  fever,  give  Aconite  or  Verat. 


■ 


viride,  and  follow  with  Nux  vomica  in  Acute  Hepatitis,  and  repeat  every 
hour  until  relief  or  chan<;e.  If  much  thirst,  give  Arsenicum.  In  the 
chronic  form,  a  daily  dose  of  Sulphur  or  Sepia,  Mcrcuriua  viv.,  Nux 
vomica,  Pulsatilla,  or  Pudojihyllin,  will  do  as  much  for  the  patient  as  auy 
treatment  in  the  world. 

Jaundioe. 

When  the  gall-duct  of  the  liver  becomes  obstructed,  and  the  bile  i.s 
prevented  from  passing  off  in  the  usual  way,  it  sc-eks  an  escape  throuj;b 
tlie  skin,  and  gives  it  a  yellow  color.  This  is  Jaundice.  Podophyllin, 
Chelidonium,  Mercuriua,  Dulcamara,  Leptandria,  and  ^ux  vomica  .ire 
competent  to  cure  the  severest  cases.  Carho  regrtabilis,  in  a  crude  form, 
may  bo  given  in  massive  doses  wlien  an  offensive  odor  conies  from  tlic 
mouth  or  breath.  The  |):iti(>nt,  having  no  appetite,  must  be  supplied  with 
some  farina  or  rice,  cooked  in  tiie  most  deli(;ate  way. 

Inflammation  of  the  Spleen. 

The  spleen,  being  an  associate  purificatory  organ  with  the  liver,  is 
liable  to  similar  affections.  When  inflamed,  it  is  manifest  by  pain  in  the 
left  side,  below  tlic  ribs.  The  same  remedies  tliat  affect  the  liver  will 
also  affect  the  spleen.  For  congestion  of  the  spleen  caused  by  running, 
unmodeiate  laughter,  etc.,  China,  a  single  ordinary  dose,  will  answer. 

Painter's  Golici 

The  effects  of  lead  upon  the  alimentary  canal  are  sometimes  disastrous ; 
and  painters  who  work  much  in  mixing  the  various  preparations  of  white 
lead  are  liable  to  imbibe  sufllclent  of  its  poisonous  quality  to  give  them  a 
most  distressing  colic:  hence  its  name.  The  remedies  employed  inanti- 
doting  the  cffiicts  of  the  load  aie  Opium  and  Alumina,  or  Colocynth. 
Should  the  first-named  remedy  fail  to  afford  relief,  try  the  next,  and  so  on, 
in  doses  of  three  drops  of  the  dilution  in  a  spoonful  of  water.  Olive  oil, 
a  wineglassftil  every  three  hours,  is  good. 

Files,  Hemorrhoids. 

There  occurs  in  the  rectum  a  class  of  small  tumors,  caused  by  conges- 
tion of  the  hemorrhoidal  veins ;  and  these  sometimes  b;come  so  swollen 
as  to  protrude  from  the  anus.  Sometimes  these  protruding  tumors  are 
numerous,  and  resemble  a  bunch  of  grapes.  They  are  exceedingly  painful, 
and  destnictive  of  comfort.  To  cure  them  is  of  the  utmost  importance. 
Constipation  being  often  one  of  tlie  proximate  causes,  such  remedies  as 
overcome  this  condition  must  be  called  into  use.  Nnx  vomica,  taken  at 
night,  has  often  proved  salutary.  Sulphur,  when  the  tumors  are  painful, 
and  sting  and  burn  so  as  to  be  almost  unbearable.  For  Hleeding  Piles, 
IJamnmelis  Virginica  is  particularly  recommended.  For  excessively  burn- 
ing piles,  Arsenicum;  and  for  those  of  a  blue  color,  Conium,  or  Muriatu' 
acid.  Each  of  these  remedies  may  be  employed  in  the  liquid  form,  and 
three  drops  of  the  dilution  may  be  taken  in  a  spoonful  of  water  every 
eight.  The  tincture  of  Podophyllum  is  also  a  valuable  remedy,  and 
may  be  administered  as  above ;  and  so  also  is  Collinaonia.    To  designate 


l! 


lllt»KA^Eil  OK    IHK    UKSt'lKAlUKY    ORGANS. 


an  appropriate  diet  for  one  afflicted  with  Piles  requires  a  little  care.  Salt 
provisions  must  peneraliy  be  avoided.  Tlie  free  use  of  stimulating  drinks 
IS  pernicious.  Bran-bread  and  fruits  are  commendable.  Meats,  not 
iiijrlily  seasoned,  are  allowable,  and  most  kinds  of  vegetables. 

IfcllinK  of  the  Anus,  which  sometimes  is  a  concomitant  of  Piles 
and  sometimes  of  worms,  is  cured  in  the  fii-st  instance  with  Sulphur^  and 
in  the  latter  with  Cina.  The  usual  dose  should  be  given  night  and 
morning. 


DISEASES  OF  THE  KESl'IRATORY  ORGANS. 


The  organs  of  respiration  embrace  the  nose,  larynx,  trachea,  bronchia, 
lungs,  pleura,  heart,  and  their  ay)pendages.  We  will  therefore  consider 
the  diseases  that  affect  them  in  their  order. 


Ooryza,  Gold  in  the  Head. 

When,  from  exposure  to  cold,  the  nose  becomes  stopped,  and  there  is 
an  inclination  to  sneeze,  and  the  eyes  become  more  or  less  affected,  the 
following  remedies,  as  indicated,  will  prove  useful :  Nux  vomica  at  night, 
should  the  Coryza  be  more  apparent  in  the  afternoon  or  evening,  and 
particularly  if  it  is  attended  with  cold  affecting  the  entin;  system.  Sti- 
biuin,  or  Tart.  «/«.,  is  a  good  remedy  to  lubricate  the  stoppage  of  the 
nasal  passages;  Hepar  sulphur,  also,  when  this  stoppage  is  paiiiiully  dis- 
agreeable ;  .Irttenicum^  or  Euphrasia,  w]wu  Ihere  is  a  thin,  acrid  dis- 
charge from  the  nose.  Fnlsatilla  is  best  for  children  and  ladies,  when 
'•;)trering  from  Nasjil  Catarrh.  Coryza  is  synonymous  with  acute  Ca- 
tarrh, as  both  affect  the  mucous  membrane  that  lines  the  cavities  of 
the  nose. 

CliroiliC  Catarrh  is  much  like  the  Acute,  only  all  the  symptoms  have 
become  persistent.  Acute  Catarrh  is  often  cured  in  a  few  days  by  Mer- 
(•urii(S,  Nux  vomica.  Belladonna,  Pidmtillu,  Tart,  cm.,  Hcpar  aulphnr, 
:  i\A  if^ulphur  ;  Mercuriun,  for  stupciying  iu'adaclK'  with  catarrli  ;  Nuxvoiu- 
ii.a,  when  the  catarrh  occasions  nau.-ca  ;  JicUadonna,  when  thure  aci-oui- 
|i;iiiies  the  difficulty  pain  over  and  in  the  eyes;  Palmtilla,  wiicn  tlii-Te  is 
lii'piossion  ot"  spirits;  Tart,  em.,  Jlrjxir  Kulphnr,  ixud  Su//ihiir,  to  remove 
obstructions  in  tiie  nasal  ducts,  and  tosubihu'  irritation  aiidsoniifss  of  the 
fxternal  orifices  of  the  ducts.     Doses  as  usual,  repeated  threi-  times  a  day. 

Ill  the  treatment  of  Chronic  (/atarrh,  other  remedies  are  called  into 
requisition.  Aurum  metallicvnn,  if  there  is  a  heavy  yellow  discharge  from 
the  nose,  or  crusts  form  at  night;  Mernirtus  I'odatus,  in  scrofidous 
persons;  Au7'um  muriaticum,  if  there  is  any  affection  of  the  vomer, 
or  partition  of  the  nose  ;  Sulphur  and  IJepar  sulphur  mv,  both  vali;- 
ablo  remedies,  as  are  Arsenicum  and  Lachesis,  when  the  peculiar 
symptoms  are  such  as  to  indicate  their  affiliation.  The  remedies  for 
the  chronic  form  need  not  be  repeated  so  often ;  once  in  twenty-four 
hours,  in  the  usual  dose,  is  sufficient. 


624 


DISEASES  OF  THE  RESPIRATORY  OBGARS. 


Inflammation  of  the  Larynx. 

The  upper  part  of  tlie  windpipe,  or  trachea,  is  termed  the  "  Larynx  ;" 
and,  wIk'ii  iiifluincd,  it  is  suid  to  be  aiFected  with  Laryngitis:  and  this  may 
1)0  acute  or  chronic. 

Acufc  liHryii<ci(iM, or  liiiliimmiitioii  of  the  Larynx.  —  This  trouhic  In 

(K'Moti'd  hy  couLjIi,  hoarseness,  and  sr»ru  throat,  alU'ctini;  the  voice,  ami 
rtMnlciinif  respiration  souicwhat  (htfieiilt,  aiitl  conversation  liiti^ninu'  "r 
paiiil'ul.  It  c6ii)('S  on  ti'oni  a  cold,  and  may  lie  the  continuation  ol  u 
nasal  catarrh.  With  the  con^rh  there  is  usually  some  expectoration,  o- 
L'lse  (h'v,  uncoutl'ortable  sensation,  and  inclination  to  he  cU-arin;.'  the  threat. 
ir  the  jtnlse  is  lehril  or  lidl,  jfivi^  Aconite  in  the  lirst  st.i;4e  ;  mid,  >'.'  tiu'i 
is  paint'nl  soreness  of  the  larynx,  j^ive  livUaduiina,  Aconitf  will  rernevt 
tin?  lever,  and  lidladonna  the  conj^estion  of  the  capillary  ve-.-i'|s  of  tin 
muc(»ii8  mombmnc,  which  ctuisos  the  hohmicss.  Afcmn-hiM  V7v.  ofieti 
follows  JJHladiniiHi  well.  If,  aftortho  ciiiploynient  of  lhes(!  r(>m(Mli(>s, 
oxpectonition  «>f  mucus  occurs  from  cou;^hiii<f.  <rive  J'/iit.s/t/i(»nis  or 
Sanginnaria.  If  the  coii<;!i  is  lii^lil,  Jis  if  th(!  larynx  was  closiiii;  up. 
givo  /Samburus.  'VUv  remedies,  in  tlu^  usual  doses,  uiay  \w  v- 
pouted  every  two  hours.     The  diet  should  he  simple,  l)Ut  nutritious. 

Chruuic  Laryu'j,-itis,  or  luliiimiiiutioii  of  tin;  Lur.vnx.  —  The  syni|v 
toms  of  this  form  of  the  disea.se  are  similar  to  thctse  (»f  the  acute  variety, 
only  the  «'ou!^li  an>[  irritatitui  are  constant,  and  the  expectoration  jfoan- 
tinies great.  The  disease  hecoines  chronica  from  the  weakeniiii^of  theori:an 
after  one  (»r  more  acute  attacks  of  the  disease.  It  sometimes  miti^ati's 
in  warm  weather,  and  returns  aa;ain  in  winter.  Art/antuin  mctallicim 
is  a  f^ooil  ri'inedy  for  tin;  chronic  form,  when  characterised  hy  soreness  (it 
the  throat.  Jirl/iulonna  is  always  useful  when  the  dillieulty  is  aggravated 
by  a  cold  ;  Ph'ispfwnis,  when  there  is  considerahle  collection  of  nmcus. 
and  Ui'par  Kii/ftltiir  when  there  are  excessive  dryni'ss  and  hoarseness. 
Caustifiiin  is  particularly  useful  when  the  inllaininatiou  is  persistent,  ami 
the  cough  constantly  excited,  and  when  it  resembles  a  croupy  cough,  ami 
comes  i)n  spasmodically  or  in  |)aroxysms.  When  Chronic  Laryngitis  is 
iu)t  kept  in  cheek  or  cured,  it  soon  runs  into  that  formidable  disease 
known  as  Laryngeal  Consumption,  or  becomes  attended  with  hectic  fever. 
In  such  a  case,  give  St(inn>iin,  or  perhaps  S  id  pi  air ;  but  in  no  case  uhmv 
than  one  dose  a  day.  The  patient  should  be  warmly  clothed,  and  slioulil 
always  provide  lor  tempering  ct)hl  air  before  it  is  inhaled  into  the  \\x\\^i. 
The  diet  must  bo  nutritious,  and  strictly  non-inodicinal. 


Group. 

Croup  is  of  two  kinds,  spasmodic  and  membranous.  The  spasmodic  is 
the  result  of  a  cold  ;  and  it  comes  on  with  a  hoarse,  rough  cough,  which  is 
often  spasmodic  and  suflocating.  Tiie  catarrhal  or  membranous  conies 
on  like  a  cold,  and  then  supervenes  a  crowing  cough  and  copious  collec- 
tion of  mucus ;  and  sometimes  an  exudation  of  a  membranous  charactir 
fills  the  larynx  and  upper  portion  of  the  trachea.  For  spasmodic  croup, 
Tartar  tmetia  is  undoubtedly  the  best  remedy ;  Aconite^  when  there  is 


fever:  Belladonna,  if  tlio  throat  is  sore ;  Ipecac.,  if  the  brcatliing  is  asth- 
inutic.  In  membranous  croup,  u  resort  must  be  had  to  Aconite  ut  first,  to 
induce  perspiration  ;  if  this  fails,  give  Brtfonin,  and  then  Spongia  Iodine, 
Bromine,  and  Hepar  nulph.,  in  the  order  mentioned.  The  usual  doses 
may  be  given  every  fifteen  or  twenty  minutes  wlien  the  symptoms  are 
alrrming.  Croui)  goes  under  the  teeluiical  name  of  C'yuanciie  TrachcaliB, 
because  it  implicates  both  tliu  larynx  and  windpipe. 

• 

Inflammation  of  the  Windpipe.  —  Tracheitis. 

There  is  some  resemblunee  of  this  disease  to  croup ;  and  yot  it  may 
occur,  and  not  munifest  tiuit  peculiar  character.  It  is  denoted  by  cough, 
wtnu'tiines  exceedingly  tight,  at  others  looser,  gnjater  or  less  obstruction 
of  the  breathing,  and  some  pain  and  soreness  of  the  throat  above,  und  a 
tickling,  raw  feeling  below,  towards  the  bronithial  tubes.  Aconite  is 
eHsciilial  in  tho  treatment  of  this  dilllcully,  and  also  IieUad<mna,  Bryonia, 
Plioxphorua,  Causticuin,  Ili'pai\  ISonyiiiuaria,  and  Spnngia.  It  is  to  bo 
oltHcrved,  however,  that  only  one  of  tiieso  remedies  must  be  given  at  a 
time  ;  fivo  drops  in  lialf  a  tumbler  of  water,  and  a  teaspoonful  every  thirty 
miuutcs.     Diet  simple  and  non-medicinal. 

Acute  Bronchial  Inflammation.  —  Bronchitis. 

Ah  the  names  implies,  the  bronchial  tubes  becomes  highly  inflamed  in 
this  disease,  or,  rather,  the  mucous  mcnibrane  that  lines  them.  There 
is  much  cough  and  exp(>ctoration.  This  disease  is  called  Catarriial 
I'cver  in  its  acuto  form  ;  un<l,  when  tho  subsUmce  of  tlu;  lungs  l)ccouies 
utt'ecti'd,  it  amounts  to  rneumonia.  Acute  Kronchitis  requires,  for  the 
reduction  of  fever.  Aconite  or  Bryonia;  BeUiulonna  may  follow;  and, 
ffhcn  copious  expectoration  commences,  give  Phonphnrua;  and,  some 
time  alter,  give  Ilyoacyamns,  especially  for  the  cough  at  night,  and 
also  Caicarea  curb,  for  tho  soreness  and  cough  tliat  may  be  created. 
lie|)cat  the  medicines,  in  tho  usual  doses,  three  times  a  day.  Diet  as  in 
all  febrile  diseases.  Barley  or  flaxseed  tea  for  drink,  and  a  light  diet  of 
toastj  is  best. 


Ohronio  Inflammation  of  the  Bronchia. 

Like  the  acuto  form  of  the  disease,  it  lias  its  seat  in  the  mucous  mom- 
hraiie  that  lines  tho  bronchial  tul)es,  and  is  believed  to  be  tho  seipiel 
of  Acute  Uroncbitis.  It  is  always  accompanied  by  a  cough,  and  more 
or  less  expectoration ;  now  and  tiien  n  paroxysm  of  fever.  It  is  a 
tedious  and  troublesome  disease  ;  ami,  when  not  cured,  is  always  better 
in  warm  weather,  and  much  aj;gravalcd  in  cold  ;  ami  tins  wouhl  point 
ti»  a  perpetual  warm  climate  as  its  cure.  When  there  are  paroxysms 
of  fi;vcr,  give  Ac  mite  ;  if  tlier"  ii  pain  in  the  chest,  Bulladonna; 
profuse  expecti)ration,  Phusphoiua,  or  Lijopod. ;  hectic  fever,  Stan- 
num ;  when  tlio  throat  is  sore,  -rive  ' 'auaticum.  Great  care  must  be 
taken  in  tho  treatment  of  this  n»' iudy,  if  a  cure  is  expected,  or  other- 
wise it  will  terminate  in  a  linger ii.g  cf)i8umption.  The  most  generous 
living  the  patient's  appetite  will  admit  of  must  bo  supplied,  but  free 
from  medicinal  condiments. 


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526 


DISEASES  OF  THE  BESPIRATOBY  0B6ANS. 


Lung  Fever.  —  PncMwionio. 

Lung  fever  is  indicated  by  pain  in  the  chest,  cough,  flushed  face,  quick 
pulse,  rusty  expectoration,  her^dache,  loss  of  appetite,  and  oppressed 
breathing.  Aconite  or  Bryonia  may  be  given,  in  the  usual  dose,  every 
hour  until  the  sivin  becomes  moist ;  Belladonna,  if  the  pain  continues 
in  the  chest,  every  hour  until  relief,  or  a  change  is  necessary  ;  Bvy 
onia  may  follow  Belladonna,  if  heat  in  the  chest  is  a  prominent  symp- 
tom ;  and  Phospliorus  may  follow  Bryonia,  provided  the  expectoration 
has  changed,  and  a  more  plentiful  secretion  of  mucus  is  thrown 
off.     Each  medicine  may  be  given  in  hourly  doses  when  called  for. 

This  disease  becomes  Typhoid  Pneumonia  when  the  fever  accompany- 
ing the  inflammation  is  typhoid  ;  in  which  event  Bryonia  may  be  given 
in  the  first  stage,  and  Belladonna  if  there  is  a  manifest  inclination  to 
sleep.  When  the  patient  begins  to  cough  up  mucus  tinged  with  blood, 
give  Phosphorus  ;  and,  if  very  much  prostrated,  give  Rhus  tax.  As  to  diet 
in  Pneumonia,  give  the  patient  any  light,  nouriehing,  and  soothing  dnnks, 
as  jelly-water,  barley-water,  rice-water,  &c.  Application  of  warm  com- 
presses to  the  chest  is  recommended. 

Whooping  Cough.  —  Tussis  Spasmodica. 

This  disease  often  comes  on  like  an  ordinary  cold,  and  the  victims  are 
observed  to  have  frequent  coughing  fits  ;  and  when  there  is  no  fever  or 
loss  of  appetite,  and  the  fits  of  coughing  continue  to  be  repeated,  it  may 
fairly  be  inferred  that  whooping  cough  is  progressing.  Soon  the  child  or 
patient  will  begin  to  whoop,  and  to  experience  frequent  paroxysms,  and 
draw  in  a  long  breath,  or  whoop,  which  is  followed  by  numerous  short 
expirations.  By  sera  will  mitigate  the  severity  of  the  paroxysms,  and 
80  will  liyoscyamus,  Corallia  rubra,  8anguinaria,  and  Oausticum  ; 
Chelidonium,  if  there  are  symptoms  of  pulmonary  congestion  ;  but 
there  is  no  remedy  known  that  will  break  it  up  at  once.  Give  si 
dose  of  the  selected  remedy  immediately  after  each  paroxysm. 

Pleuritis.  —  Pleurisy. 

Inflammation  of  the  pleura  is  denoted  by  sharp,  shootmg  pains  in  tln' 
sides  of  the  chest,  that  interfere  with  respiration ;  quick  pulse,  flushed  liu 
great  heat  over  the  chest,  &c.     Aconite^  in  the  usual  dose,  may  be  givci 
every  twenty  minutes,  and  a  cloth  compress  of  warm  water  may  U- 
applied  to  the  region  of  the  pain.     Aconite  may  be  followe<l  with 
Phosphorus,  given  every  hour  until  relieved.     Bryonia  is  good. 

Asthma. 

Difficult  and  laborious  breathing  may  be  hereditary,  or  be  brought  on 
by  a  cold,  over-exertion,  or  exposure  of  some  kind.  It  comes  on  <n 
paroxysms  that  sometimes  interfere  with  the  respiration  to  so  great  a 
degree  as  to  oblige  the  patient  to  sit  or  stand  in  order  to  get  breath. 
Many  cases  are  entirely  curable  with  Ipecac^  Arsenicum,  Apis  mellijica, 
Apocynum,  Lobelia,  and  Tart,  emetic.  When  one  remedy  fails,  ti  v  the 
next,  until  a  fair  warfare  with  the  disease  has  been  encountered. 


Bleeding  from  the  Lungs. 

This  trouble  is  occasioned  by  the  rupture  of  some  of  the  blood-vesseli 
in  the  bronchial  tube,  caused  either  by  mechanical  injury  or  tubercles. 
IF  from  the  former,  Arnica  is  the  remedy  ;  if  from  the  latter,  Hamame- 
lis.  In  case  of  pain  and  inflammation,  give  Phosphorus  ;  and  if  motion 
iiggravates,  give  Bryonia.  Let  the  patient  sit  up,  if  able,  in  an  easy- 
iliair,  until  tho  bleeding  ceases.  If  fever  and  excitement  of  the  cir- 
culation exist,  give  Aconite  often. 

Consumption. 
Tliis  formidable  disease  may  be  hereditary,  or  result  from  accidental 
r;auses.  When  hereditary,  it  may  not  develop  itself  until  adult  age  ;  and 
one  of  the  first  signs  is  extreme  sensitiveness  to  cold,  a  slight  cough, defec- 
tive nutrition,  and  extreme  emaciation  ;  night-sweats  come  on  subsequent- 
ly, with  hectic  fever ;  and,  at  a  later  stage,  there  may  be  diarrhoea,  which 
resists  remedial  measures,  and  exhausts  the  life  of  the  patient.  That  kind 
brought  on  as  the  sequel  of  primary  affections  usually  supervenes  upon 
bronchitis  or  some  other  exhaustive  disease  that  proves  destructive  to  nu- 
trition. In  the  first  stage,  or  when  chilliness^  debility,  and  loss  of  flesh 
become  apparent,  much  benefit  can  be  obtained  from  the  use  of  good  old 
Bourbon  or  rye  whiskey :  fro;n  a  half  to  a  whole  wine-glassful  may  be  taken 
twice  a  day.  The  introduction  of  carbon  into  the  system  in  this  way 
lias  often  proved  of  great  service.  When  there  is  deep-seated  pain  in  the 
lungs,  especially  in  the  upper  portion,  i?/coj90(Zmm;  the  usual  dose  maybe 
given  every  day,  and  continued  as  long  as  any  benefit  is  peiceived.  Z^- 
eopodium  may  be  followed  by  Stannum  or  Sulph.,  provided  there  is 
any  hectic  fever ;  by  Carbo  animalis  when  there  are  night-sweats.  If 
the  cough  becomes  troublesome,  and  the  expectoration  muco-purulent. 
Phosphorus  in  the  usual  dose  may  be  given  twice  a  day.  If  occasional 
hemorrhage,  Belladonna  may  be  given,  if  there  is  pain  ;  Ipecac.  ^  if 
(here  is  asthmatic  breathing ;  and  Hamamelis  vir. ,  if  there  is  bleed- 
ing from  the  lungs  without  much  pain.  For  the  first  stage  of  bron- 
chial consumption,  see  the  treatment  directed  for  Bronchitis.  After 
tubercles  become  manifest,  the  same  remedies  may  be  indicated  as 
for  the  hereditary  disease.  The  diet  for  consumptives  should  be  fish, 
game,  beef,  mutton,  and  vegetables  such  as  potatoes,  beans,  and  egg- 
plant ;  butter  and  cream,  with  toast,  are  also  allowable.  Let  the  £et 
be  as  generous  as  the  patient  can  take. 


For  the  oonolusion  ot  Homoeopatoio  Temeoies,  see  pages  785  to  878. 


PROCESSES   OP  fHS  HYDROPATHIC  TREATMENT. 


For  the  description  of  the  hydropathic  appliances  contained  in  the 
following  pages,  I  am  indebted,  in  substance,  to  the  "  Hydropathic 
Family  Physician,"  by  Joel  Shew,  M.  D.,  author  of  several  popular 
works  upon  the  principles  and  practice  of  hydropathy.  I  have  not 
uniformly  adopted  his  exact  language,  wiiich  is  not  always  the  best 
he  might  have  chosen  to  express  his  thoughts. 

Priessnitz  is  admitted  to  have  been  the  originator  of  the  hydro- 
pathic modes  of  treating  diseases.  He  was  an  unlearned  man,  though 
he  had  original  powers  of  mind ;  and,  imperfect  as  the  treatment  is, 
he  benefited  his  race  by  conferring  it  upon  the  woild. 

At  first,  and  for  some  time,  baths  were  made  too  cold,  and  were 
continued  too  long;  the  result  was,  much  injury  to  the  patient  in 
many  cases.  Tin>e  and  experience  have  brought  a  better  adaptation 
of  the  temperature  and  continuance  of  the  water  appliances  to  the 
symptoms,  constitution,  and  temperament  of  each  patient.  Formerly, 
weak,  exhausted,  and  nervous  persons,  not  less  than  the  fuU-biooded 
and  strong,  were  put  into  the  wet-sheet  pack,  and  reduced  near  to 
death's  door ;  and  there  is  reason  to  believe  that  in  some  cases  where 
the  practice  is  in  ignorant  hands,  this  barbarity  is  not  wholly  discon- 
tinued. The  practice,  however,  is  now  mainly  in  better  hands ;  and 
although  I  by  no  means  admit  its  sufficiency  as  a  system  of  remedial 
agencies,  I  am  persuaded  it  is  doing  some  good.  Used  in  connectioiv 
with  the  ancient  system  of  regular  medicine,  which  is  the  joint  pro- 
duct of  time,  science,  and  experience,  the  water  treatment,  moulded 
and  modified  to  the  circumstances  and  strength  of  the  patient,  is  an 
auxiliary  of  no  mean  power.  As  such,  I  accept  it  As  such,  it  is  re- 
ceived by  hundreds  and  thousands  of  regular  practitioners  throughout 
the  world.  Further  than  this,  it  never  can  or  will  be  generally  re- 
ceived. By  pushing  it  beyond  this,  its  rightful  and  honored  sphere^ 
its  friends  only  limit  its  progress,  and  injure  its  influence. 

The  following  is  the  substance  of  Dr.  Shew's  description  of  hydro- 
pathic appliance. 

The  Wet-Sheet  Pack. 

In  this  process  a  coarse  linen  or  cotton  sheet  is  used,  long  enough 
to  reach  from  the  patient's  head  to  'he  soles  of  his  feet,  arid  about 
two  yards  in  width.     The  bed  is  stripped  of  all  its  covering,  one  or 


Via.  178. 


two  pillows  only  being  left  for  the  head.  One  or  two  comforters  are 
then  spread  upon  it,  and  over  these  the  same  number  of  woollen 
blankets,  which  are  less  injured  by  wet  than  cotton  comfortables. 
The  sheet  having  been  pretty  well  wrung  out  of  cold  water,  —  always 
pure  and  soft,  if  such  can  be  had, — is  then  spread  out  smoothly  upon 
the  blanket.  The  patient,  being  undressed,  lays  himself  upon  the 
sheet,  and,  his  arms  being  held  up,  an  assistant  laps  one  side  of  it 
over  the  body  and  lower  limbs  ;  when,  the  arms  being  dropped  at  the 
sidp,  the  other  part  of  the  sheet  is,  in  like  manner,  lapped  over.  The 
blankets  are  then,  one  by  one,  brought  over 
the  person  in  the  same  way,  and  tucked 
under  from  head  to  foot  Comfortables 
may  be  added,  if  necessary.     (Fig-  178.) 

It  is  always  Oest  i-o  place  a  wet  towel, 
covered  with  a  dry  one,  on  the  patient's 
head  while  he  is  packed.  If  too  much 
chill  is  not  produced,  the  dry  one  may  be 
left  off. 

This  is  the  ordinary  way  of  taking  a  pack 
in  chronic  disease. 

'J'he  wet  sheet  is  one  of  the  most  soothing  and  agreeable  of  all  the 
water  appliances.  Hence  it  is  that  it  is  so  often  misused.  It  is  so 
delightful,  and  tends  so  much  to  produce  slumber,  that  the  patient 
never  feels  ready  1o  get  out  of  it.  But  this  slumber,  —  so  profound  and 
sweet  as  it  often  is,  —  he  should  remember,  way  be  only  an  apoplectic 
stupor,  which  leaves  him  with  a  swimming  head,  attended  with  faint- 
ness,  perhaps,  and  ending  in  a  severe  headache ;  giving  him,  in  short, 
a  congestion  of  the  brain.  All  this  happens  in  consequence  of  robbing 
the  skin  too  long  of  the  air  it  should  breathe. 

There  has  been  a  notion  at  some  of  the  establishments  that  the 
wet  sheet  is  to  be  used  for  sweating ;  and  to  this  end,  the  patient  has 
been  literally  stewed  hour  after  hour,  in  some  cases,  even  fuur,  five, 
and  six  hours  in  succession,  with  the  view  of  sweating  him.  All 
such  practice  is  hurtful.  If  the  patient  gets  better  under  it,  it  is  iii 
consequence  of  the  good  effects  of  water  used  in  other  ways,  coupled 
with  the  ever-important  adjuncts,  air,  exercise,  and  diet.  In  later 
times,  Priessnitz  never  sweat  patients  at  all,  much  less  in  wet  sheets. 
If  a  man  must  sweat,  leave  off  the  wet  sheet  assuredly,  as  that  only 
hinders  the  operation.     Use  the  blanket  pack,  or  the  vapor  bath. 


How  Lony  shall  the  Pack  Continue  ?  —  Here,  too,  tliere  has  been, 
and  still  is,  much  error  in  hydropathic  practice.  "  Stay  in  the  pack 
till  you  get  warm,"  has  been  the  old  doctrine.  But  some  get  warm 
at  first,  and  afterward  get  cold  ;  —  so  at  least  they  feel.  What  is  to 
be  done  ? 

One  of  Priessnitz's  improvements  was,  to  give  short  packs.  "  Re- 
main enveloped  for  fifteen  or  twenty  minutes  only,"  he  saul.  "  If  you 
are  not  able  to  bear  the  pack  in  that  way,  take  the  rubbing  wet  sheet 
and  the  lighter  processes  until  you  are."  In  some  cases  he  gave  two 
or  three  of  these  short  packs  in  succession,  the  patient  rising  between 


rw 


530 


PROCESSES  OF  THE  IIYDROPATTIIC  TREATMENT. 


each  to  take  an  airing,  a  rubbing  wet  sheet,  or  other  bath,  and  then 
returning  to  the  pack. 

Thus  far  the  wet  sheet  has  been  spoken  of  jis  used  in  chronic  dis- 
eases. In  acute  attacks  it  is  managed  differently,  according  to  the 
case.  If  the  object  be  to  abstract  caloric  from  the  body,  we  cover  the 
sheet  but  little,  —  with  a  single  dry  shec^t,  or  a  blanket  or  two,  or,  per- 
haps, with  noMi;  of  these. 

We  know  that  if  we  keep  a  towel  about  a  keg  of  water  in  a  hot 
day,  th(^  water  will  l)c  made  cooler  by  evaporation.  In  the  same  way, 
when  a  paticMit  is  hot  and  feverish,  we  keep  one,  or,  still  better,  two 
\vr\  slieets  around  him,  without  oth(!r  covering,  and  thus  bring  down 
the  licivt  and  circulation  to  any  desirable  degree.  We  sprinkle  watfer 
upon  the  sheets,  or  rewet  them  as  often  as  is  necessary,  —  in  some 
extreme  cases  of  fever  continuing  them  a  whole  week  or  more.  Ex- 
perience teaches  that  the  continuous  applicatio'i  of  the  wet  linen  is, 
in  such  cases,  a  most  serviceable  application,  and  one  that  tends  most 
powerfully  to  induce  in  the  dermoid  structure  its  natural  and  health- 
ful state. 

The  Wet  Sliect  Acts  by  Absorption.  —  It  draws  morbific  matter  out 
of  the  body,  as  any  one  may  see  who  applies  the  sheet  for  a  short 
time,  and  then  washes  it.  Observe,  too,  what  an  odor  comes  from 
the  sheet  when  a  diseased  j)atient  has  been  packed.  At  the  same 
time,  it  absorbs  the  pure  water  into  its  finest  tissues  on  a  large  scale, 
thus  supplying  that  duid  which  of  all  substances  the  system,  under 
such  circumstances,  most  needs.  This  moist  warmth  of  the  sheet 
also  acts  as  a  most  soothing  poultice. 

The  Wet  Press. 

A  MODIFICATIo^:  of  the  wet  sheet,  and  in  some  respects  an  improve 
ment,  is  the  "  wet  dress,"so  called. 

A  coarse  linen  or  coiton  dress  is  made  with  large  arms,  so  that  one 
may  take  the  application  without  help.  The  dress  being  wet  and  ap* 
plied,  the  patient  lays  himself  upon  blankets,  in  which  he  wraps  himself 
just  sufficiently  to  become  comfortable.  Or,  he  may  have  dry  flannel 
dresses  to  put  on  over  the  wet  one,  and  then  lie  in  a  common  bed 
In  this  application,  the  air  is  not  excluded  from  the  surface  to  any 
thing  like  the  same  extent  as  in  the  common  tight  pack.  Hence,  i. 
patient  may  remain  in  it  a  half,  or  the  whole  of  the  night,  if  he 
chooses,  —  being  careful  to  become  neither  too  warm  nor  too  cold 
Rewetting  once  or  twice  in  the  night  will  be  of  service.  Often  in  a 
single  night  a  bad  cold  may  be  thrown  off"  in  this  simple  way. 


The  Half  Pack. 

Many  patients  have  so  little  reactive  energy,  that  while  they  can 
bear  a  half  pack,  so  called,  the  entire  sheet  would  abstract  so  much 
caloric  from  the  body  as  to  injure  them.  In  such  cases,  the  sheet  is 
to  be  applied  so  as  to  extend  only  from  the  arm-pits,  or  at  most,  from 


rilOCKSSES  OF  THE  HYnUOPATHIC  TREATMENT. 


5;n 


thn  neck  to  the  hips,  leaving  the  lower  extremities,  as  it  \vi  re,  in  the 
dry  park.  Sometimes  the  sheet  is  allowed  to  extend  to  the  ankh's, 
not  ineinding  the  feet.  Packing  the  trunk  of  the  body  in  wet  towel:>. 
acts  upon  tlie  same  principle  as  the  partial  or  half  pack,  and  is,  in 
many  cases  a  valuable  preliminary  measure.  It  is  well  to  take  these 
preparatory  steps  when  a  patient  who  has  sulll'red  long  from  <rhronic 
disease,  is  beginning  with  the  eiivclopinent. 


m 


The  Folded  Wet  Sheet. 

In  domestic  practice,  a  modi licat ion  of  the  wet  sheet  may  be  had 
by  fokliiig  fonr-doul)le  a  common  coarse  sh(>et,  for  enclosing  the 
trunk  from  the  armpits  down.  Two  thicknesses  of  this  are  wet  in 
cold  water,  to  come  niwt  the  body. 

This  is  a  valuable  applicati»)n  in  a  host  of  ailments,  as  pleurisy, 
iridaimnation  of  tlu;  lungs,  inflammation  of  the  bowels,  colic,  cholera, 
cholera  morbus,  rlunimatism,  painful  menstruation,  after  pains,  etc. 
This  remedy,  which  can  be  applied  in  live;  minutes,  will  often  soothe 
a  patient  (piietly  to  slee|),  whose  lot,  without  it,  would  be  a  night  of 
agony.  One  advantage  of  this  application  is,  that  if  a  patient  is  loo 
,weak  to  rise,  the  sheet  may  be  opened  in  front,  so  that  fresh  water 
may,  when  needed,  be  sprinkled  upon  it,  and  wet  towels  may  be 
added  under  it,  upon  the  abdomen,  if  necessary. 

In  all  the  methods  of  applying  the  wet  sheet,  there  can  be  no  pos- 
sible objection  to  using  warm  bricks,  bottles,  etc.,  for  the  feet  when 
cold. 

Bath  after  the  Pack.  —  It  is  the  practice  generally  to  take  some 
form  of  the  bath  after  the  pack.  If  the  patient  is  too  feeble  to  rise, 
an  ablution  is  performed  while  he  is  in  bed.  In  other  cases,  a  wet- 
sheet  rubbing,  shallow,  plunge,  towel,  or  other  bath  is  resorted  to,  but 
not  strictly  of  necessity.  It  is  better,  however,  as  a  rule,  to  make  the 
process  a  compound  one,  that  is,  to  take  some  form  of  bath  aftef  the 
pack.  This  should  also  be  followed  by  exercise  in  the  open  air,  if  it 
can  possibly  be  taken.  A  pack,  followed  by  a  faithful  turn  at  work, 
or  by  exercise  in  the  open  air,  is  always  worth  much  more  than  when 
followed  by  rest  within  doors. 

The  Rubbing  Wet  Sheet. 

The  rubbing  wet  sheet,  too  little  appreciated,  and  too  seldom  used, 
is  one  of  the  most  valuable  of  all  the  hydropathic  resources.  There 
is  probably  no  other  single  application  of  water,  in  all  the  multiform 
modes  of  hydropathic  medication,  that  can  be  made,  on  the  whole,  as 
useful  as  this.  It  is  a  tonic,  a  stimulant,  a  sedative,  an  antispasmodic, 
a  derivative,  or  a  febrifuge,  according  to  the  circumstances  under 
which  it  is  applied. 

We  take  a  coarse  linen  sheet,  —  although  cotton  answers  a  very 
good  purpose,  —  large  enough  to  throw  around  the  body  like  an  In- 
dian's blanket     It  is  wrung  more  or  less,  according  to  the  demands 


r)d2 


I'UOCKSSES  OF  THE  HYDROPATHIC  TREATMENT. 


case.     Thereupon,  it  is  thrown  quickly  around  the  patient's 
who,  if  strong  enougli,  is  in  the  standing  posture ;  and  then, 


of  tht 

body, 

both  patient  and  assistant  set  vigorously  to  ^,^^  j.g 

•\vork,  rubbing  over  the  sheet,  not  vnlh  it, 

as  some  do,  three,  four,  or  more  minutes, 

until  the  surface  becomes  thoroughly  warm 

(Fig.  179). 

It  there  is  fever,  less  friction  is  required. 
After  the  wet  sheet,  comes  a  drt/  one,  to 
be  used  in  the  same  manner.  Those  who 
have  sullicient  reactive  energy,  —  and  most 
have,  —  may  dry  the  body  simply  by  fan- 
ning it  with  the  dry  sheet,  the  windows  at 
the  same  time  being  open.  This  sort  of 
air-bath  exerts  a  highly  pleasurable  effect 
upon  the  skin.  Instead  of  giving  one  a 
cold,  it  helps  greatly  to  ward  it  off.  This  method  of  drying  the  body 
was  one  of  Priessnitz's  later  improvements. 

The  rubbing  wet  sheet,  it  should  be  remembered,  is  not  a  single 
application,  capable  of  producing  only  one  effect.  It  is  used  in  three 
different  gradations,  and  to  produce  very  ditTerent  results.  It  is  well 
wrung,  or  only  moderately  wrung,  or  left  quite  wet  and  dripping.  If 
a  person  is  fatigued,  or  has  a  low  degree  of  reactive  energy,  the  first 
form  is  the  one  to  adopt ;  if  there  is  not  much  fatigue,  and  good  re- 
active energy,  the  second ;  and  if  the  patient  is  feverish,  and  the 
object  is  to  abstract  heat  simply,  we  use  the  sheet  quite  wet  and  drip- 
ping ;  and  we  repeat  it  as  many  times  in  succession  as  the  case  may 
need.,  One  great  advantage  is,  that  we  give  it  before  or  after  a  wet 
pack,  when  no  bath  is  at  hand ;  we  also  give  it  in  connection  with 
an^  other  bath  ws  may  choose. 

See  how  admirable  a  remedy  the  rubbing  wet  sheet  is,  when  pro  v 
erly  understood !  A  patient,  —  a  child,  perhaps,  —  is  so  feeble  in  the 
reactive  power,  that  almost  any  form  of  bath  we  can  give  it  sends  the 
biood  from  the  surface,  making  the  lips  and  nails  pale  or  blue,  and 
the  extremities  cold,  showing  congestion  of  the  internal  organs. 
When  a  bath  produces  such  effects,  it  is  very  apt,  to  say  the  least,  to 
do  more  harm  than  good.  But  we  can  apply  the  rubbing  wet  sheet 
in  such  a  way  as  to  cause  none  of  these  ill  effects ;  besides,  it  may 
be  repeated  many  times  in  the  day,  so  as  to  give  the  patient  the  ad- 
vantage of  a  strong  treatment ;  for  a  lig-ht  treatment,  which  can  be 
easily  borne.  Is  made  a  strong"  one  by  the  frequency  of  its  repetition, 

A  wet  sheet,  well  wrung,  holds  perhaps  a  pint  of  water;  or,  at 
most,  a  quart.  Now,  it  must  appear  plain,  that  a  pint  or  quart  of 
cold  water,  spread  over  so  large  a  surface  as  the  whole  skin,  must  be- 
come very  easily  warmed  by  the  body's  heat.  Besides,  if  there  is 
g'reat  delicacy  of  constitution,  we  may  wring  the  sheet  out  of  water 
at  seventy,  eighty,  or  even  ninety  degrees,  gradually  lowering  it  as 
the  patient  can  bear  it. 

The  domestic  availabiliti/  of  this  application  is  also  to  be  spoken  of. 
Ti?.  every  dwelling,  however  humble,  there  is  the  coarse  sheet,  and  the 


bucket  of  water.     How  useful,  therefore,  as  a  resort,  in  home  prac- 


tice ! 


The  rubbing  wet  sheet  appears  a  trifling  application,  —  one  which 
is  not  capable  of  producing  any  great  result.  But  when  we  rcmem- 
bor  the  myriads  of  nerves  of  aninjal  life,  spread  over  the  skin,  and 
(l(!riv('d  from  the  brain  and  spinal  cord,  it  need  not.  surpri/e  us  that 
its  a|)plication  should  so  invigorate  the  body,  take  otl'  bodily  and 
mental  depression,  remove  languor  and  fntigue,  expel  flatus  from  the 
bowclt^,  remove  thirst,  give  appetite,  and  cause  a  feeling  of  calmness 
and  relief  which  can  be  appreciated  only  by  those  who  experience  it. 
A  minister,  for  example,  j)reaches  three  times  on  a  Sunday,  nnd  gets 
his  brain  so  excited  that  he  cannot  sleep.  A  cold  bath  would  be  too 
powerful,  and  opiates  would  only  act  as  stimulants,  making  the  mat- 
ter worse.  Two  or  three  successful  applications  of  the  rubbing  wet 
sheet,  with  powerful  friction,  bring  the  blood  so  much  to  the  surface, 
that  his  brain  becomes  relieved,  and  he  very  .«ioon  falls  into  a  sound 
and  refreshing  sleep.  So,  too,  when  a  man  has  been  long  wet  and 
drenched  on  a  rainy  day,  and  comes  home,  with  the  surface  and  ex- 
tremities cold,  and  the  blood  pressing  hard  upon  the  brain  and  other 
internal  organs,  —  the  well-wrung  rubbing  sheet  is  applied,  with  plen- 
tiful friction,  and  at  once  the  oppressed  organs  are  set  free. 

In  using  the  rubbing  wet  sheet,  as  in  all  other  forms  of  general 
bath,  it  is  well  to  wash  the  hands  and  face  in  cold  water,  both  before 
and  after  it.  There  is  no  need  of  throwing  it  over  the  head,  as  some 
have  thought  it  necessary  to  do.  A  patient  needs  to  breathe  freely 
when  he  takes  a  bath. 

This  a|)plication  is  not  always  the  most  pleasant  cine.  It  does,  in 
S'act,  require  a  good  degree  of  mor' !  courage  to  enable  one  to  endure 
the  first  shock.  The  sensations  produced  by  it  are  worse,  if  possible, 
than  those  from  a  plunge  into  cold  water;  1  mean  the  first  touch  of 
the  sheet  to  the  body.  Nervous  ladies  sometimes  tell  us  they  cannot 
take  the  rubbing  wet  sheet,  when,  at  the  same  time,  they  take  the 
cold  plunge,  which  is  far  more  powerful,  and  perhaps  too  powerful  for 
their  case.  This  unpleasant  feeling  does  no  harm,  for  it  vanishes  in  a 
moment  or  two  after  the  sheet  touches  the  body. 

The  Douche  Bath. 

This  is  the  most  powerful,  but  not  the  most  useful,  of  all  the  hydro 
pathic  appliances.     A  common  douche  consists  of  a  stream  of  watei 
from  one  to  two  inches  in  diameter,  with  a  fall  of  ten,  fifteen,  or 
twenty  feet.     But  douches  may  be  arranged  of  any  desirable  size  and 
height.     (Fig.  180.) 

This  remedy  is  useful  in  paralysis,  stiff  joints,  gout,  rheumatism, 
tumors,  and  old  swellings  of  various  kinds.  Those  who  have  weak 
lungs,  stotnach,  or  other  abdominal  organs,  should  not  resort  to  the 
douche  without  the  best  of  medical  advice. 


The  Shower  Bath. 

This  is  also  one  of  tbo  more  powerful  of  the  hydropat'iio  appli- 
anccs,  and  needs  judgment  in  its  vise.  It  consists,  in  faet,  of  a  vast 
number  of  small  streams  or  douches,  and  hence  is  a  powerful  refrig- 
erant, as  well  as  excitant,  to  the  system.  It  is  useful  to  commenco 
this  bath,  for  a  time  at  first,  only  upon  the  litnbs. 

The  Cataract  Bath. 

This  also  is  one  of  the  more  powerful  of  tin;  hydropathic  processes, 
and  is  to  be  classed  with  the  two  preceding  baths.  Like  them  it  may 
be  said  to  be  stimulant,  toiiic,  and  ulleralive,  while  it  is  also  highly 
sedative  as  far  as  animal  heat  is  concerned. 

The  Hose  Bath. 

Tnitouon  the  modern  improvements  in  India-rul)ber,  gutta  percha, 
leather,  etc.,  it  is  easy,  whenever  there  is  a  small  fall  or  head  of  water, 
to  arrange  what  is  called  a  hose-bath.  It  is  in  |)rinciple  a  douche, 
with  the  additional  advantage  that  it  can  be  made  to  act  upon  any 
part  of  the  body,  and  from  whatever  direction  we  (thoose.  Rightly 
applied,  the  hose  bath  is  a  valuable  remedy.     (Fig-  181.) 


Fia.  180. 


Fia.  181. 


The  Pail  Douche. 

The  process  which  passes  under  this  name  is  taken  thus :  Tlie 
patient  seats  himself  in  an  empty,  shallow,  or  other  bathing  tub,  and 
crosses  his  hands  over  his  chest.  As  many  pails  of  water  as  are  or- 
dered are  then  dashed  over  him  suddenly,  one  after  another,  before 
and  behind  alternately,  —  not  poured,  but  thrown  with  some  force,  by 
first  a  backward  and  then  a  forward  motion  of  the  pail. 

A  better  method  of  using  it  is,  for  the  patient  to  stand  in  an  empty 


PROCESSES  OF   THE  IlYDllOl'ATMlC  TREATMENT. 


5ar. 


bathing  tub,  while  an  assistant  takes  two  pails  of  water,  one  ten  de- 
grees warmer  than  the  otiier,  and  empties  th(^  warmer  half  upon  the 
chest  and  half  upon  the  back,  and  then  bestows  the  colder  pailful  in 
the  same  manner  ;  then  dries  with  friction. 

The  Wave  or  Sluice  Bath. 

This  is  taken  at  the  sluice-way  of  an  undershot  mill-wheel,  or  in 
any  similar  place.  The  patient  takes  hold  of  a  rope,  or  something  by 
wliicli  he  can  maintain  his  position,  and  th(Mi,  iyini^  down,  subjc^cts 
Ills  body  to  tilt!  action  of  the  wafer.  This  is,  on  tlic  whole,  a  pleasant 
and  agreeabu;  bath,  and  in  its  eflects  somewhat-  rcsenibles  the  douche, 
being,  howeviT,  milder  and  safer. 

The  Half  Bath. 

Tins  bath  may  be  used  as  one  of  the  mildest  of  the  water-cnre 
p^o'•.essf^,  or  as  one  of  the  most  powerful.  An  ordinarv  bathing  tub  is 
a  very  good  apparatus  for  the  purpose.  A  good  sized  washing  tub 
will  answer  very  well,  if  there  is  nothing  else  at  hand.  The  water 
should  generally  be  quite  siiallow  in  this  bath,  —  from  three  to  six 
inches.  Priessnitz's  half-baths  were  made  of  wood,  four  or  five  feet 
long,  about  two  and  a  half  feet  wide,  and  twenty  inches  deep.  This 
simple  contrivance  is  one  of  his  most  powerful  remedial  means, — 
that  by  which  some  of  his  highest  triumphs  are  achieved. 

The  water  is  generally  used  of  moderate  tem|)erature,  at  sixty  to 
seventy  degrees  Fahr.,  and,  when  long  continued,  is  changed,  as  it 
becomes  warm  from  the  heat  of  the  body. 

This  bath  may  be  used,  ■ 

First,  as  a  means  of  cooling  the  mass  of  the  circulation  in  the  hot 
stages  of  fever,  and  in  inllammatory  attacks  of  every  kind  ; 

Set'Onilly,  as  a  revulsive,  or  means  of  drawing  blood  in  congestions 
or  inflanunations  of  the  nobler  organs,  the  brain,  lungs,  stomach, 
liver,  etc. 

Thirdly,  as  a  means  of  resuscitation  in  the  shock  of  s(!rious  acci- 
dents, sun-stroke,  and  before,  during,  or  after  apoplectic  and  other  lits 
In  drunkenness  and  delirium  tremens,  the  half  bath  is  a  sovereign 
remc^dy ; 

Fourthly,  as  a  middle  means,  and  preparatory  to  the  general  bath 
in  weak  constitutions.' 

In  the  latter  of  these  indications,  the  bath  is  generally  used  but  for 
a  few  minutes  after  the  wet  sheet,  or  at  other  times,  as  may  be  de- 
sired. In  the  former,  much  practical  knowledge  is  necessary  iii  order 
to  proceed  always  with  safety,  and  to  obtain  the  best  results.  Thus, 
six,  or  even  nine  hours  may  be  required,  with  the  greatest  persever- 
ance, the  patient  being  thoroughly  rubbed  over  the  whole  surface,  and 
,thia  to  be  kept  up  constantly  by  relays  of  assistants,  the  patient's  head 
and  shoulders,  meanwhile,  being  supported. 


I:  i; 


\m. 


"~ii 


536 


PROCESSES  OF  THE  IlYDUOrATriTC  T.IEATMENT. 


The  Plunge  Bath. 

In  sea,  rivor,  and  lake,  as  wrll  as  by  artificial  means,  and  as  a 
matter  of  luxury,  religious  observance,  purific^ation,  and  the  preven- 
tion and  cure  of  dirfcase,  the  phuige  bath  has,  in  all  periods  of  time, 
and  in  ixll  parts  of  the  world,  been  a  favorite  resort.  So  elli(^acions, 
indeed,  has  this  simph;  means  proved  in  healinij;  the  sicU,  that  not  a 
little  su|)erstition  has  been  mir.gled  with  it.  Springs  and  wells  have 
often  been  supposed  to  possess  soiik!  mysterious  |)ovver,  and  for  that 
reason  l)een  named  after  some  |)atron  saint.  \n  this  respect,  the 
world  has  loved  mystery  and  marvellousness  rather  than  the  pure  and 
simple  truth. 

In  hydropathic  practice,  the  plunge  is  much  used ;  but  many  pa- 
tients are  not  able  to  bear  it.  Those  who  are  not  suHieiently  strong 
for  it  at  first,  should  practise  the  rubbing  wet  sheet,  the  half-bath, 
drinking,  exercise,  etc.,  until  the  plunge  can  be  borne.  It  is  a  favorite 
remedy  at  all  the  establishments,  to  be  taken  directly  on  coming  from 
the  wet  sheet  pack.  .     . 

The  Head  Bath. 

FnoM  time  immemorial,  cooling  applications  to  the  head  have  been 
much  depended  upon  in  that  violent  and  dangero'^s  disease,  inflam- 
mation of  the  brain.  All  other  known  r.ic^ans  failing,  certain  obsti- 
nate affections  of  the  heaa  have  been  known  to  give  way  to  affusion 
of  cold  water  upon  the  part.  In  headache,  drunkenness,  delirium 
tremens,  the  delirium  of  fever,  epilepsy,  rheumatism  of  the  head,  dis- 
eases of  the  eye,  earache,  deafness,  loss  of  smell  and  taste,  and  in 
nose-bleed,  this  highly  energetic  remedy  is  brought  to  bear.  In  taking 
it,  the  patient  lies  down,  placing  the  back  of  his  head  in  a  shallow 
dish,  filled  only  an  inch  or  two  with  water.     (Fig.  182.) 


Fio.  182. 


Fio.  188. 


The  Leg  Bath. 

This  is  usefal  in  cases  of  ulcers,  swellings,  eruptions,  gout,  rhea* 
matism,  spriins,  wounds,  etc.,  of  the  leg  or  thigh.      The  relief  and 


PR0CKS8ES  OF  THE  HYDROPATHIC  TREATMENT. 


537 


etrength  obtained,  oft(  n  by  a  single  application  of  this  remedy,  is  truly 
wonderful.  A  variety  of  apparatus  may  be  contrived  for  auminiHter* 
ing  the  leg  bath.  A  eomnion  wooden  tub,  contrived  for  the  purpose, 
like  that  represented  in  Fig.  183,  answers  a  good  purpose.  In  such  a 
vessel,  he  covers  the  inflamed  limb  introduced,  and  cools  the  blood 
flowing  to  it. 

The  Sitz-Bath. 

Convenient  tubs,  wooden  or  metallic,  are  constructed  for  this  bathj 
but  an  ordinary  wash-tub  answers  very  well.  The  vessel  should  be 
Jiir^e  enough  to  permit  the  motion  of  the  arms  in  nibbing  the  abdo* 
men,  sides,  and  hips,  first  witl<  one  hand,  and  then  with  the  other 
Water  enough  should  generally  be  used  to  pretty  nearly  cover  the 
belly.  The  more  movement  and  friction  while  in  this  bath,  the  better. 
It  is  more  conveniently  administered  when  the  tub  is  elevated  two  or 
three  inches  from  the  floor.  Some  undress  the  patient  completely, 
and  place  a  blanket  or  sheet  over  the  upper  part  of  the  body :  bui 
oftener,  only  those  parts  are  uncovered  which  are  to  be  exposed  ^ 
the  water.     (Fig.  184.) 

In  a  variety  of  ailments,  this  bath  is  highly  valuable.  It  may  be 
made  one  of  the  most  powerful  of  all  the  hydropathic  mode.  Lik»: 
all  other  powerful  applications,  it  should  be  taken  only  when  diges- 
tion is  nearly  or  quite  ron  vleted. 

As  a  tonic  to  ,the  stomach,  liver,  bowels,  womb,  spine,  etc.,  this 
bath  is  highly  u  "ful.  In  constipation,  and  other  irregularities,  it  ia 
famous.  Those  of  sedentary  habits  will  find  its  use  of  rare  service. 
For  the  tonic  effect,  ten,  twenty,  twenty-five,  or  thirty  minutes.  If 
continued  for  some  length  of  time,  the  water  is  to  be  changed  once 
or  more,  as  it  would  otherwise  become  too  warm. 


Fro.  184. 


Fio.  186. 


The  Wash-Tnb  Bath. 

Under  a  great  variety  of  circumstances,  the  wash-tnb  bath  ia  as 
invaluable  remedy.     For  example,  a  patient  is  feverish ;  by  setting 


.,t.v  :. 


538 


PROCESSES  or  THE  HTBROI'ATIIIC  TREATMENT. 


him  in  a  wash-tub  half  filled  with  water,  and,  at  the  same  time,  if  we 
choose,  putting  his  feet  in  a  pail  of  water,  cold  or  warm,  according  to 
the  case,  we  may  give  him  any  desirable  amount  of  cooling.  We 
cannot,  indeed,  too  highiy  prize  this  simple  contrivance  for  using 
water,  —  a  means  which  every  family  possesses.     (Fig.  185.) 

The  water,  as  a  general  rule,  should  be  tepid,  ranging  from  72°  to 
90°,  and  may  be  prolonged  from  two  to  fifteen  minutes,  according  to 
the  strength  of  the  patient.  It  should  never  be  carriixi  to  the  extent 
of  producing  bluencss  of  the  nails.  The  patient  should  be  dried  with 
towels,  or  tlie  dry  rubbing  sheet. 

This  bath  is  useful  in  flie  treatment  of  eruptive  fevers,  bilious  k- 
mittents,  the  hot  stage  of  intermittents,  and  in  hectic  and  typlioid 
fevers.  It  is  often  used  after  the  wet  sheet  paciv,  in  clironic  alloc 
tions,  and  may  then  have  a  little  coolor  temperatun^  or  else  be  fol- 
lowed by  pouring  a  pail  of  cooler  water  over  the  shoulders,  to  tone 
up  the  skin. 

The  Affusion. 

Thk  patient  stands  in  a  wash-tub,  bat'iing-tub,  or  other  convenient 
place,  when,  by  means  of  a  pail,  pitclKu-,  or  basin,  the  assistant  pours 
water  upon  the  head,  neck,  etc.,  either  upon  the  whole  of  the  body  or 
only  upon  a  part.  The  water  is  used  in  quantity  and  temperature 
according  to  the  necessities  of  the  case.  The  aHusion  is  one  of  the 
best  of  hydropathic  modes. 

Fifty  years  ago.  Dr.  Currie,  of  England,  performed  great  cures  in 
fever  by  the  afl'usion,  sometimes  tepid.  others  cold,  according  to  the 
strength  and  heat  of  the  patient.  If  there  was  great  heat,  the  water 
was  used  cold ;  if  not,  the  reverse.  In  a  variety  of  febrihi  disea.se8, 
such  as  typ'ius  fever,  scarlet  fever,  small-pox,  measles,  tetanus,  con- 
vulsions, etc.,  he  used  this  remedy  with  remarkable  success. 

Towel  and  Spong^e  Bath. 

With  one  or  two  coarse  towels  and  a  quart  or  two  of  water  we 
may  take  a  very  good  bath  almost  anywhere,  even  in  a  carpeted 
room,  at  a  hotel,  or  wherever  we  may  be,  without  spilling  a  drop  of 
the  water.  After  a  person  becomes  iutaistonied  to  this  form  of  »l)lu" 
tion,  none  but  the  most  indolent  will  be  willing  to  do  without  it, 
unless  they  can  have  some  other  form  of  bath.  A  daily  towel  ablu- 
tion, thoroughly  performed,  is  an  excellent  prevention  against  colds, 
helps  the  appetite  and  digestion,  and  is  a  good  means  of  preventing 
constipation. 

Some  are  in  the  habit  of  sitting  in  a  half-batli  or  a  sitz-tub,  and 
with  a  large  sponge  making  the  water  pass  freely  upon  the  head,  ucc.\i, 
shoulders,  and  other  parts  of  the  body.  At  the  same  time,  the  bather 
may  pour  water  from  a  cup,  basin,  or  pitcher,  upon  the  head,  neck, 
etc.  This  is  a  mild  afi'usion,  and  stronger  in  eflect  than  the  towel> 
bath. 


'^;'i'i|'  i!'r.i!- 


■'    •.  'fi'''''W^3^ 


PROCESSES  OF  THE  HYDllOPATIIIC  TREATMENT. 


539 


Wpsh-Down. 

The  process  to  which  thiti  name  is  given  by  Dr.  Edward  Johnsoiii 
is  practised  as  follows :  "  The  patiiMit  stands  in  an  empty  sitting  or 
wash  tub,  beside  which  stands  a  j)ail  of  cold  water  with  two  coarse 
towels  souliing  in  it.  The  bath  attendant,  taking  his  place  behind  the 
patient,  lifts  one  of  the  towels,  all  loaded  with  water,  and  lays  it 
(luiolily  on  the  paticMit's  head.  The  |)atient  itnmediately  seizes  it. 
removes  it  from  his  head,  and  rubs  himself  rapidly  with  it. —  liis  face, 
his  throat,  shoulders,  arms,  chest,  stomach,  bowels,  thighs,  and  legs. 
Having  gone  rapidly  ov(>r  the  whole  body  onee,  he  drops  his  Towel 
into  the  pail  again,  which  the  bath-man  presses  down  to  the  bottom 
of  the  water,  then  lil'ts  it  out,  and  places  it  on  his  he;id  Mgaiii.  As 
Ix'fore,  the  patient  seizes  it,  and  goes  all  over  the  same  ground  once 
more,  and  then  drops  it  into  the  water  again,  when  the  bath-man 
again  lifts  it  and  places  it  on  the  head  to  be  a  third  time;  removed  by 
the  patient,  and  applied  as  before,  rapidly,  aetivelv,  and  energetically, 
all  over  his  [)0(ly  in  front.  'J'hi;  bath-man  is  inilustriously  occupied 
all  the  time  bi^hind  in  the  same  mamier,  from  the  back  of  the  neck  to 
the  back  of  the  legs,  wetting  his  own  towel  as  often  as  he  wets  that 
used  by  the  patient,  viz.,  three  times.  This  is  called  a  wash-down  of 
three  towels.  The  patient  is  then  dried  in  a  dry  sheet.  It  is  a  more 
powerful  bath  than  the  common  towel-bath,  but  not  in  all  respects  so 
convenient  to  take. 

The  Cold  Foot-Bath. 

Onr  of  the  first  things  people  who  are  troubled  with  cold  feet  do,  is 
to  plunge  them  into  cold  water.  Nor  is  the  assertion,  put  forth  in 
some  of  the  hydropathic  works,  that  the  cold  foot-bath  was  prescribed 
by  Priessnitz  for  the  same  purpose  that  the  faculty  order  warm  ones, 
correct.  When  the  feet  arc  already  cold,  neither  Priessnitz  nor  any 
one  in  his  sober  reason  would  prescribe  cold  water,  which  can  only 
make  the  parts  colder.  To  obtain  th(!  good  elleet  of  tlu^  cold  foot- 
bath, so  far  as  the  feet  are  concerned,  they  should  be  warm  whenever 
it  is  tiiken.  For  a  tendency  to  coldness  of  the  \'vi;f,  —  a  very  common 
symptom  in  these  days  of  so-called  luxury  and  relinenKMH,  and  one 
that  indicates  a  state  of  things  in  the  system  incomparably  mon;  to 
be  dreaded  than  the  mere  eoldness  of  the  feet,  —  this  is  l/ie  remedy, 
It  may  be  taken  at  any  convenient  tinu^ :  just  before  the  morning 
walk  is  a  very  suitable  occasion,  the  parts  being  usually  wi.rm  early 
iti  the  day. 

At  other  times,  if  cold,  thpy  shonhl,  if  at  all  |)racticable,  bo  warmed 
by  exercise  and  friction,  before  subjecting  them  to  the  action  of  cold 
water.  But  in  cases  of  old  i.ge,  great  debility,  etc.,  the  warm  foot- 
bath, and  other  warm  applications  may  be  resorted  to  before  the  cold 
Thus  with  cold,  exercise,  and  friction,  accustoming  the  feet  daily  and 
frequently  to  cold  water,  will  beget  in  them  a  habit  of  remaining 
Warm.     In  a  grc  it  variety  of  ailments,  such  as  toothache,  rush  of 


riia 


540 


PROCESSES  OF  THE  HYDROPATHIC  TREATMENT 


blood  to  the  head,  headache,  earache,  inflammation  of  the  eyes,  gout, 
rheumatism,  hemorrhages,  etc.,  the  cold  foot-bath  is  a  valuable  remedy. 
It  is  ordered  deep  or  shallow,  and  of  duration  according  to  the  nature 
of  the  case. 

Wading  Foot-Baths. 

I  HAVE  often  directed  patients  to  wade  in  water  in  some  convenient 
place,  as  a  means  of  hardening  the  system  and  of  giving  tone  to  the 
nerves.  Delicate  ladies  who  were  not  able  as  they  supposed,  to  v.n- 
dure  cold  water  applied  to  the  feet,  have  by  degrees,  wetting  the  feet 
but  little  at  first,  become  so  accustomed  to  the  coldest  watei ,  that  in  a 
few  weeks  they  could  bear  as  much  as  any  one  would  desire.  Caution 
and  perseverance  should  be  the  rule. 

It  is  partly  by  sympathy  and  partly  by  the  abstraction  of  heat,  that 
foot-baths  and  wetting  the  feet  act  in  so  beneficial  or  deleterious  a 
manner  as  we  know  them  to  do.  The  principle  of  sympathy  is  an  old 
one  in  the  medical  art,  but  none  the  worst;  for  that. 


The  Warm  Foot-Bath.  —  Fediluvium. 

I  AM  aware  that  some  wiio  consider  themselves  genuinely  hydro- 
pathic, object  to  the  use  of  this  remedy.  Having  truth  for  my  object, 
however,  1  care  not  for  such  objections  so  far  as  myself  am  concerned, 
and  without  stopping  here  to  argue  the  question,  I  simply  remark  that 
warmth  under  some  circumritances  is  as  natural  au  application  for  the 
living  body,  as  cold  under  other  circumstances.  I  have  already  re- 
marked, under  the  head  of  the  cold  foot-bath,  that  putting  the  feet  into 
warm  water  is  often  a  good  preparat..ry  process  to  that  bath.  It  is 
good  also,  now  and  then,  for  soothing  divers  aches  and  pains,  and  also 
for  warming  the  feet  of  old  and  weakly  people,  who  cannot  exercise 
sufficiently. 

The  Nose-Bath. 

In  a  variety  of  nasal  ailments,  catarrh,  colds  in  the  head,  inflamma- 
tion and  ulceration  of  the  nasal  passages,  nose-bleed,  etc.,  the  nose- 
bath  is  a  salutary  remedy.  The  water  is  used  either  tepid  or  cold, 
according  to  the  case.  It  should  be  drawn  back  if  possible,  so  that  it 
is  ejected  by  the  mouth.  Those  who  have  injured  the  nasal  cavities 
by  much  snuff-taking,  will  find  advantage  from  sniffing  water  freely 
into  the  nostrils.  If  one  is  determined  to  leave  off  snuff,  as  every  one 
addicted  to  it,  if  he  regards  either  health  or  bodily  comfort,  ought, 
he  will  find  it  useful  often  to  take  cold  water,  instead  of  the  abomina* 
ble  weed. 

The  Eye  and  Ear  Bath. 

Various  contrivance*  may  be  brought  to  bear  in  applying  water  to 
the  eye  and  ear.     Light,  ascending  douches  and  showers  are  useful  in 


PROCESSES  OF  THT5  HYDROPATHIC  TREATMENT. 


541 


various  diseases  of  the  parts.  There  should  not  be  much  force  tised 
in  this  way.  Immersing  them  also  in  water  is  often  useful.  The 
water  should  not,  in  general,  be  very  cold,  tepid  or  warm  being  often 
the  best 

Mouth,  or  Oral  Bath. 

For  inflammation  of  the  gums,  mouth,  throat,  and  palate,  in  slimy 
secretions  from  the  throat  and  stomach,  in  toothache,  catarrh,  colds, 
and  chronic  hoarseness,  garglings  and  baths  for  the  mouth  are  of  great 
service.  Pauley,  a  merchant  of  Vienna,  has  been  thought  singular 
for  his  zeal  in  recommending  this  bath.  Clergymen  and  others  who 
sutler  hoarseness  by  much  speaking,  will  find  that  holding  very  cold 
water  in  the  mouth  until  it  begins  to  grow  warm,  and  then  ejecting  it, 
and  by  frequently  repeating  the  process,  much  benefit  will  be  obtained. 
Coughs  and  tightness  of  the  chest  may  ofteil  be  essentially  relieved 
by  this  bath.  In  mucous  secretions  from  the  throat  and  stomach,  by 
ejecting  the  water  a  number  of  times,  it  will  surprise  those  who  have 
not  witnessed  the  remedy  to  see  the  amount  of  slimy  secretion  thrown 

off- 
Division  of  Baths. 

On  no  one  subject  connected  with  hydropathy  has  there  been  more 
."confusion  of  tongues,"  than  concerning  the  temperature  of  baths. 
Botli  ill  books  and  in  popular  language,  among  physicians  as  well  as 
laymen,  have  words  been  used,  sometimes  confusedly,  and  at  other 
tiiiies  without  any  meaning  whatever.  Orthodox  medical  works,  as 
weil  as  the  Mworthodox,  come  under  the  same  category  of  error.  A 
few  simple  explanations  on  this  head,  properly  made,  will  be  sufficient 
for  all  practical  as  well  as  scientific  purposes. 

The  simplest  and  most  natural  division  of  baths  is  into  cold^  tepid^ 
warm,  and  hot.  These  are  all  terms  of  every-day  life,  and  are  fully 
sufficient  to  guide  us  in  the  selection  of  any  and  all  the  multiform 
uses  of  water  which  hydropathy  teaches.  I  admit,  however,  that 
when  we  wish  to  be  especially  explicit,  the  actual  thermometrical 
temperature  should  be  mentioned.  Hot  baths,  I  maintain,  have  no 
proper  place  in  hydropathic  practice.  He  who  resorts  to  them  either 
does  not  at  all  understand  the  true  principles  of  the  Water-Cure, 
or  is  guided  merely  by  the  whims  or  caprices  of  those  who  employ 
him. 

But  whatever  words  we  use  to  designate  the  different  baths,  there 
is  one  objection,  which  is,  that  all  such  terms  arc  necessarily  arbitrary 
in  a  greater  or  less  degree.  What  appears  to  one  person  cold,  may 
to  another  appear  tepid,  or  warm,  or  even  hot.  Thus  it  is  said  that 
on  a  road  over  the  Andes,  at  about  half  way  between  the  foot  and 
the  summit,  there  is  a  cottage  in  which  the  ascending  and  descending 
travellers  meet.  The  former,  who  have  just  quitted  the  sultry  valleys 
at  the  base,  are  so  relaxed,  that  the  sudden  diminution  of  temperature 
produces  in  them  a  feeling  of  intense  cold ;  while  the  latter,  who  left 


wr-f^ 


542 


PROCESSES  OF  THE  HYDROPATHIC  TREATMENT. 


the  frozen  summit  pf  the  mountain,  are  overcome  by  distressing  sen- 
sations of  extreme  heat.  If  on  a  cold  winter's  morning  we  go  from  a 
warm  bed  to  a  bath  of  sixty  to  seventy  degrees  Fahr.,  the  water  ap- 
pears cold.  If  we  then  plunge  immediately  into  water  which  is  at 
about  the  freezing  point,  and- then  return  again  to  the  water  at  sixty 
to  seventy  degrees  Fahr.,  it  appears  warm.  "When  the  temperature 
of  the  atmosplicre  is  at  til'ty-five  degrees  Fahr.,  in  November  or  Octo- 
ber, in  this  latitude,  and  tlie  body  of  a  comfortable  degree  of  warmth, 
and  we  take  three  basins  of  wyter  at  sixty,  seventy,  and  eighty  de- 
grees Fahr.,  placing  one  hand  in  the  water  at  sixty  degrees,  the  other 
in  that  at  eighty  degrees,  letting  them  remain  thirty  seconds  in  each, 
and  then  immerse  them  both  in  the  water  at  seventy  degrees,  it  ap- 
pears to  one  cofd,  to  the  other  ivarvi. 

But  we  can  arrive  at  rules  which  approximate  so  nearly  to  the  ac- 
tual truth,  that  they  will  serve  us,  as  before  remarked,  for  guides  in 
all  practical  and  scientific  purposes. 

Tlie  Cold-Bntli.  —  "With  a  majority  of  persons,  and  at  most  seasons 
of  the  year,  water  at  from  seventy  to  eighty  degrees  Fahr.  downward, 
gives,  when  immersed  in  it,  a  sensation  of  coldness.  The  spring  water 
of  all  countries  furnishes  what  may  therefore  be  called  a  cold-bath, 
although  there  will  be  a  range  of  many  degrees  variation  in  what  we 
term  cold. 

The  Tepid-Bath.  —  The  word  tepid  is  from  the  Latin  tepeo,  to  be 
warm.  The  true  English  meaning  of  the  term  however  is,  according 
to  Mr.  Webster,  moderately  warm,  or  lukeivarm ;  in  other  words,  water 
which,  when  a  person  is  immersed  ir'  it,  gives  a  kind  of  indefinable 
sensation,  one  which,  coming  properly  under  the  neither  cold  nor  warm, 
is  said  to  be  tepid.  This  temperature  will  be  found  to  range  at  from 
eighty  to  ninety-two  degrees  Fahr. 

The  Warm-Biith.  —  The  term  warm  is  generally  well  understood. 
It  means  that  temperature  of  water  which  is  peculiarly  agreeable  to 
the  sensations.  Fresh-drawn  milk  or  blood  we  say  'e  warm.  The 
temperature  of  water  which  will  cause  this  sensation,  varies  from 
ninety-two  to  ninety-eight  degrees  Fahr. 


The  Vapor-Bath.  —  The  temperature  of  the  vapor  of  simple  waiNr 
varies  from  about  ninety  degrees  Fahr.  upward,  according  to  the  heat 
of  the  water,  and  the  space  through  which  the  vapor  passes. 

The  Hot-Bath. — The  term  hot  is  also  expressive  of  its  proper  mean- 
ing. If  the  body  is  immersed  in  water  above  blood-heat,  it  causes  an 
uncomfortable  sensation,  which  we  designate  as  hot.  Hot  water  is  a 
disturber  of  the  vital  functions,  particularly  if  the  whole  body  is  im- 
mersed in  it.  Hot-baths,  therefore,  should  be  used,  if  ever,  only  in  a 
most  urgent  necessity.  Hot  water,  in  no  form  whatever,  entered  into 
any  part  of  Priessnitz's  treatment 

Having  thus  explained  the  temperatures  of  the  different  divisions 
of  the  bath,  it  is  proper  to  state  them  in  a  tabular  form,  the  better  to 
aid  the  memory.     They  are  as  follows : 


Cold-bath  from  freezing  point, 
Tepid  "     .        .        .        . 
Warm"  .         .         .         . 

Vapor "     .         .        .         . 
Hot      "  .         .        .         . 


32  to  85°  F. 
80  to  92° 
92  to  98° 
90°  and  upward, 
above  98° 


I  now  propose  to  explain  somewhat  minutely,  and  at  the  same  time 
with  a  due  regard  to  the  needs  of  the  non-professional  reader,  the 
physiological  etlects  of  eaoii  of  the  several  kinds  of  bath,  and  I  here 
r(!s|)ectfully  premise  that  any  one  who  attempts  to  practise  the  water 
treatment  without  having  in  his  mind  clear  notions  upon  this  subject 
is,  to  say  the  least,  as  much  a  "  gro|)er  in  the  dark"  as  he  who  attempts 
the  practice  of  drugs  of  which  he  knows  nothing,  upon  the  living  body 
of  which  he  knows  less.  How  can  a  itiari  be  trusted  in  water  treat- 
ment if  he  cannot  tell  beforehand  what  effect  a  bath  is  to  have ;  and 
this  he  cannot,  if  he  does  not  fully  understand  the  meaning  of  the 
terms  which  I  have  here  explained. 

Effects  of  the  Cold-Butli. —  The  effects  of  the  cold-bath  are  properly 
spoken  of  under  two  heads,  the  primarif  and  the  secondary.  The 
terms  are  sufficiently  expressive  of  their  meaning.  The  first  are 
those  which  take  place  at  the  time  of  the  immersion  ,  the  second, 
those  that  occur  later,  constituting  what  we  understand  by  the  term 
nadion. 

Immediately  on  immersion  in  cold  water,  the  bather  experiences 
some  acceleration  of  respiration  and  the  heart's  action,  although  the 
pulse  becomes  at  the  same  time  smaller  and  weaker.  Very  soon, 
however,  the  panting;  if  I  may  so  call  it,  passes  off;  the  temperature 
of  the  body  is  found  diminished,  the  surface  paler  than  natural,  the 
skin  taking  on  that  form  of  appearance  known  as  "  goose-flesh." 

The  first  effect  of  cold  water  applied  to  the  body,  generally,  is  to 
abstract  a  certain  amount  of  heat  from  the  surface,  to  constringe  the 
capillary  vessels,  and  to  force  the  blood  inward.  Now,  as  the  living 
body  possesses  the  remarkable  property  of  maintaining  its  tempera- 
ture at  very  nearly  the  same  point,  whether  it  is  in  a  colder  or  hotter 
medium  than  itself,  the  vitals  at  once  set  to  work  in  restoring  the 
caloric  abstracted  by  the  contact  of  the  water ;  and  as  the  functions 
of  circulation  and  calorification  go  necessarily  together,  the  vital 
power,  acting  through  the  heart  and  blood-vessels,  attempts  a  return 
of  the  blood  that  had  been  forced  inward  by  the  coldness  of  the 
water. 

This  is  wha  »  call  reaction.  If  the  individual  is  sufficiently 
strong  and  well  stocked  with  vitality,  the  blood  is  quickly  returned 
to  the  surface  and  to  the  extremities  (which  are  always  most  liable 
to  become  cold,  being  farthest  from  the  heart),  constituting  what  la 
termed  good,  or  vigorous  reaction.  But  if  the  surface  and  extremities 
continue  to  remain  unwarmed  by  this  return  of  the  blood  to  them,  as 
happens  in  the  case  of  feeble  persons,  there  is  said  to  be  poor^  or  ir^ 
sujficient  reaction. 

Effects  of  the  Tepid-Bath.  —  The  tepid-bath,  which  we  have  seen 
ranges  from  eighty  to  uinety-two  degrees  Fahr.,  produces  effects  anal- 


(^#1 


544 


PROCESSES  OF  THE  HYDROPATHIC  TREATMENT. 


ogous  to  those  of  the  cold-bath,  only  not  so  lasting  and  permanent 
It  Ik  especially  useful  in  the  treatment  of  infants  and  children,  and  in 
all  cases  where  the  reactive  energy  is  feeble.  If  in  any  case  we  are 
in  doubt  as  to  whether  the  cold  bath  is  admissible,  the  tepid  form  will 
be  a  milder  measure,  and  at  the  same  time  serve  as  a  test  in  ventur- 
ing upon  the  cold.  The  tepid  bath  may  be  continued  longer  at  a 
time,  which  in  some  cases  will  be  found  an  advantage. 

Etfects  of  the  Wunii-Buth.  —  There  is  among  hydropathic  physi. 
cians,  if  I  am  not  mistaken,  too  great  a  fear  of  warm  applications  on 
the  part  of  some,  while  others  go  to  the  opposite  extreme.  Mark,  I 
speak  of  warm  applications.  Hoty  as  before  remarked,  have  no  proper 
place  in  hydropathy,  —  a  rule  to  which  the  exceptions  are  few. 

The  warm-bath,  as  before  remarked,  ranges  from  ninety-two  to 
ninety-eight  degrees  Fahr.  It  is  not  the  most  useful  of  the  hydro- 
pathic resources,  but  one  of  the  most  useful,  as  I  shall  endeavor  here- 
after to  show. 

Among  the  ancient  Romans  the  warm-bath  was  not  considered  as  a 
means  of  luxurious  indulgence  that  tended  to  weaken  the  vital  powers, 
but  a  means  of  refreshment  for  the  wearied  traveller,  and  of  prepar- 
ing him  for  the  repast  and  the  enjoyment  of  other  rites  of  hospitality. 
The  effect  of  the  warm-bath  is  not  one  of  debility,  as  many  suppose, 
but,  on  the  contrary,  it  is  a  sedative,  lowering  the  heart's  action  and 
the  circulation,  and  tending  to  repose  rather  than  excitement. 

Effects  of  the  IIot-Bilth.  —  The  hot-bath,  before  remarked,  is  one 
which  is  above  the  temperature  of  the  blood,  ninety-eight  degrees 
Fahr.  It  was  laid  down  ais  a  precept  by  Hippocrates,  that  a  bath  en- 
feebles when  the  heat  exceeds  that  of  the  body  immersed  in  it.  The 
truth  of  this  precept  has  often  been  verified  in  practice. 

I  do  not  wish  to  be  understood  as  affirming  that  hot  applications 
can  never  be  made  with  benefit  to  the  body ;  on  the  contrary,  heat 
applied  *o  a  part  locally  may  be  of  service,  although  I  am  inclined  to 
believe  that  even  in  those  cases  where  heat  acts  in  a  beneficial  way, 
8ome  other  form  of  hydropathic  appliance  can  be  used  more  benefi- 
cially. I  make,  it  will  be  remembered,  a  broad  distinction  between 
the  terms  hot  and  warm. 

Sea-Bathing. 

As  regards  temperature,  sea-bathing  comes  under  the  gerieral  head 
of  cold-baths.  Sea  water,  however,  at  those  seasons  of  the  year  when 
sea-bathing  is  resorted  to,  is  of  but  a  moderate  degree  of  coldness, 
varying  in  this  latitude  not  much  from  seventy  degrees  Fahr. 

In  order  to  appreciate  fully  the  eftects  of  sea-bathing  upon  the  sys- 
tem, a  number  of  things  are  to  be  considered. 

Sea  water  differs  in  its  effects  from  common  water  by  its  possessing 
greater  density.  This  circumstance,  however,  is  not  of  so  great  im- 
portance as  that  of  the  stimulating  nature  of  the  mineral  it  contains. 
The  saline  ingredient  is  a  powerful  stimulant  and  even  irritant  of  the 
skin.    On  account  of  this  property,  it  is  found  that  an  exposure  to  the 


PROCESSES    OF   THE   HYDROPATHIC   TREATMENT. 


545 


action  o '  salt-water  is  not  so  liable  to  cause  ill  effects  as  that  to  fresh. 
The  salt  causing  a  degree  of  heat  upon  the  surface  somewhat  higher 
than  that  of  the  natural  state,  the  system  is  for  the  time  shielded  from 
the  actitm  of  cold.  It  does  not  follow  from  this,  however,  that  a 
person  could  live  longer  immersed  in  sea  than  in  common  water,  any 
more  than  it  follows  that  because  alcohol  for  a  time  increases  the  ani- 
mal tnniporature,  life  can,  under  circumstances  of  great  exposure  to 
colli,  bo  the  longer  preserved.  This  it  is  now  well  known  is  not  the 
case. 

An  advantage  of  sea-bathing  in  the  hot  season  is,  that  tne  air  at 
the  sca-shoro  is  cooler  than  on  land.  That  our  climate  in  summer  is 
too  hot  for  the  most  favorable  development  of  health  is  proved  by 
tho  great  increase  of  mortality,  not  only  in  our  cities,  but  in  other 
parts,  during  the  hot  season.  Tlifi  European  cities,  with  all  their 
iiurabirs  of  inhabitants,  dampness,  narrow  streets,  intemperance, 
pauperism,  etc.,  would  naturally  be  expected  to  show  a  higher  range 
of  mortality  than  our  American  cities,  but  such  is  not  tho  fact.  Even 
Now  York,  with  all  its  natural  advantages,  is  as  sickly,  probably,  as 
any  of  tho  British  or  European  cities.  This,  it  is  agreed  on  all 
hands,  must  bo  owing  in  great  part  to  the  great  heat  of  our  summer 
months. 

The  manner  of  taking  tho  salt-water  bath  has  some  peculiarities 
which  are  favorable  to  health.  It  is,  in  tho  first  place,  in  tho  open 
air,  which,  if  the  weather  is  favorable,  that  is,  neither  too  hot  nor 
cold,  is  always  a  great  advantage.  Other  things  being  equal,  a  bath 
in  tho  open  air  is  always  attended  with  a  better  reactiuo  and  a  greater 
(leirreo  of  iuvijroration  than  ono  within  doors. 

In  the  second  place,  sea-bathing  is  usually  and  almost  necessarily 
connected  with  exercise  both  before  and  after  the  bath,  circumstances 
which  are  alwa^'s  highly  favorable  to  the  action  of  cold  water.  So 
beneficial,  indeed,  is  exercise  taken  in  this  way,  that  it  would  be  dif- 
ficult to  determine  which  of  tho  two  —  the  exercise  or  the  bathing 
—  is  the  more  beneficial.  In  connection,  the  two  act  reciprocally 
upon  each  other,  each  rendering  the  other  doubly  beneficial. 

Injections. 

The  term  injection  implies  the  act  of  throwing  a  fluid  into  some 
cavity  of  the  body. 

In  Water-Cure  we  inject  water  ,more  frequently  into  the  bowels 
than  any  other  cavity.  This  kind  of  injection  is  also  called  enema, 
or  clyster. 

Most  people  have  so  little  confidence  in  simple  water,  that  if  a 
clyster  is  administered  to  them,  they  have  no  idea  that  it  can  operate 
ill  so  effectual  a  way  as  it  usually  does.  Years  ago,  when  the  water 
treatment  was  much  less  known  than  at  the  present  time,  I  have  f^een 
suspected  of  having  secretly  put  some  cathartic  sul)stance  in  tho 
water,  "  for,"  said  the  patients,  "  how  is  it  possible  for  water  to  act 
in  this  way  ?  " 

A  great  variety  of  injection-i'^struments  have  been  invented.    Some 

_^ G9 


WV.-3 


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546 


FBOCESSES  OF  THE  HYDROPATHIC  TREATMENT. 


of  these  are  very  convenient  and  useful ;  others  are  got  up  on  mere 
speculation,  and  are  but  little  worth.  Every  family,  at  least,  ought 
to  have  a  good  force-pump  injection-instrument,  it  they  can  obtain 
such  a  one.  A  lady's  toilet  is  never  complete  without  it.  A  good 
article  is  either  manufactured  or  sold  by  most  surgical-instrument 
makers,  and  druggists  often  have  a  good  article.  J^ut  beware  of  im- 
position.  It  is  better  to  got  along  with  a  common  bladder  and  goose- 
quill,  as  wc  may  in  an  emergency,  than  to  pay  for  a  good-for-nothiug 
syringe. 

Modus  Operandi  of   Water. 

It  is  often  objected  to  hydropathy  that  water,  being  but  one  agent, 
cannot  be  made  useftd  in  all  diseases.  •  I  propose  here  to  make  some 
remarks  on  Ihe  modus  operandi  of  water,  in  which  I  shall  endeavor  to 
explain,  not  only  to  the  scientific  scholar,  but  to  the  ordinary  reader, 
that  water  is  capable  of  being  made  available  as  a  remedy, — and 
that  powerfully  too,  —  in  a  great  variety  of  ways.     It  then  acts : 

1.  By  its  Presence. — Water,  as  we  have  seen  elsewhere,  com- 
poses the  larger  part  of  the  living  body ,  and  that  without  its  pres- 
ence in  a  large  proportion  in  the  living  system,  the  vital  processes 
cannot  for  a  moment  go  on. 

2.  By  its  Coldness.  —  Cold,  within  proper  limits,  preserves  and 
augments  life,  while  heat  tends  to  debility  and  decay.  In  proportion 
as  the  animal  heat  is  diminished  in  the  different  classes  of  animals, 
the  less  is  the  want  of  air  felt.  If  in  a  puppy  the  eighth  pair  of 
nerves  bo  divided,  producing  a  closure  of  the  glottis  so  that  no  air 
can  enter  its  lungs,  the  animal  dies  in  half  an  hour,  if  kept  at  an  or- 
dinary temperature.  But  if  the  animal  is  benumbed  with  cold  it 
survives  the  operation  ri)r  a  whole  day.  Frogs,  in  the  summer,  when 
the  temperature  of  water  is  elevated,  are  obliged  to  come  often  to 
the  surface  for  air.  But  in  winter,  when  the  water  is  colder,  they 
live  almost  entirely  under  its  surface.  A  cholera  patient  in  collapse, 
a  person  who  has  been  stifled  by  foul  gases,  one  in  the  sinking  stage 
of  a  fever,  or  fainting  from  loss  of  blood,  or  in  any  way  asphyxiated, 
desires  always  coldness  rather  than  heat.  It  may  not  be  possible  in 
the  present  state  of  science  to  explain  these  phenomena  ;  but  unde- 
niably we  have  the  facts. 

3.  By  Endosmose  and  Exosmose.  —  Animal  membranes  have  the 
power  of  absorbing  liquids,  —  called  endosmose,  or  imbibition,  and  of 
throwing  them  out,  exosmose,  or  transudation.  ?  _,, 

If  we  take  a  portion  of  the  intestine  of  a  chicken,  tie  one  end, 
nearly  fill  it  with  milk,  then  tie  tne  other  end,  and  lastly  immerse.it 
in  a  tumbler  or  other  vessel  of  pure  water,  we  find  that  in  a  short 
time  the  milk  passes  out  of  the  intestine  into  the  water,  and  the 
water  inwardly  mingling  with  the  milk.  This  process  goes  on  till 
the  fluid  within  and  without  the  intestine  becomes  one  and  the  same. 
This  is  a  familiar  illustration  of  the  principle  in  question. 


li 


4.  By  Dilution.  —  Water  is  the  greatest  diluent  in  nature.  There 
is  no  substance  which  is  at  all  comparable  t«)  it  for  penetrating  the 
myriads  upon  myriads  of  capillaries  that  exist  in  nil  parts  of  the 
living  structure.  When  the  fluids  become  thick,  viscid,  and  filled 
with  impure  matters,  as  is  usually  the  case  to  a  greater  or  less  extent, 
iiidisease,  it  is  an  important  olycct  to  dilute  these  matters.  For  this 
purpose  water  is  the  only  available  remedy. 

5.  By  its  Tonic  Effect — Water  is  the  greatest  of  all  tonics,  and 
possesses  the  valuable  property,  not  of  wearing  out,  but  of  increas- 
ing in  its  good  effects. 

6.  By  its  Excittint  or  Electriciil  Power.  —  A  man  feels  dull  aid 
stupid  from  excessive  bodily  or  mental  labor,  from  excessive  alinien> 
lation,  or  spirit,  or  tea  and  coffee-drinking,  with  the  blood  all  crowd- 
ing up  into  his  head.  We  apply  the  well-wrung  rubbing  wet  sheet 
one,  two,  or  three  times,  to  his  surface,  according  as  he  may  need, 
and  he  at  once  perceives  a  roost  wonderful  change  for  the  better.  Or- 
a  man  feels  of  a  morning  dull  and  stupid,  with  his  muscles  sore  ;  he 
has  the  rubbing  wet  sheet,  the  plunge,  shower,  or  douche,  and  in- 
stantly his  troubles  banish.  Or  he  may  have  a  lumbar  abscess,  which 
has  run  him  down  so  low  that  when  he  wakes  in  the  morning  he  finds 
he  cannot  walk.  Two  or  three  gallons  of  cold  water  are  poured  over 
him,  upon  which  ho  walks  readily.  Now  these  effects  of  water,  re- 
markable as  they  are,  arise  simply  from  its  excitant  or  electrical 
power. 

7.  By  its  Temperature.  —  In  acute  disease,  in  all  fevers  and  in- 
flammations, of  whatever  name  or  grade,  the  great  power  of  water  to 
filiate  the  temperature  of  the  body  is  one  of  the  most  striking  of 
all  the  phenomena  cognizable  by  man.  By  the  use  of  cold  water  wo 
can  always  vary  the  heat  of  the  body  and  the  velocity  of  the  heart's 
action  to  any  desirable  extent. 

8.  By  Pnrifyins  the  Blood.  —  Water  accomplishes  one  thing  which 
no  drug,  no  other  substance  in  nature  can.  It  purifies  the  blood.  It 
does  this  because  it  penetrates  every  laiw  and  alley  of  the  system, 
however  minute.  No  capillary  is  so  delicate  that  it  does  not  pene- 
trate its  smallest  possible  part.  It  purifies  the  blood,  because  as  long 
as  the  vital  principle!  lasts,  the  tendency  of  nature  is  to  preserve  the 
vital  fluid  in  a  healthy  state ;  and  penetrating  every  tissue  of  the 
body  as  water  does,  it  assists  nature  in  the  purifying  process  as  no 
other  substance  can. 

9.  By  A:i$:mentin]g^  the  Vital  Force,  —  No  fact  in  science  is  better 
established  than  that  water  possesses  the  power  of  actually  increas- 
ing the  amount  of  vitality  in  the  system.  This  is,  in  fact,  the  prime 
effect  of  water.  It  aids  the  system  in  throwing  off  disease  in  the 
eatne  way  that  increasing  a  merchant's  capital  aids  him  in  throwing 
off  debt. 

The  foregoing  propositions  are  submitted  as  elucidating  some  of 
the  leading  principles  concerned  in  the  action  of  water  upon  the  Ut- 


FT 


548 


PROCE8SE9    OF    THE    nTDHOPATinO    TRBATMBNT. 


ing  body.  I  do  not  claim,  howv  ver,  thtit  tho  whole  of  the  philoao- 
phy  of  tho  cfTocts  of  water  is  yet  uiidorstooc]  by  any  one.  Doubtless 
those  who  know  most  about  it  buve  yet  much  to  Icain. 

Rules  for  Using  Water. 

The  Time  of  Day.  —  In  general,  the  more  powerful  applications 
should  be  made  in  the  early  part  of  the  day.  At  this  time  the  calor- 
ific powers  and  the  circulation  are  more  vi<rorous,  and,  consequently, 
the  body  more  able  to  resist  powerful  applications  of  whatever  kind. 

The  Meals.  —  Ordinarily,  no  powerful  bath  should  be  taken  within 
three  to  four  hours  after  a  meal.  A  full  stomach  and  cold  water  lO 
not  at  all  agree.  But  in  certain  diseased  conditions,  as  feverishness, 
inflammation,  colic,  cramp  in  the  stomach,  cholera  morbus,  and  other 
sudden  attacks,  water  appliances  are  to  be  commenced  without  refer- 
ence to  hours  or  meals.     The  symptoms  then  are  our  only  guide. 

The  Lighter  Biitlis.  —  If  there  is  doubt  as  to  which  application  to 
make,  the  well-wrung  rubbing  wet  sheet,  the  tepid  shallow-bath,  or  a 
warm-bath  should  first  be  taken. 

Reaction.  —  Within  a  reasonable  time  after  a  bath,  the  body  in  all 
its  parts  should  become  naturally  warm.  If  the  feet  and  handa  ro- 
main  cold,  and  the  nails  and  lips  blue,  the  bath  has,  to  say  the  least, 
done  no  good.  In  some  cases  of  fevers  and  other  inflammatory  dis- 
eases, it  is  better  to  keep  the  body  chilly  than  to  allow  it  to  become 
too  warm. 

Ulceration.  —  If  any  part  of  the  body,  as  the  extremities,  lungs, 
bowels,  etc.,  is  undergoing  any  considerable  ulceration,  very  cold 
baths  are  iuiilmissible. 

Nenronsneiis.  —  With  some  persons  who  are  highly  nervous,  and 
particularly  with  nervous  females,  much  cold  bathing,  although  it  ap- 
pears to  agree  well,  and  to  be  the  best  for  a  time,  is  in  the  end  harm- 
%1,  rendering  the  nervousness  and  general  debility  worse. 

Exercise.  —  For  the  douche,  plunge,  cold  sitz,  and  foot  baths,  and 
all  others  that  abstract  a  large  amount  of  caloric  from  the  system,  the 
body  should  be  fully  warm,  and  the  circulation  somewhat  accelerated 
by  exercise.  Exercise  should  also  be  taken  afibb  the  bath,  until 
the  heat  and  circulation  are  fully  restored.  But  if  exercise  is  im- 
practicable either  before  or  after  the  bath,  friction  should  be  made  to 
take  its  place. 

Increased  Heat Elevation  of  temperature  constitutes  no  objec- 
tion to  bathing,  provided  the  body  is  not  excessively  fatigued.  The 
reason  why  overheated  persons  sometimes  lose  their  lives  by  plunging 
into  or  drinking  largely  of  cold  water,  is,  that  the  vital  force  has 
been  too  much  exhausted.     Mere  heat  is  au  advantage. 

Perspiration.  —  Neither  does  this  constitute  an  objection  to  bath- 
ing or  water-drinkiug,  if  the  foregoing  rules  are  observed. 


&rg 


Tlic  Ain  —  Bjithin;^:  in  tho  open  air  is  always  proforal)lo  to  in-doors, 
provided  the  extremes  of  heat  uiul  cold  are  avoided. 

The  Ilcatlt  —  It  is  well  always  to  wet  tho  head  with  cold  water, 
both  before  and  after  a  bath.  Douches  and  tho  shower  should  never 
bo  tiiken  on  this  part.  Simple  poin'in^j  or  aflusion  is  the  only  mechan- 
ical force  of  water  that  should  bo  allowed  on  tho  head. 

Pr?ffniinfy.  —  This,  as  abundant  experience  proves,  forms  no  ob- 
jection to  bathinir,  or  any  form  of  jjroperly  reticulated  water  treat- 
ment. Cold  bathing  and  water-drinking  are  of  tho  greatest  service 
during  this  period. 

The  Season,  —  If  tho  lungs  are  not  extensively  diseased,  and  if 
there  is  no  cunsiderablo  ulceration  going  on  in  any  part  of  tho  sys- 
tem, tho  cool  andcold  seasons  are  preferable  for  a  course  of  bathing. 
With  right  management,  a  patient  gains  two  or  three  times  as  much 
in  a  given  time  during  the  cold  months  as  he  does  in  tho  hot. 

Days  of  Rest.  —  One  day  in  seven  water  treatment  should  be  dis- 
continued, with  the  exception  of  a  simple  ablution  in  the  morning. 
Six  days'  treatment  in  the  week  is  worth  more  than  seven,  because  it 
ia  a  law  of  nature  that,  if  a  remedy  is  continued  steadily  and  with- 
out change,  it  loses  much  of  its  good  cfTect.  This  is  as  true  of  water 
as  of  any  other  agent.  Those  who  do  wisely  will  omit  tho  treat- 
ment on  Sunday,  whatever  their  religious  convictions  may  be. 

lutcrnnl  Use  of  Water.  —  The  same  general  rules  apply  hero  as  in 
tho  external  applications.  Thirst  should  for  tho  most  part  bo  grati- 
fied whenever  it  is  experienced.  As  a  rule,  tho  less  water  drank  at 
meals  the  better.  For  tho  tonic  effect,  it  is  to  bo  taken  while  tho 
stomach  is  empty,  and  it  is  better  that  cxereiso  should  accompany  it. 
From  six  to  twelve  tumblers  per  diem  is  a  fair  allowance  for  average 
patients. 

Qualify  of  Water. — For  all  remedial  as  well  as  hygienic  purposes 
water  should  be  as  pure  and  soft  as  can  bo  obtained.  With  proper 
cure  and  ingenuity  in  tho  construction  of  cisterns,  filters,  etc.,  this 
desirable  end  can  be  everywhere  accomplished.  Lead,  and  lead 
pipes,  should  be  avoided,  except  where  the  water  runs  freely  antl 
constantly. 

The  Sweating  Piocess.  —  Formerly  it  was  much  in  vogue  to  sweat 
patients  in  tho  blanket  pack,  but  latterly  the  practice  has  quite  gone 
into  disrepute.  For  several  years  of  the  latter  part  of  Priessnitz's 
career  he  was  very  averse  to  using  the  process.  It  was  a  remark  of 
his,  that  tho  cures  by  sweating  were  not  permanent. 

Wet  Bandages  and  Compresses,   etc. 

These,  as  we  have  already  seen  imderthe  head  of  wounds  and  in- 
juries, are  of  great  value  in  water  treatment.  They  are  used  of  any 
desirable  size,  upon  any  part  of  tho  body,  and  produce  different  effects 
accordingly  as  they  are  used.     Cooling  wet  compresses  are  such  as 


fl^^r 


iHIP 


550 


PROCESSES  or  niB  HYDROPATniO  TREATMENT. 


are  ohauged  or  rewet  frequently,  and  for  the  most  are  loft  uncovorod. 
The  warming  or  stimulaliny  are  covered  and  left  upon  the  part  until 
it  becomes  as  warm  or  warmer  than  natutal.  Warm  fomentations 
arc  useful  in  certain  cases,  but  the  hot  should,  as  a  rule,  be  discarded. 

The  wet  girdle  is  one  of  the  most  useful  of  all  medical  appliancca. 
Two  and  a  half  or  three  yards  of  good  towelin«;,  with  tapes  arran<jcd 
at  one  end,  the  corners  of  which  h.ivo  been  turned  over  and  sewed  so 
as  to  form  a  point,  forms  a  good  girdle.  It  should  puss  usually  tlirco 
times  about  the  body,  one  half  having  been  wet.  This  brings  two 
thicknesses  of  wet  on  the  abdomen  and  one  upon  the  back.  At 
Graefciiborg  this  appplication  was  worn  by  every  patient,  and,  as  a 
rule,  all  of  the  time.  It  is  useful  in  a  great  variety  of  aiUuents,  both 
acute  and  chronic.  The  same  form  of  application  is  also  useful  for 
the  arms,  leg^»,  etc.,  the  tapes  being  used  in  prefc^rence  to  pins. 

The  wet  jacket^  or  cheat  vwapper,  is  also  a  valuable  nisort  in  dis- 
eases of  the  chest.  Oiled  silk  and  other  similar  articles,  as  I  havo 
elsewhere  observed,  are  not  to  bo  used  upon  these  local  applications. 


DOMESTIC  MANAGEMENT  OF  THE  SICli-ROOM.* 


Choice   of  the   Sick-Room,   etc. 

Sleeping^  Apartment.  —  In  every  case  of  disease,  however  slight  its 
nature,  the  sleepiiii^  :ii)iirtim'nt  of  llio  sick  should  be  airy  and  well 
ventilated  ;  but,  when  Providenee  visits  any  member  of  a  family  with 
disease  of  a  serious  and  protracted  descriptifju,  all  other  considera- 
tions giving  way  to  the  necessity  of  the  case,  an  apartment  should  be 
chosen  and  arranged  in  a  special  manner  for  the  reception  of  the  in- 
valid. It  should  bo  one  calculated  to  administer  to  his  teinporaiy 
comfort,  as  well  as  to  aid  his  recovery.  It  is  not  time,  when  the 
alarm  is  sounded  and  the  danger  is  already  urgent,  to  think  of  8u«:h 
arrangements ;  forethought  must  bni  put  in  requisition ;  ev  n-y  want 
anticipated ;  and  whatever  is  likely  to  bo  required  should  i.ot  only 
be  provided,  but  so  arranged  that  it  can  bo  instantly  found  when  it  is 
needed. 

The  sick-room  should  bo  large,  lofty,  and,  if  possible,  with  a  north- 
em  aspect,  in  order  to  avoid  the  heat  of  the  mid-day,  or  tho  aftornoon 
smi;  the  windows  should  be  capable  of  being  opened  by  drawing 
down  the  uppermost  sash ;  an  advantage,  however,  which  cannot 
always  be  ol>tained,  as  this  mode  of  opening  windows  is  too  gener- 
ally neglected  in  the  construction  of  modern  houses.  No  room,  how- 
ever large,  should  be  used  as  a  sick-room,  unless  it  has  a  chimney  ; 
but  neither  the  chimney-board  nor  the  soot-board  of  tho  apartment 
should  bo  put  up,  even  in  summer.  No  article  of  unnecessary  furni- 
ture should  be  pei'mitted  to  remain  in  tho  room  ;  and  lliut  which  is 
left  in  it  should  be  of  a  description  fitted  to  administer  to  tho  conven- 
ience of  the  invalid. 

Two  tables  are  sufficient.  One  of  them  may  bo  small,  to  stand 
near  the  bed,- for  tho  immediate  use  of  tho  patient :  namely,  to  hold 
his  jug  of  barley-water,  or  toasc- water,  or  other  beverage  ;  —  a  small 
tea-pot,  or,  what  is  preferal?le,  a  half-covered  cup  with  a  sjiout,  to 
enable  fluids  to  be  administered  without  raising  tho  sufferer  in  bed  ;  — 
his  medicines  for  tho  day ;  —  and  any  other  thing  which  ho  may  fre- 
quently require. 

The  other  table  should  be  large,  for  tho  accommodation  of  medi- 
cines not  in  immediate  use,  and  also  "or  spare  glasses,  jugs,  cups, 

*  Thompson,  On  the  Manageme  ^  of  the  Sicl>  fioom. 


552 


DOMESTIC    MANAGEMENT    OF    THE    SICK-ROOM. 


spoons,  both  large  and  small,  and  other  necetrsary  j.rticles.  Thij 
table  should  have  one  drawer,  at  least,  which  ought  to  bo  furnished 
with  the  following  articles:  broad  and  narrow  tape;  two  or  three 
half-worn  ril)bc)ns  ;  a  bundle  of  old,  soft  linen  ;  a  sponge  ;  a  few  ounces 
of  lint ;  scissors,  large  and  smaH  ;  a  bone  spatula  for  spreading  oint- 
ment; a  couple  of  rolls  of  nmslin,  and  the  same  quantity  of  flannel 
bandage  two  inches  broad;  a  pin-cushion  well  supplied  with  pins; 
needles  and  thread  ;  and  al)()ut  half  a  yard  of  simple  adhesive  plaster. 

A  Sofa  or  Reclininii:  Chair,  —  A  sofa,  if  th*^  apartment  be  suffi- 
ciently largo  to  admit  of  it,  is  a  very  important  piece  of  furniture  in 
the  sick-room;  the  erect  or  the  sitting  posture  being  injurious  in 
many  diseases ;  and,  when  the  sick-bed  requires  to  be  made,  a  sofa 
affords  the -means  of  removing  the  patient  from  the  bed  with  as  little 
inconvenience  to  him  as  possible. 

If  there  is  not  space  for  a  sofa,  there  should  be  an  invalid  or  re- 
clining chair;  and,  when  circumstances  will  permit,  it  should  be  of 
that  kind  which  is  susceptible  of  a  variety  of  changes,  so  as  to  vary, 
at  pleasure,  the  position  of  the  patient.  There  should  not  be  more 
than  two  other  chairs  in  the  room.  If  there  is  a  looking-glass  in  the 
apartment,  in  a  situation  which  admits  of  the  patient  seeding  himself 
in  it  as  he  lies  in  bed,  its  place  should  changed,  or  it  sl.oulu  be  alto- 
gether removed  from  the  room.  A  chest  of  drawers  is  ossential ;  but 
none  of  the  drawers  should  be  appropriated  for  the  reception  of  dirty 
linen,  which  ought  never  to  bo  allowed  to  remain  a  moment  in  the 
sick-room.  One  drawer  should  be  specially  allotted  lor  towels,  of 
which  an  ample  supply  is,  in  evcvy  case,  necessary.  The  washing- 
stand  will  require  two  additional  basins  ;  an  additional  water  bottle 
and  u  tumbler ;  and  a  largo,  supernumerary  water  jug,  under  tue  ta- 
ble, always  full  of  water. 

IVo  Cooking  in  Sick-room.  —  Thei-e  should  l)e  no  kettle,  nor  any 
implement  of  cooking,  in  the  sick-room  ;  even  in  Avinter,  and  when  a 
tiro  is  required.     In  general,  a  tire  in  the  sick-room  is  only  necessary 


for  the  comfort  of  the  attendants  ;  but  nurses  too  frequently  take  ad- 
vantage of  it  to  bo;l  the  water  for  tiieir  own  tea,  and  to  prepare  the 
slops  for  the  invalid ;  a  custom  which  cannot  be  t(»o  severely  repro- 
bated. Tlie  lamp  termed  a  Nighl-nurse,  consisting  of  a  water-bath 
placed  over  a  lamp  in  a  wiic-worUed  cylinder;  a  small  tin  kettle 
which  enters  the  top  of  the  cylinder ;  and  a  covered  earlhen-waro 
vessel  which  fits  it  into  the  water-bath  ;  are  useful  for  keeping  fluids 
warm,  and  at  the  same  time  for  preserving  t*  light  in  the  room,  when 
an  unshadod  lamp  or  a  candle  would  bo  hurtful. 

In  continued  fevers,  the  sense  of  hearing  is  often  so  morbidly  acute, 
that  ordinary  sounds  become  causes  of  pain.  In  this  case,  if  the  floor 
of  the  sick-room  bo  lutt  wholly  carpeted,  every  precaiition  to  lessen 
the  intensity  of  sound  should  be  taken.  One  of  the  most  effectual  is 
to  have  a  couple  or  more  pairs  of  large  list  shoes  outside  the  door, 
into  which  the  feet,  even  of  the  doctors,  may  be  advantageously 
thrust,  when  their  shoes  make  a  creaking  nois),  or  when  a  visitor  or 
nurse  treads  with  a  heavy  foot.     On  the  samo  account,  when  more 


mmm 


DOMESTIC  MANAGEMENT  OP  THE   SICK-ROOM. 


553 


than  one  nurse  or  attendant  is  required  to  be  in  the  room  at  the  same 
time,  no  conversation,  although  it  may  be  carried  on  in  a  whisper, 
should  bo  permitted.  Whispering,  indeed,  is  apt  to  excite  delirium, 
and  to  augment  it  when  it  is  already  present. 

Beds  and  Ileddliig;.  —  The  French  beds,  without  curtains,  are  those 
best  adapted  for  the  sick-room.  When  four-posted  bedsteads,  i^v.r- 
roiuulcd  by  curtains,  were  more  in  use  than  at  the  present  time,  the 
mischief  arising  from  excluding  the  free  air,  by  dniwing  the  curtains 
close  around  the  bed,  was  frequent  and  serious.  In  every  case  of 
disease,  indeed,  especially  when  it  is  attended  by  fever,  the  patient 
should  bo  kept  cool,  and  the  most  perfect  freedom  bo  given  to  the 
hrcathing;  the  mattress  should  bo  placed  over  the  feather  bed,  and 
the  pillows  be  firm  and  elastic.  The  Marseilles  coverlets,  which  are 
spread  upon  beds  during  the  day,  and  often  retained  at  night,  are 
heavy,  and  calculated  rather  to  increase  than  to  subdue  fever ;  conse- 
quently they  should  be  Avholly  discarded  from  the  sick-bed.  Indeed, 
when  the  disease  is  fever,  and  when  it  is  acc()n4)anied  with  great  rest- 
lessness owing  to  the  evening  exacerbation,  if  the  bed-room  be  suffi- 
ciently largo,  two  beds  should  be  placed  in  it ;  or  if  two  adjoining 
bed-chambers  can  be  obtained,  a  bed  ought  to  be  put  in  each,  so  that 
the  patient  can  bo  moved  from  one  bed  to  the  other  every  morning 
and  evening.  This  both  aids  sleep,  and  it  also  tends  greatly  to  insure 
the  personal  cleanliness  of  the  patient.  The  bed-clothes  of  the  bed 
from  which  the  patie;it  is  moved,  should,  on  his  removal,  bo  iujinedi- 
atcly  turned  down  and  fully  exposed  to  the  air;  a  precaut.  ^n  which 
will  set  aside  tho  necessity  of  so  frequent  a  change  of  lintMi,  as  wcdd 
ho,  otherwise,  required.  When  there  is  only  one  bed,  and  when  (ho 
disease  ia  fever  (unless  the  patient  is  too  ill  to  permit  his  l)eing 
moved),  the  shoots  which  have  been  used  iit  niglit  should  be  rephicod 
hy  others  in  the  morning,  and  hung  up  in  tho  free  air  during  tho  day, 
to  bo  again  used  at  night.  But,  when  it  can  conveniently  be  done, 
in  every  case  of  contiiiuod  fever,  especially  of  ar»  infectious  kind,  tho 
sheets  should  bo  changed  once  in  twenty-four  hours  ;  a  practice  which 
id  likely  to  prevent  tho  fumes  of  infection  from  being  communicated 
to  the  blankets  or  to  any  of  the  furniture  of  tho  room. 

Ventiliition  is  always  of  primary  importance;  and  that  rieriod, 
happily,  is  gone  by,  in  which  air  Avas  carefully  excluded  from  tho 
chambers  of  the  sick,  even  when  they  were  suffering  imder  febrile 
disease. 

Ventilation  is  ]3articidarly  demanded  in  those  fevers  in  which  mil- 
iary eruptions  d  splay  themselves ;  uuder  no  circumstances  is  it  so 
essential  as  in  febrile  diseases  of  an  infectious  kind.  It  may,  how- 
ever, bo  consolatory  to  those  whose  duty  it  is  to  attend  such  cases,  to 
know  that  infoct.on,  communicated  through  tho  air,  rarely  extends 
above  a  few  feet  from  the  body  of  the  patient ;  and  evtn  in  the  most 
malignant  diseases,  with  the  exception  of  confluent  small  pox,  and 
malignant  scarlet  fever  of  tho  worst  kind,  its  influence  does  not  ex- 
ceed a  few  yards,  if  the  room  be  well-ventilated.  On  tho  contrary, 
if  ventilation  be  neglected,  the  power  of  infection  becomes  greatly 


M 


mk-' 


554 


DOMESTIC  MANAGEMENT   OP  THE   SICK-ROOM. 


augmented  from  its  concentration  in  confined  and  quiescent  air ;  it 
even  settles  upon  the  clothes  of  the  attendants,  and  on  the  furniture 
of  the  room  ;  and  these  imbibe  it  most  readily  when  their  texture  is 
wool,  fur,  or  cotton,  or  any  loose  or  downy  substance  capable  of  re- 
ceiving and  readily  retaining  the  air.  Smooth  and  polished  surfaces 
do  not  easily  receive  or  retain  infectious  matter ;  consequently  the 
nurses  and  attendants,  in  cases  of  infectious  diseases,  should  have 
glazed  gowns,  and  aprons  of  oiled  silk. 

In  no  infectious  diseases  are  these  rules  more  essentially  necessary 
than  in  small  pox  and  scarlet  fever.  It  is  well  known  that,  if  the  bod- 
clothes  of  a  patient  laboring  under  either  scarlet  fever  or  small  pox 
be  closely  folded  up,  they  will  retain  tiie  infectious  matter,  and  com- 
municate the  disease  at  a  great  distance  of  time  ;  but  the  influonco  of 
free  ventilation  is  so  great,  that  medical  practitioner.s  who  are  attend- 
ing small  pox  patients,  and  who  go  from  them  into  the  open  air,  do 
not  spread  the  disease.  Indeed,  all  infection  is  weakened  by  dilution 
with  air.  The  danger  of  infection  is  augmented,  if,  along  with  bad 
ventilation,  the  atmosphere  of  the  room  bo  moist  from  any  cause. 

It  is  further  consolatory  to  know  that  tho  infectious  matter,  even 
of  the  most  virulent  description,  is  not  poisoiicms  to  every  one  who 
is  placed  within  the  sphere  of  its  influence.  A  predisposition  of  the 
body  to  receive  the  infection  must  exist  before  it  can  be  communi- 
cated ;  a  condition  which  i-s  augmented  by  fatigue  and  watching,  de- 
fective nourishment,  mental  depression,  or  anything  which  can  lower 
the  vital  powers.  The  necessity,  therefore,  of  maintahiing  these 
powers  by  attention  to  rest,  a  sufficient  quantity  of  good  and  gener- 
ous diet,  and  cheerfulness  of  mind,  need  not  be  insisted  upon. 

In  every  case  of  infectious  disease,  the  attendants,  evei  in  tho  best 
ventilated  rooms,  should  stand  on  the  windward,  or  on  that  side  of 
the  sick-bed  from  which  the  current  of  air  comes  ;  as,  by  neglect  of 
this  rule,  and  by  standing  in  the  current  which  has  passed  over  tho 
patient,  the  infectious  exhalations  are  blown  upon  them  in  a  direct 
stream  from  the  body  of  the  patient.  The  attendants  should  never 
lean  over  the  sick,  nor  should  they  receive  their  breath.  The  health 
also  of  the  nurses  should  always  be  supported  by  nutritious  and  gen- 
erous diet ;  but  not  by  brandy,  nor  any  other  ardent  spirit. 

The  terra  infection,  in  its  most  extensive  signification,  implies  some 
deleterious  matter,  originating  from  any  source,  and  transmitted 
through  the  air,  which  is  capable  of  causing  diseases  in  tho  human 
body.  When  this  matter  is  emanated  from  the  diseased  bodies  of 
men,  the  term  is  frequently  regarded  as  synonymous  vv^itli  coniwjion; 
but,  in  strictness  of  ianguage,  the  latter  refers  only  to  the  communi- 
cation of  disease  by  contact.  Whatever  may  bo  the  matter  of  infec- 
tion, it  may  enter  the  body  through  tho  medium  of  the  lungs,  which 
is  the  most  ready  inlet,  or  by  the  saliva,  or  even  through  the  surface, 
if  the  skin  be  abraded,  or  if  any  ulceration  be  present.  Tho  influ- 
ence of  infectious  matter  is  evidently  exerted  on  tho  nervous  system, 
displaying  itself  by  debility,  inertness,  dislike  to  motion,  great  sus- 
ceptibility of  cold,  irritability  and  despondency  of  mind,  and  by  the 
production  of  a  disease  similar  to  that  of  the  person  from  whom  the 


II'- 


i-  • 


DOMESTIC   MANAGEMENT   OF   THE   SICK-ROOM. 


555 


infectious  matter  has  proceeded.  The  infectiou  may  be  supposed  to 
have  taken  effect,  and  to  have  produced  the  actual  disease,  when  the 
person  who  has  been  exposed  to  its  influence  is  attacked  with  giddi- 
ness, pain  of  the  head,  irreguhir  heat  and  chills,  nausea,  and,  if  the 
infectious  disease  be  small  pox,  convulsions.  These  symptoms  are 
sufficient  to  denote  the  necessity  for  immediate  medical  advice. 

Tfiiiperature.  —  Next  to  ventilation  nothiuf!^  is  of  more  importance 
than  the  regulation  of  the  temperature  of  the  sick-room,  avoiding 
both  extremes  of  elevation  or  of  depression  ;  but  much  depends  on 
the  nature  of  the  disease. 

The  best  general  temperature  of  a  sick-room  is  60°  (Fahr. )  ;  and 
it  is  preferable  to  regulate  this  rather  by  the  thermometer  tlian  by  the 
«ensations  of  the  patient  or  the  attendants.  Uiulor  soiro  circum- 
stances, however,  the  feelings  of  the  patient,  and  his  susceptibility  of 
impressions  upon  the  skin,  should  not  be  overlooked.  Thus  if  the 
temperature  be  a  little  above  that  of  summer,  and  the  pjitient,  never- 
theless, feel  chilly,  it  should  bo  raised  five  or  six  degrees.  Thia  chil- 
liness is  very  apt  to  be  felt  in  a  dyspeptic  state  of  tlio  habit,  and 
more  especially  when  it  is  accompanied  with  hyi)ochondriasis.  It 
differs  from  that  more  severe  but  transient  coldness  which  accompa- 
nies intermittent  fevers,  and  some  other  periodical  affections ;  and  it 
requires  an  elevated  temperature  of  the  air  for  its  rer^>oval,  whilst  the 
cold  stage  of  intermittent  diseases  is  best  relieved  by  the  warm  bath, 
either  general  or  local. 

So  important  is  the  regulation  of  temperature,  especially  in  fevers, 
\hat  it  often  does  more  good  than  any  other  remedial  measure.  I 
have  seen  patients,  laboring  under  high  delirium  in  a  close,  ill-venti- 
lated room,  become  rapidly  quite  collected  by  merely  lowering  the 
heat  of  the  apartment  twelve  or  tifteen  degrees. 

In  convalescence,  as  the  air  of  the  sick-chamber  should  be  fre- 
quently renewed,  the  temperature  in  spring  and  autumn  ought  to  be 
maintained  as  near  as  possible  at  55°  to  G0°  (Fahr.)  ;  and  it  should 
be  very  gradually  lowered  as  the  invalid  acquires  strength,  so  aa  to 
enable  him  to  bear  with  impunity  the  varying  tein[)erature  of  these 
seasons  in  the  open  air.  Even  thon,  if  the  previous  disease  has  been 
I  ulmonary,  the  air  admitted  to  the  lungs  should  bo  tempered  by  the 
use  of  tho  Respirator,  or  a  muslin  hiindkcrchiof  tied  around  the 
mouth.  When  the  invalid  first  ventures  out  of  doors,  nothing,  in- 
deed, is  so  essential,  in  a  prophylactic  point  of  view,  as  avoiding 
extremes  and  sudden  transitions  of  temperature. 

Cleanliness.  —  Although  deanlinens  in  the  sick-room  is  essential, 
yet  it  may  bo  carried  so  far  as  to  become  an  annoyance  to  tho  inva- 
lid, and  consequently  to  prove  injurious.  It  is  not  requisite  to  sweep 
tho  room  daily,  nor  to  dust  and  arrange  tho  furniture  every  morning, 
provided  order  be  preserved  in  the  room,  and  nothing  but  what  is 
ifmmediately  necessary  for  the  comfort  and  convenience  of  the  invalid 
be  permitted  to  remain  in  it.  It  is  truly  distressing  to  observe  the 
confusion  which  prevails  in  some  sick-rooms  ;  everything  being  out 
of  place,  and  to  be  searched  for  when  it  is  wanted. 


n! 


656 


DOMESTIC   MANAGEMENT   OF   THE    SICK-ROOM. 


The  period  chosen  for  clpanin<5j  and  arranging  the  sick-room  shouid 
be  the  morning ;  us,  after  a  night's  rest,  the  patient  h  more  ahle  to 
hear  the  little  noise  and  bustle  which  it  always  more  or  less  occasions. 
!rhe  carpet  should  bo  sprinkled  with  moist  tea-leaves,  and  liiihtly 
swept ;  and  during  this  operation  the  curtains  of  the  bed,  if  there  ho 
any,  should  be  drawn. 

It  is  scarcely  requisite  to  insist  on  the  necessity  of  the  utmost 
attention  to  the  cleanliness  of  everything  in  the  sick-room.  The 
moment  attc  any  vessel  or  implement  is  used  by  the  invalid,  it 
should  be  removed  from  the  apartment,  and  returned  as  soon  :is  it  u 
cleaned.  Nothing  in  the  form  of  a  slop-basin  or  a  slop-pail  is  admis- 
Bible  ;  they  only  administer  to  the  laziness  of  nurses. 

The  necessity  of  cleanliness  in  the  vessels  used  for  the  food  of  in- 
valids is  strikingly  illustrated  in  the  bad  eflfects  arising  from  the  no<r- 
lect  of  it  when  an  infant  is  brought  up  by  hand.  In  such  a  case,  if 
either  the  feeding-bottle,  or  the  boat,  which  is  employed,  be  not  in- 
stantly cleansed  after  the  meal  has  been  given,  the  small  portion  of 
the  pap  or  food  which  remains  in  the  vessel  becomes  sour,  and  taints 
the  whole  of  the  fresh  food  mixed  with  it,  causing  colic  and  convul- 
sions in  the  infant.  The  same  risk  of  injury  occurs  in  the  sick-room, 
if  the  vessels  used  for  administering  food  to  the  invalid  be  not  in- 
stantly and  well  cl(;ansed  after  every  time  they  are  used. 

It  is  too  conmion  also  to  use  one  glass  or  cup  for  administering 
medicines,  and  to  leave  it  unrinsed  from  time  to  time,  —  a  custom 
which  may  [)rovc  as  deleterious  as  a  defect  of  cleanliness  in  vessels 
employed  f\)r  food.  Some  medicines,  when  they  are  exposed  to  the 
air,  rapidly  undergo  changes  which  alter  their  properties  ;  and  this 
alteration  having  i>eon  undergone  by  the  small  portion  which  is  always 
left  in  the  gl;iss  or  cup,  coinniiuiicatos^  the  disposition  to  be  decom- 
posed to  that  which  may  be  noxt  poured  into  the  cup.  An  active 
medicine  may  be  thus  rendered  inert;  or  one  which  is  mild  in  its 
operation  maybe  so  chsmgcd  as  to  operate  witii  hazardous  energy. 
The  same  precaution,  as  to  cleanliness,  is  also  requisite  as  to  the 
minim  measure,  Avhen  the  medicines  are  directed  to  be  administered 
in  a  form  which  requires  its  employment. 

Darkeiiiii<?  tlie  Siek-room. — It  is  a  common  error  to  imagine  tlmt 
a  sick-i'oom  should  always  be  e'ltlmr pnrtiallt/  or  luholh/  darkened.  In 
some  diseases,  as,  for  example,  fevers,  wlien  the  eyes  aie  acutely  sen- 
sible to  light,  so  that  they  remain  half  closed,  and  the  eyebrows  are 
contracted,  the  greatest  relief  is  experienced  from  darkening  the 
room.  When  deliriiun  is  present,  a  certain  degree  of  darkening  is  in 
Bfjme  instances  serviceable ;  whilst  in  others,  especially  when  the  de- 
lirium is  accompanied  with  visual  illusions,  nothing  so  readily  dispels 
these,  and  consequently  abates  the  delirium,  as  the  admission  of  the 
full  daylight  into  the  sick-room.  There  is  much  diflSculty,  however, 
in  determining  which  state  of  the  apartment  is  likely  to  bo  most  ser- 
Ticeable  in  any  particular  case.  Observation  of  the  effects  of  light 
and  darkness,  in  the  individual  case,  must  be  our  guide. 

These  illusions  of  the  sight  are  generally  the  result  of  former  im- 


DOMESTIC   MANAGEMENT  OF  THE   SICK-ROOM. 


557 


pressions,  renewed  at  a  moment  when  the  brain  is  in  such  a  disturbed 
condition  as  to  set  aside  the  exercise  of  judgment.  In  this  condition 
of  the  brain,  the  renewed  conceptions  are  not  readily  corrected,  as  in 
health,  by  impressions  received  from  the  external  world ;  hence,  they 
become  more  vivid  in  the  mind  of  the  invaltd  when  the  sick-room  is 
darkened,  and  all  visible  objects  are  shut  out.  They  are  usually  dis- 
pelled by  new  impressions  on  the  organ  of  sense  chiefly  implicated ; 
on  which  account,  those  which  are  connected  with  sight  seldom  occur 
during  the  duy,  when  real  objects  are  presented  to  the  eye,  unless  the 
brain  be  so  over-excitod  as  to  bring  the  couccptive  faculty  into  in- 
tense exercise,  sufficient  to  awaken  those  false  perceptions  which 
create  a  belief  of  the  presence  of  individuals  not  only  not  present, 
but  who  have  been  long  dead.  This  state  of  the  mental  organ  is 
similar  to  that  on  which  depend  the  spectral  illusions  of  the  insane, 
but  differing  from  it  in  its  transient  nature.  I  have  frequently  wit- 
nessed the  conversation  with  one  of  these  spectral  beings  instantly 
terminated,  and  the  whole  illusion  dispelled,  on  opening  the  window 
shutters  of  the  room;  whilst  the  invalid  has  thus  expressed  himself: 


•'Bless  me!  I  thought  I  was  talking  with  Mr. 


just  now 


must  have  been  dreaming ;  for  now  I  recollect  he  has  been  dead  n)any 
years."  A  twilight  obscurity  in  the  sick-room  is  often  more  produc- 
tive of  these  illusions  than  darkness. 

The  Naise.  —  When  all  the  arrangements  are  completed  in  the 
sick-room,  little  benefit  can  be  anticipated  if  a  proper  nurse  bo  not 
obtained  to  render  them  available  to  the  invalid.  Every  female,  who 
wishes  to  act  as  a  sick  nurse,  should  be  obliged  to  serve  a  certain 
time  as  an  assistant  nurse  in  one  of  the  public  hospitals,  and  to  re- 
ceive a  certificate  of  her  efficiency  before  she  leaves  the  establish- 
ment. The  advantages  which  the  public  would  derive  from  a  body 
of  nurses,  educated  in  this  manner,  must  be  obvious  to  every  one  who 
has  had  opportunities  of  observing  the  miserable  working  of  tho 
present  system. 

In  hiring  a  sick-nurse,  the  qualifications  which  should  regulate  our 
choice,  refer  to  age,  strength,  health,  temper,  disposition,  habits,  and 
education. 

Age.  —  She  should  not  bo  under  twenty-five,  nor  above  fifty-five 
years  of  age.  This  period  is  fixed  upon,  on  account  both  of  the 
physical  powers  and  the  moral  conduct  of  the  individual.  Under 
twenty-five,  tho  strength  of  n  woman  has  not  reached  its  maturity, 
and  is  scarcely  adequate  for  lifting  patients  in  and  out  of  bed,  and 
for  many  other  duties  which  require  strength,  connected  with  the 
office  of  a  nurse  ;  but  the  strength  and  the  muscular  power  in  females 
begin  to  fail  after  fifty-five,  when  tho  natural  transition  from  maturity 
to  decay  takes  place.  , 

Streng;tli. — The  foregoing  remarks  respecting  ago  render  it  almost 
unnecessary  to  say  that  a  woman  of  a  naturally  delicate  frame  of 
body  is  unfit  for  a  sick-nurse :  at  the  same  time,  a  coarse,  heavy, 
and  masculine  woman  is,  for  many  rea8on3,  objectionable.     Whilst 


Pl^ 


I 


U 


558 


DOMGSTTO  MANAOEMEMT  OF   THE   SICK-ROOM. 


strength  is  requisite,  the  fi  ame  should  be  such  as  to  indicate  activ> 
ity. 

Health.  —  None  of  the  quali^catious  of  a  sick-nurse  are  of  impor- 
tance more  than  health.  An  individual  who  herself  requires  atten- 
tion is  ill-calculated  to  attend  upon  others.  A  woman  who  is  asth- 
matic, or  has  any  difficulty  of  breathing,  or  an  habitual  cough ;  who 
is  rheumatic  or  gouty,  or  haa  any  spasmodic  affection ;  who  is  af- 
flicted with  palpitation  ;  or  suffers  from  periodical  headache,  vertigo, 
or  a  tendency  to  paralysis  ;  or  who  is  consumptive,  or  scrofulous ;  or 
has  defective  sight  or  hearing ;  or  anything  Avhich  causes  decrepitude, 
is  disqualified  for  a  sick-nurse.  It  is  important,  also,  to  ascertuiu 
there  is  no  hypochondriacal  nor  hysterical  tendency,  nor  predisposi- 
tion to  mental  depression. 

Temper  and  Disposition.  —  It  is  scarcely  requisite  to  say  that  an 
attendant  upon  the  sick  should  possess  a  happy,  cheerful,  equal  flow 
of  spirits ;  a  temper  not  easily  ruffled ;  and  kind  and  sympathetic 
feelings ;  but,  at  the  same  time,  not  such  as  to  interfere  with  firm-  | 
ness  of  character.  The  exf  ression  of  the  countenance  should  be 
open  and  winning,  so  as  to  attract  the  good-will  and  confidence  of 
the  invalid ;  a  pleasing  and  gei:tle  manner  being  more  likely  to  gain 
esteem,  and  insure  obedience  to  the  orders  of  the  physician,  than  the 
most  persuasive  arguments  which  can  be  addressed  to  the  under- 
stuniing  of  the  patient. 

A  collected,  cheerful  expression  of  the  countenance,  in  the  attend- 
ant on  the  sick,  is  likely  to  inspire  hope,  and  to  aid  the  efforts  of  the 
physician  for  the  recovery  of  his  patient. 

The  general  disposition  of  a  sick-nurse  should  be  obliging.  Every 
little  oflice,  which  the  invalid  may  require  to  bo  done,  should  be  i)er- ' 
formed  at  once,  and  without  the  smallest  apparent  reluctance,  even 
when  the  necessity  for  its  immediate  performance  is  not  absolute- 
There  is  also  an  earnestness  of  manner,  which  should,  if  possible,  be 
obtained  or  acquiesced  m  by  the  sick-nurse,  as  it  impresses  the  idea 
that  she  feels  deeply  interested  in  the  case  ;  a  circumstance  which  is 
always  highly  appreciated  by  the  patient. 

Finally,  it  is  unnecessary  to  say  that  a  nurse  should  bo  honest,  as 
no  description  of  servant  has  so  much  in  her  power.  But  the  honesty 
of  the  nurse  is  not  to  be  measured  by  her  respect  for  property ;  she 
must  be  above  imposing  on  the  physician,  with  respect  either  to 
medicines  or  to  diet.  Her  religion,  also,  should  be  sincere,  but  not 
Pharisaical ;  and  although  she  may  occasionally  persuade  her  charge 
♦♦  to  put  his  trust  in  God,  the  fountain  of  health,"  *  yet  she  must  rec- 
ollect that  preaching  is  not  her  province ;  and,  when  mistimed,  even 
the  best  advice  may  prove  not  only  profitless,  but  injurious ;  and  this 
is  especially  likely  to  be  the  result,  when  the  doctrines  which  she 
professes  are  of  a  controversial  kind. 

With  respect  to  gossiping,  it  is  a  detestable  habit  under  any  cir- 

*  Toller. 


DOMEPyriC   MANAGEMENT  OF   TIIE   SICK-ROOM. 


559 


ciirastances ;  but,  in  a  nurse,  it  may  bo  productive  of  the  greatest 
danger,  produce  family  feuds,  and  a  tliousaiul  oth'^i  evils. 

In  her  Habits,  a  sicli-nurse  should  bo  sober,  active,  orderly,  and 
clean,  and   neat  in  her  person. 

The  first  of  those  habits  —  namely,  sobriety  —  is  so  essential  a 
qualification  in  every  attendant  in  the  sick-room,  that  it  requires  no 
comment.  Happily,  the  desire  for  ardent  spirits  is  now  less  frequent 
than  formerly,  when  women  were  seldom  employed  as  nurses  until 
they  were  nearly  superannuated,  and  until  their  habits,  good  or  bad, 
were  too  firmly  rooted  to  be  removed. 

The  Activity  essential  for  a  good  nurse  docs  not  imply  a  bustling  or 
fidgety  manner,  but  a  quiet,  steady  method  of  proceeding  in  the  per- 
formance of  her  duties,  equally  devoid  of  fluster,  turbulence,  or  noise. 
This  activity  is  generally  associated  with  orderly  habits ;  a  most  valua- 
l)le  qualification,  and  without  which  the  sick-room  becomes  a  scene  of 
confusion  and  disgust.  Every  medical  man  must  have  witnessed  thb 
state  of  disorder  with  regret,  when,  on  visiting  his  patient,  he  finds  no 
chair  to  sit  upon,  until  some  article  of  bedding,  or  of  clothing,  bo  re- 
moved from  it,  and  the  seat  dusted  with  the  apron  of  the  nurse  ;  and 
when  a  former  prescription,  or  anything  else,  is  wanted,  he  must  wait 
until  the  nurse  rummages  out  half  a  dozen  of  drawt      in  search  of  it. 

Another  quality,  usually  conjoined  with  activity  and  orderly  habits 
in  a  nurse,  is  cleanliness  in  her  own  person,  and  in  that  of  her  charge, 
as  well  as  that  of  the  sick-room.  The  dress  of  a  nurse  should  be 
simple  and  neat,  without  trimmings.  Nothing  is  more  out  of  place 
than  a  fine  lady  attempting  to  perform  the  duties  of  a  nurse. 

Edacation.  —  It  may  appear  a  refinement  to  talk  of  the  education  of 
a  nurse ;  but  there  is  not  a  greater  difference  between  noon-day  and 
midnight  than  between  an  educated  and  an  ignorant  nurse.  The  for- 
mer is  often  an  aid  to  the  physician,  not  only  in  carrying  his  orders 
into  effect,  but  by  observing  and  informing  hira  of  symptoms  of  great 
importance  which  have  occurred  during  his  absence  :  whereas  the  lat- 
ter is  a  source  of  constant  anxiety,  and  too  often  assumes  the  privi- 
lege of  acting  in  direct  contradiction  to  his  orders,  and  according  to 
her  own  opinion. 

XTnhired    Attendants. 

Tee  selection  of  a  good  nurse,  however  eminently  qualified  she 
may  be  for  her  duties,  does  not  supersede  the  attendance  of  a  rela- 
tive or  a  friend  in  the  sick-room ;  on  the  contrary,  I  can  conceive  no 
condition  so  deplorable  as  that  of  an  invalid  left  altogether  to  the  care 
and  management  of  a  hireling.  It  is,  nevertheless,  too  true  that  few 
ladies,  even  those  /vho  are  wives  and  mothers,  have  any  acquaintance 
with  the  arrangements  of  the  sick-room,  and  the  management  of  the 
invalid  ;  they  are,  consequently,  too  often  forced  to  be  guided  by,  and 
to  i;ely  for  instruction  on,  the  nurse,  instead  of  being  able  to  superin- 


I 


■'¥. 


J'"  "'9 


5G0 


DOMESTIC  MANAGEMENT  OP  THE   SICK-ROOM. 


tend  her  conduct,  to  ascertain  that  she  performs  her  cluty,  and  to  cor- 
rect lier  failings. 

Tlio  degree  oi  intelligence  which  is  demanded  in  a  nurse  is  very 
diflcrent  to  that  which  is  requisite  for  a  wife  or  a  relative  in  the  sick- 
room. Tiie  intelligence  of  the  nurse  is  directed  to  supply  the  wants 
of  the  invalid,  to  administer  to  his  comforts,  and  toohcy  the  instruc- 
tions of  the  physician  ;  that  of  the  friend  or  relative  involves  tlio 
power  of  discriminating  disposition  and  temper;  of  Avatching  the 
progress  of  the  disease,  and  judging  of  the  propriety  of  not  pursuing 
certain  measures,  which,  although  indicated  by  the  symptoms  at  tlio 
time  of  prescribing,  yet  may  require  to  bo  altered,  and  consequently 
detailed  to  the  physician,  whoso  presence  may  be  requisite  before  his 
next  intended  visit.  It  is  of  the  utmost  importance,  also,  that  rela- 
tives attending  in  the  sicU-room  should  be  able  to  control  their  feel- 
ings in  the  jiresence  of  the  invalid. 

Nothing  is  more  essential,  in  the  domestic  management  of  diseases, 
than  a  knowledge  of  the  natural  disposition  and  temper  of  the  inva- 
lid. An  irritable  or  a  passionate  man  requires  a  very  different  man- 
agement from  that  which  is  pioper  for  a  man  of  naturally  mild  and 
easy  disposition.  Disease  awakens,  in  an  augmented  degree,  the  irri- 
tability of  the  former ;  he  becomes  impatient  of  contradiction ;  and 
every  time  his  opinions  are  injudiciously  opposed,  the  turbulent  agi- 
tation of  the  nervous  system  which  follows  either  increases  the  dis- 
ease or  weakens  the  influence  of  the  remedial  agents.  On  the  other 
hand,  a  mild  and  gentle  disposition  often  leads  to  extreme  sensitive- 
ness, when  disease  attacks  the  body :  a  word,  a  look,  is  sufficient  to 
touch  some  sympathetic  cord  ;  to  unstring  the  whole  nervous  system ; 
and  to  augment  the  morbid  susceptibility  already  present  in  the  habit 
to  a  degree  which  is  not  always  devoid  .of  danger.  Much  discretion 
and  judgment,  therefore,  are  requisite  in  both  instances:  in  the  one 
case,  to  prevent  ebullitions  of  temper ;  in  the  other,  to  refrain  from 
ari3i;hing  that  might  be  construed  by  the  invalid  into  harshness ;  and 
yet,  at  the  same  time,  in  each  case,  to  maintain  that  influence  over 
the  patient  which  the  treatment  of  every  disease  demands  in  an  at- 
tendant on  the  sick. 

Prejudice  and  Antipathies.  —  In  those  who  are  imperfectly  or  erro- 
neously educated,  the  judgment  is  apt  to  be  biassed  by  prejudice  and 
antipathies;  and,  under  the  influence  of  these,  it  is  misdirected  in  a 
manner  of  which  the  individual  is  often  wholly  unconscious  ;  thence 
the  necessity  of  freedom  from  prejudice  in  the  attendants  in  the  sick- 
room, and  the  farther  importance  of  the  friends  or  relatives  of  the 
sick  being  able  to  superintend  the  conduct  and  the  management  of 
hired  nurses.  On  the  other  hand,  the  judgment,  even  in  the  well- 
educated,  is  apt  to  be  misled  by  the  affections^  the  influence  of  which 
is  as  much  opposed  to  the  healthy  exercise  of  discrimination  as  tlie 
prejudices  of  the  ignorant.  Self-control,  therefore,  is  also  an  essen- 
tial qualification  of  the  sick-room. 

It  is  only  from  knowing  that  tlic  attendants  of  the  sick  are  pos- 
sessed of  intelligence  and  self-control,  that  a  physician  can  rely  upon 


DOMESTIC   MANAGEMENT   OF   THE    SICK-ROOM. 


561 


having  hi9  orders  correctly  and  duly  executed  :  when  those  qualities 
ure  absent,  he  has  to  dread,  on  the  one  hand,  the  presumption  ofi 
ignorant  projndiice  ;  and,  on  the  other,  the  improper  yielding  of  sen- 
sitive indulgence.  To  the  invalid,  also,  it  is  important  to  know  that 
tlie  directions  of  his  physician  are  fulfilled  by  an  intelligent  person  ; 
for,  even  in  the  most  severe  diseases,  as  long  as  the  mental  faculties 
rcmiiin  unaffected,  a  sick  man  is  capable  of  detecting  ignorance,  or 
the  effects  of  prejudice,  in  his  attendants ;  and,  when  he  is  convinced 
of  the  existence  of  either,  nil  the  influence  of  the  individual,  whether 
nurse,  or  friend,  or  relative,  is  at  an  end. 

Were  the  business  of  the  sick-room  (independent  of  the  wants  and 
comforts  of  the  invalid)  confined  to  the  mere  observation  and  collec- 
tion of  facts  —  namely,  the  noting  of  the  symptoms  of  disease  —  and 
reporting  them  to  tlie  physician,  it  would  be  superfluous  to  urge  the 
necessity  of  superior  intelligence  in  its  superintendent ;  but  many  of 
its  duties  require  not  only  a  well-regulated  understanding,  but  an 
cqiiiilly  sound  condition  of  the  moral  feelings  and  the  benevolent 
affections,  with  a  recognition  of  the  authority  of  conscience  in  the 
whole  operations  of  life.  In  the  period  of  sickness,  under  the  direc- 
tion of  the  judicious  and  discreet,  an  invalid  may  be  led  to  the  inves- 
tigation of  his  moral  and  religious  condition,  and  to  review  his  past 
conduct,  with  the  determination  of  turning  the  result  to  his  future 
welfare,  should  he  happily  recover  and  re-enter  society.  Surely  such 
important  duties  as  these  cannot  be  intrusted  to  the  unqualified,  or 
the  ignorant,  or  the  hireling ;  nor  can  more  be  required  to  demon- 
strate the  importance  of  adding  to  the  other  branches  of  female  edu- 
cation a  knowledge  of  the  various  important  duties  of  the  sick-room, 
which  females,  whether  as  mothers  or  daughters,  or  wives  or  friends, 
arc  likely  to  be  called  upon  to  fulfil. 


Prognostics. 

Ik  every  disease  the  medical  attendant  is  naturally  called  upon  to 
deliver  his  opinion  of  the  degree  of  danger  which  hangs  over  the 
patient :  hence,  it  is  unnecessary  to  enter  into  any  minute  details  on  tho 
subject  of  prognostics.  But,  as  in  many  diseases  changes  occur,  in 
the  absence  of  the  practitioner,  which  ought  instantly  to  bo  examined 
into,  in  order  that  the  danger  likely  to  accrue  from  them  may  be 
averted,  it  is  iniportant  that  the  friends  and  ordinary  attendants  of 
tho  sick  should  be  aware  of  their  presence,  so  as  to  obtain  the  imme- 
diate assistance  of  the  medical  attendant.  Were  this  information, 
also,  more  generally  diffused,  many  unnecessary  visits  would  be  saved 
to  the  physician,  and  much  unfoinided  suspicion  of  danger  prevented 
from  distressing  and  torturing  the  minds  of  the  friends  of  the  sick. 

In  Fevers  delirium  ahme  should  excite  no  alarm,  unless  it  be  very 
high,  or  of  tho  low,  muttering,  incoherent  kind.  In  jaundice,  and  in 
diseases  of  the  chest,  it  is  alarming;  and  in  the  latter  stages  of 
pulmonary  consumption,  its  presence  always  indicates  the  approach 
of  death. 


r^ 


562 


DOMESTIC   MANAGEMENT  OF   THE   SICK-ROOM. 


Great  confusion  of  thought,  loss  of  recollection  of  the  most  recent 
occurrence,  a  restless,  wandering  eye,  and  a  correspondent  vacancy 
or  confusion  of  countenance,  are  always  to  be  dreaded  in  fevers  and 
in  diseases  of  the  brain.  An  expression  of  (/reat  anxiety/  is  equally 
alarming  in  all  acute  diseases ;  and  a  presentiment  of  death  is  still 
more  to  bo  dreaded. 

Hoarseness,  with  constant  spitting,  occurring  at  an  early  period  in 
small-pox,  is  very  unfavoruhlo. 

Squinting  in  ufTectionsofthehead  ought  to  be  particularly  noticed, 
and  mentioned  to  the  attending  practitioner ;  and  the  same  remark 
applies  to  a  greatly  contracted,  or  a  dilated,  or  an  immovable  condi- 
tion of  the  pupil  of  tlie  eye  ;  or  the  turning  up  of  the  pupils  under 
the  upper  eyelids. 

Deafness  is  not  an  unfavorable  occurrence  in  continued  fever ;  but 
a  sudden  attack  of  headache  in  pulmonary  diseases  ought  instantly 
to  be  mentioned  to  the  physician. 

The  Sudden  Disuppearnnce  of  Pain  in  inflammatory  affections  or 
the  bowels  is  always  to  be  dreaded ;  but  it  does  not  in  every  instance 
portend  the  existence  of  mortification. 

Cong^h,  depending  on  inflammation  of  the  bronchial  membrane,  sud- 
denly supervening  on  a  suppressed  eruption,  is  always  to  be  dreaded. 

In  Croup,  when  the  breathing  is  audible,  or  when  there  is  a  crow- 
ing sound  in  inspiration,  or  a  cooing  or  croaking  respiration,  danger 
is  present. 

In  Hoopiuj^-Coujph,  when  the  paroxysms  suddenly  increase  in  vio- 
lence, and  the  face  becomes  livid,  and  the  thumbs  are  drawn  across 
into  the  palms'  of  the  hands,  the  appearance  of  convulsions  may  be 
anticipated :  hence  immediate  notice  of  these  symptoms  should  be 
communicated  to  the  medical  attendant. 

Rig;ors  invariably  excite  alarm ;  but  they  are  only  dangerous  in 
chronic  internal  diseases,  in  which  they  often  indicate  the  formation 
of  pus,  or  the  existence  of  suppuration. 

Pallidness  of  the  countenance,  with  a  slight  degree  of  lividity,  are 
symptoms  of  hazard  in  the  inflammation  of  the  lungs. 

The  Position  of  the  Patient  as  he  lies  in  bed,  especially  in  fevers, 
is  of  much  importance.  Constantly  lying  on  his  back,  with  a  ten- 
dency to  sink  to  the  bottom  of  the  bed ;  a  propensity  to  keep  the 
arms  and  the  feet  out  of  bed,  and  to  uncover  the  trunk ;  or  to  pick 
the  bed-clothes  ;  tremors  ;  twitching  of  the  tendons ;  grinding  of  the 
teeth,  and  sleeping  with  the  eyelids  half  open,  and  the  white  of  the 
eyes  only  seen  ;  are  all  justly  regarded  as  symptoms  of  great  danger. 

Fainting  (Syncope)  is  to  be  considered  alarming  in  diseases  of  the 
heart,  or  during  profuse  bleeding  from  the  nose,  or  from  any  other 


^  ipl'lf 


UOMKSTIO    SIAXAOKMKNT    OF   TIIK    8ICK-UOOM. 


56a 


part :  deep  Highiufj ,  also,  under  such  circumstances,  is  most  unfavora- 
ble, and  often  indicates  rapid  dissolution. 

Hiccup,  in  the  advanced  stages  of  cither  acute  or  chronic  diseases, 
is  invariably  alarming. 

Difficulty  of  Swalloulngp,  also,  in  the  advanced  stages  of  fever, 
palsy,  and  aflections  of  the  head,  always  indicates  extreme  danger ; 
vomiting,  on  the  contrary,  is  not  nntUvorable,  unless  it  be  very 
severe  and  protracted  ;  but,  if  the  ejected  matters  be  putrid,  or  fecu- 
lent, then  the  vomiting  is  always  to  be  dreaded. 

Coma,  or  an  irresistible  propensity  to  sleep,  following  the  sudden 
suppression  of  gout,  or  the  cessation  of  periodical  bleeding  in  piles, 
or  the  healing  of  old  sores,  is  always  alarming,  and  requires  prompt 
medical  assistance. 

Convulsions  without  fever  or  any  affection  of  the  head  seldom 
prove  dangerous ;  but  they  are  never  free  from  danger  when  they 
are  accompanied  with  stupor  or  coma.  They  are  also  dangerous 
when  inflammatory  fever  is  present.  They  are  less  dangerous  in 
women  than  in  men,  in  the  young  than  in  advanced  ago.  In  infancy, 
convulsions  are  more  to  be  dreaded  in  the  robust  than  in  the  delicate 
and  irritable  child. 

Diarrhoea  is,  under  every  circumstance,  an  unfavorable  event,  when 
it  occurs  either  iu  fevers,  or  in  the  termination  of  chronic  diseases ; 
and  the  passing  of  involuntary  stools,  when  scarcely  any  diarrbcea 
exists,  is  equally  to  be  dreaded. 

Retention  of  the  Urine,  as  well  as  its  involuntary  discharge,  is  al- 
ways an  unfavorable  symptom. 

Purple  Spots  appearing  on  the  skin,  livid  lips  and  cheeks,  oozing 
of  blood,  sudden  flushings  followed  by  pallor,  are  unfavorable  symp- 
toms ;  and  the  appearance  of  oedematous  swellings  of  the  legs  and 
skin  in  the  last  stage  of  chronic  organic  diseases  always  indicate  ap- 
proaching death.  When  purple  spots,  also,  appear  in  small-pox, 
with  flattening  of  the  pustules  on  the  trunk  of  the  body,  and  a  white 
pasty  aspect  of  the  eruption  in  the  face ;  and  if,  at  the  same  time,  the 
extremities  become  cold,  any  hope  of  recovery  can  scarcely  be  enter- 
tained. 

Great  and  continued,  or  progressing  emaciation  in  chronic  diseases, 
and  what  is  termed  the  Jades  Hippocratica,  are  to  be  dreaded. 

Excoriations  on  the  parts  on  which  the  body  rests,  —  for  example, 
the  haunches,  or  the  lower  part  of  the  back,  —  especially  if  these 
become  livid  and  sloughy,  always  indicate  extreme  danger. 

Great  Difficulty  of  Breathini?,  even  to  a  feeling  of  suffocation,  is 
not  necessarily  hazardous  iu  asthma;  for  although  few  diseases  are 
so  little  under  control  by  the  interference  of  the  physician,  yet 
asthma  seldom  proves  fatal,  unless  it  tends  to  the  production  of  o^er 

diseasee. 


FT 


564 


DOMESTIO    MANAORMENT   OP  THE   SIGK-IiOOM. 


Ff'';. 


In  Consumption,  partial  sweating,  as  of  tho  head,  the  chest,  or  the 
liml)!*,  are  always  unfavorable  symptoms. 

When  pretjnancy  occurs  in  a  woman  laboring  under  consumption, 
tho  disease  is  arrested,  until  after  delivery,  as  if  Providence  throw  a 
shield  over  tho  mother  for  tho  safety  of  tho  offspring. 

Tlie  Sudden  ilisappeaninee  of  Swelliujp  of  the  Le8;s,  in  chronic  or* 
guuic  uisouses,  is  indicative  of  approaching  death. 

When  a  child,  instead  of  rallying  after  any  ncuto  disease,  bocomes 
emaciated^  and  tho  belly  is  largo  and  tympanitic,  there  is  always  much 
daugor.  • 

Ovarian  Disease,  or,  as  it  is  usually  termed,  ovarian  dropsy ,  has 
hitherto  proved  incurable  ;  but  it  is  relieved  by  tapping ;  and,  if  tho 
powers  of  life  be  sustained  by  proper  food,  and  carriage  exercise  iu 
the  open  air;  and  if  all  medicines  be  let  alone,  except  such  as  are 
required  to  regulate  tho  bowels,  life  may  bo  sustained  for  many  years. 

All  diseases  not  involving  organic  changes  are,  with  a  few  excep- 
tions, more  or  less  under  tho  control  of  medicines,  and  are  conse- 
quently curable.  But  some  diseases,  iu  which  no  organic  changes 
have  been  discovered,  are  nevertheless  incurable.  This  is  the  case 
with  spasmodic  asthma,  which  has  rarely  been  cured. 

It  is  true  that  functional  disturbances  are  not  unfrequently  associ- 
ated with  organic  diseases ;  but,  under  such  circumstances,  it  is  the 
province  of  tho  attending  physician  to  point  out  to  the  friends  of  the 
patient  tho  greater  or  the  less  degree  of  danger  iu  those  complicutious. 


Diet,  etc.,  in  Disease  and  Convalescence. 

In  numerous  instances,  much  hazard  often  exists  after  disease  has 
disappeared,  and  when  the  patient  is  declared  convalescent :  and  as 
this  period  in  the  removal  of  diseases  ia  left  to  the  management  either 
of  the  patient  himself  or  of  his  friends,  some  general  remarks  respect- 
ing it,  and  also  in  reference  to  particular  diseases,  are  requisite. 

In  every  recovery  from  sickness,  whether  external  or  internal,  be- 
fore tke  salutary  advantages  obtained  from  the  treatment  be  confirmed, 
the  organ  or  part  which  has  suffered  must  be  either  left  at  res^  or  be 
used,  according  to  tho  nature  of  the  case.  Thus,  if  any  part  have 
suffered  from  inflammation,  it  must  not  be  used  'or  some  time  after 
the  inflammation  is  subdued.  If  tho  eyes  have  suffered,  the  person 
must  neither  read  nor  write,  nor  expose  the  .yes  to  the  heat  of  tho 
fire,  nor  to  a  strong  light,  until  some  days  after  every  trace  of  tho 
disease  has  disappeared.  If  tho  arm  has  been  affected  it  must  bo 
kept  at  rest ;  and  if  tho  leg,  not  only  should  walking  bo  refrained 
from,  but  tho  limb  should  bo  placed  rather  higher  than  the  trunk  of 
the  body.  If  tho  previous  disease  has  affected  the  brain,  every  men- 
tal exertion  must  bo  avoided ;  and  so  on,  whatever  may  be  tho  organ 
which  has  especially  suffered.  Even  when  the  exercise  of  tho  organ 
is  resumed,  it  should  not  be  carried  to  fatigue,  nor,  on  any  accouut, 
should  it  be  such  as  to  produce  excitement.     At  tho  same  time,  it 


iH^^PWf 


IX)ME8TIC   MANA(!EMKNT   OP    TIIK    HICK-UOOM. 


5(55 


must  not  bo  forgotten  that,  in  tho  treatmont  of  external  injiirips,  when 
it  has  been  nocossary  to  Ivccp  the  limb  long  in  a  filing,  in  one  position, 
—  lis,  for  instance,  in  fractures, — tho  muscles  which  hciu]  the  arm 
ncquiro  from  tho  habit  a  contraction  whic^h  cannot  l)e  ovcrcotnn  l>y 
tho  antagonist  mnscslcs,  owing  to  tho  length  of  time  they  have  been 
oil  tlio  stretch  weakening  their  contractile  jxtwer.  Tiie  arm,  there- 
fore, should  bo  frequently  takcMi  from  the  sliii'_',  and,  being  retsted  upon 
the  elbow,  a  moderate  weight  should  beheld  in  the  hand,  and  friction 
with  oil  employed  upon  tho  contractt'd  muscles,  k  is  true  tiiiit  sur- 
geons usually  glvo  directions  for  this  o[)eration,  before  they  quit  the 
raaiiagement  of  tho  case ;  but  surgeons,  as  W(dl  as  physicians,  are 
sometimes  dismissed  before  tlio  convalescenco  is  complete  ;  on  which 
account,  arms  and  limbs  have  remained  contracted  for  life,  from  a  want 
of  tiie  knowledge  necessary  to  counteract  tho  ovil  at  an  early  stage. 

I  say  nothing  respecting  the  continuance  of  ren\edie3  during  con- 
valescence from  many  diseases,  ex(;cpt  urging  tho  necessity  of  regu- 
lating the  bowels. 

The  most  important  part  of  the  management  of  convalescence  cer- 
tainly refers  to  air^  exercise,  and  diet.  Tlie  errors  daily  connnitted, 
in  all  those  matters,  oxcrt  the  most  powerful  influence  in  retarding 
complete  restoration  to  health;  and  often,  indeed,  Induoo  evils  of  a 
more  formidable  kind  than  the  d'scases  from  which  the  jjationts  have 
just  emerged. 

1.  Air.  In  every  convalescence,  whatever  may  have  been  the 
nature  of  tho  disease,  if  it  has  been  so  severe  as  to  wear  down  the 
strength  of  tho  invalid,  country  air  is  essontial.  Tho  benevolent 
Author  of  our  existence  has  made  medicinal  tho  hills,  tho  vales,  the 
groves,  and  Jill  tho  harmonies  of  nature ;  and  in  the  reposo  of  these 
man  finds  a  balm,  not  only  for  a  wounded  sprit,  but  for  his  stricken 
body. 

Ill  selecting  a  country  rcsideneo  for  a  convalescent,  care  must  be 
taken  to  ascertain  whether  any  source  of  malaria  exists  in  tlio  neigh- 
borhood ;  as,  in  that  case,  even  if  all  other  circumstances  bo  favorable, 
tho  place  is  exceptionable. 

2.  Exercise.  In  convalescence,  much  caution  is  requisite  in  nppor- 
tioniiii;  tho  exi-rciso  to  the  de£rreo  of  retiirnin;'  streiiijih.  When  tho 
convalescent  is  still  too  feeble  to  take  sufficient  exercise  on  foot,  the 
best  substitute  for  it  is  riding  horseback  ;  but,  as  soon  as  walking  can 
bo  borne,  it  should  be  preferred  to  either  horse  or  carriage  exercise. 

3.  Diet,  In  health,  diet  may  be  left,  in  a  great  degree,  to  the  in- 
clination or  the  taste,  as  far  as  regards  tho  quality  of  the  food  ;  and, 
although  diseases  occasionally  originate  from  repletion,  yc^t,  in  gen- 
eral, the  appetite  may  be  considered  as  the  best  regulator  of  quantity, 
when  the  food  is  simple,  and  tho  a[)petito  is  not  pampered  by  high 
seasoning  and  rich  sauces.  la  disease,  however,  ii  very  opposite  rule 
is  to  he  observed  ;  the  regulation  of  both  tho  quantity  and  the  quality 
of  the  food  is  of  the  utmost  importance.  The  taste  is  often  so  per- 
verted as  to  desire  that  which  would  prove  injurious  ;  and  were  appe- 
tite to  be  the  guide  of  quantity,  diseases  would  frequently  not  only  be 
increased  in  severity,  but  life  itself  would  be  brought  into  jeopardy. 


566 


DOMESTIC   UtANAQEMENT'OF   THE   SICK-ROOM. 


As  soon  as  solid  animal  food  can  be  taken  with  impnnity,  that 
which  is  most  digestible  should  be  selected.  An  opinion  has  ^oner- 
ally  prevailed  that  gelatinous  matters,  and  meats  which  readily  yield 
jelly,  — such;  for  example,  as  veal  and  lamb,  —  are  the  most  easily 
digested,  and  at  the  same  time,  are  also  the  most  nutritive.  This  is 
a  mistake  ;  for,  with  the  exception  of  poultry,  the  flosh  of  young*ani- 
mals  is  stringy  and  of  a  lax  fibre,  and  is  oven  loss  easily  digested  than 
that  of  too  old  animals,  wliich  presents  a  great  density  of  texture. 
The  middle-aged  animals  afford  the  most  digestible  food. 

Nothing  tends  to  lessen  the  density  of  the  fibre  of  every  kl.id  of 
animal  food  so  much  as  keeping  it  for  a  certnin  time  l)efore  it  is 
cooked.  In  this  case,  the  tenderness  is  tlic  result  of  incipient  decom- 
position or  putrefaction ;  but  the  utmost  caution  is  requisite  to  pre- 
vent this  from  advancing  so  Car  as  to  present  the  slightest  trace  of 
taint,  in  the  food  of  the  convalescent.  In  the  low  stitc  of  vitality  in 
convalescence,  the  change  which  commencing  decouiposition  (putre- 
faction) causes,  renders  anlmiil  food,  in  that  condition,  a  source  likely 
to  occasion  either  a  relapse  into  the  disease  from  which  the  patient 
bas  recovered,  or  to  form  a  now  disease. 

In  examining  the  relative  vaklfi  of  other  articles  of  d  ict  adapted  for  tho 
sick  and  convalescent,  the  firsOlWhich  presents  itself  to  our  notice  ia 

Hilk.  —  As  milk  is  the  food  of  almost  all  young  animals,  its  diges- 
tibility appears  at  once  evident ;  and  there  can  be  little  douI)t  that  it 
is  very  digestible,  when  it  is  drunk  Immodiately  after  it  is  drawn  from 
the  udder  of  tho  cow,  or  that  of  the  a^s,  or  the  goat,  before  its  com- 
poneiits  have  time  to  separate.  Wh^n  this  separation  is  eifcctcd, 
either  spontaneously  by  time,  or  1  y  means  of  rennet  or  other  agents, 
its  properties  are  altered,  and  its  digestibility  is  lessened. 

Cream,  when  intimately  imited  with  t!<e  other  components  of  milk, 
—  namely,  the  curd,  or  the  caseous  part,  and  the  whey,  — is  not  the 
same  substance  as  after  its  se^^'iration.  In  the  milk,  it  is  more  easily 
digested,  and  is  the  most  nutr'tlve  part  of  the  milk.  But  in  its  sepa- 
rate state,  it  is  ill  adapted  cither  for  the  sick  or  convalescent,  except 
in  the  form  of  butter,  which  is  not  unwholesome,  unless  it  be  cuteu 
in  excoss  or  bo  melted.*  In  the  same  manner  tho  s(  uarate  curd  is  in- 
digestible ;  and  whei/  itself,  although  highly  nutritive,  yet  is  ilutiileiit; 
nevertheless,  it  is  an  excellent  demulcent  in  many  cases  of  disease. 
But  none  of  tho  components  of  milk  are  equal  to  milk  itself.  It  is 
often  necessary,  in  convalescence,  to  dilute  it  in  water. 

EjfjfS.  —  It  is  not  uncommon  to  hear  that  the  yolk  of  a  raw  egg, 
beaten  up  with  water  and  sugar,  with  tho  addition  of  a  small  quiui- 
tity  of  white  wine,  is  a  light  and  nutritive  aliment  in  convalescence, 
and  even  in  some  states  of  disease  ;  but  effrjs  are  much  less  digestible 
\n  this  form  thiiu  when  they  are  lightly  boiled.  In  jaundice,  however, 
.•irisinjr  from  viscid  mucu.-j  obstructing  tho  orifice  of  the  common  duct, 
the  yolk  of  a  raw  egg  beaten  up  with  cold  water  is  serviceal)le. 

•  [Althouffh  cream  is  not  i\s  digostiblp  as  milk,  ytt  it  is  mtuli  loss  lialilc  to  turn  acid 
in  the  Htomaoh;  it  is  often  bunoflcial  to  dyspeptics,  eitiier  alone  or  diluted  with  water.] 


R'.ilTUl 


DOMESTIC   MANAGEMENT  OF   THE   SICK-ROOM. 


507 


Fish,  at  least  the  white  kind,  stimulates  much  less  than  the  flesh 
of  land  animals ;  hence  it  is  a  proper  food  for  those  laboring  under 
some  acutt)  diseases ;  and  also  for  convalescents,  when  a  sudden  re- 
turn to  more  stimulating  food  would  prove  hurtful.  But  it  is  not 
adapted  for  convalescents,  when  the  object  is  to  bring  up  rapidly  the 
strength  of  debilitated  hahits. 

Raw  oyders  have  been  erroneously  supposed  to  be  both  easy  of 
digestion  and  nutritive.  The  latter  opinion  is,  in  some  degree,  true  ; 
but  the  former  is  erroneous.  Haw  oysters  are  less  digestible  than 
plainly  cooked  oysters.  Both  are  improper  for  the  sick  and  for  early 
convalescents.  Lobsters,  crabs,  pni*vns,  cray-fish,  scallops,  and 
other  shell  lish,  are  still  more  objectionable. 

If  fish  of  any  kind  bo  !idmissii)le,  it  should  bo  simply  boiled  :  fried 
fish  is  even  worse  fc.v  invalids  than  the  outside  or  the  brown  of  roasted 
moat. 

Vejfctables.  —  In  reference  to  vegetable  diet,  it  is  only  the  mildest 
description  of  esculent  roots  that  are  fitted  for  the  use  of  thv;  sick.  In 
preparing  all  of  them  for  the  sick-room,,  they  should  be  well  boiled  in 
two  distinct  waters,  until  they  are  soft  and  very  soliil)le,  and  in  a  state 
not  to  leave  undissolved  anything  \;hich  could  act  as  a  mechanical 
irritant  on  the  intestinal  canal.  W'en  properly  cooked,  they  are 
moderately  nutritive,  and  free  from  any  stimulant  properties ;  ;:nd 
they  are  well  adapted  for  the  stomach  of  the  sick,  unless  in  cases  in 
which  the  torpor  of  the  organ  is  such  as  to  permit  them  to  nm  into 
acetous  fermentation  and  to  prove  flatulent. 


Fraits.  —  With  respect  to  /mitu  they  produce  the  most  diversified 
efiects  ;  and,  consequently,  are  p.ioro  or  less  proper  for  invalids,  ac- 
cording to  circumstances,  either  connected  with  themselves  or  with 
the  condition  of  the  patient  at  the  time.  The  stone  fruits,  with  the 
exception  of  the  ripe  ne.ich,  or  the  nectarine,  are  to  be  rejected.  The 
apple  tribe,  except  very  soluble  pears,  are  still  less  admissible.  The 
apple,  however,  when  roasted,  and  when  the  seeds  and  the  hard  ceu- 
tral  parts,  as  well  as  the  skin,  are  removed,  is  loss  objectionable  ;  and, 
as  it  possesses  laxative  properties,  tlie  roasted  apple  is  well  adapted 
for  the  sick,  when  food  is  at  all  J<l!owablo,  and  when  the  bowels  are 
torpid.  The  orange,  if  fnliy  ripi;,  is  gratofid  and  wholosoino  to  all 
invalids,  and  is  only  equalled  in  these  qualities  by  the  gra[)(' ;  but  in 
using  the  orange,  the  pulp  should  be  rejected.  Care,  also,  should  bo 
taken  not  to  bwallow  either  the  sk»';  oi  the  seeds  of  the  giMpi\ 
Strawberries  are  a  little  stimulant,  of  easy  digestion,  and  more  cool- 
ing than  the  other  small  fruit.;  mulberries  are,  also,  unexceptiona- 
ble ;  !)ut  currants  and  go'jdcberries,  and  e^'.  ii  raspberries,  are  not 
free  fiom  objection  for  invidids  laboring  under  acute  diseases. 

With  the  exception  of  ont  and  wheatca  bread,  all  the  vari(!ties  of 
farinaceous  aliments  may  bo  regarded  asmoditicatioiis  of  stanch,  con- 
taining little  nutritive  matter,  and  therefore  well  adapted  for  tl»o  sick- 
room. It  has  been  supposed  that  arrow-root,  sago,  taijioea,  and 
similar  substances,  are  very  nutritive,  because  they  form  mucilages 
with  boiling  water :  but  this  is  not  the  fact ;  and  were  they  very 


i' "  >  \ 


368 


DOMESTIC   MAXAGEMENT   OF   THE    SICK-ROOM. 


nutritive,  they  Avould  bo  ill  adapted  for  invalids.  Rice  in  every  case 
where  the  stomach  is  in  an  acescent  state,  is  preferable  to  the  cLher 
farinacefB,  because  it.  ia  i^^c.  fnrr^iCuuible.. 

The  fiiriuaoeoiis  fond,  which  is  ordered  in  the  convalescence  of 
children  from  acute  diseases,  is  often  made  of  bread  so  as  to  const'- 
tute^ap.  No  description  of  food  h.is  a  greater  tendency  than  this  to 
become  sour  ;  a  quantity  only  sufficient  for  a  single  meal,  therefore, 
should  be  made  at  a  time;  i'or  what  remains'  is  always  sour  bcforo 
the  next  meal ;  and  even  if  the  quantity  he  .small,  and  it  bo  mixed 
with  fresh  pap,  it  communicates  its  faculty  of  becoming  sour  to  the 
whole  mass. 

Fluid   Aliments. 

Water.  —  The  best  and  the  most  unlv^ersal  beverage  for  the  sick  is 
water:  but  the  qualities  of  y.ater  differ,  according  to  the  sources 
whence  it  is  procured.  The  fewer  foreign  ingredients  it  holds  in  so- 
lution the  greater  are  its  diluent  properties.  Distilled  water,  or  rain 
or  river  water  filtered,  and  that  of  soft  water  springs  which  filtrate 
through  silicious  strata,  are  the  only  kinds  proper  for  the  use  of  the 
sick-room.  Hard  water,  under  whatever  name  it  is  found,  whether 
as  spring  water,  or  pump  water,  or  well  water,  should  be  excluded. 
The  impurities  of  river  and  rain  water  are  merely  held  in  suspension ; 
consequently,  they  are  readily  removed  by  filtration. 

Water  itself  is  aliment ;  many  individuals  under  certain  circum- 
stances have  lived  for  a  considerable  time  upon  it  alone.  Those  who 
live  chiefly  on  a'lhnal  food  require  more  drink  than  those  who  eat 
much  vegetable  Uiatter. 

The  influence  of  water  on  the  animal  economy  may  be  regarded  in 
two  points  of  view  : 

As  an  article  of  diet. 
As  a  medicinal  agent. 

As  an  article  of  diet^  in  health,  water  is  the  bevferage  provided  by 
nature  for  all  animals,  man  not  excei)ted.  The  sensation  of  thirst  is 
the  natural  call  for  fluids,  cither  to  assist  digestion,  or  to  allay  a  dry, 
hot  condition  of  the  mouth  and  the  gullet.  The  con.sequence  of  not 
satisf;yiiig  this  call  is  fever  of  a  nervous  kind  ;  and,  if  it  be  long  re- 
sisted, inflammation  of  the  air  passages.  On  the  other  hand,  too 
much  fluid  is  injurious;  foralthough  the  vital  ))owers  of  the  stomach 
counteract  the  tendency  which  it  affords,  by  over-diluting  the  gastric 
fluid,  to  the  fermentation  of  the  aliment  in  the  stomach,  yet,  when  it 
is  in  excess,  those  vital  powers  languish  ;  hence  spontaneous  chemi- 
cal changes  in  the  contents  of  the  stomach  take  place,  and  induce 
dyspepsia.  For  all  the  purposes  of  dilution,  in  healthy  water  is  ade- 
quate, and  it  is  the  only  truly  wholesome  beverage. 

As  a  medicinal  arfent,  water  is  demanded  in  every  disease  in  which 
a  dry  skin,  and  an  elevation  of  the  natural  heat  of  the  siu'face,  consti- 
tuting fever,  are  present.     In  this  case,  the  desire  is  for  cold  water,  or 


DOHESTIO  MANAGEMENT  OP  THE   SICK-ROOM.  569 


cooling  fluids ;  and  it  should  always  be  indulged.  The  degree  of 
temperature,  however,  must  be  regulated  by  the  condition  of  the  in- 
valid ;  but  the  best  medium  temperature  is  between  50°  and  60°  Fahr  ; 
although  even  60°  is  too  low,  when  the  debility  of  the  frame  is  consid- 
erable. 

The  qualities  of  the  various  kinds  of  beverages  proper,  and  gener- 
ally employed  in  the  sick-room,  should  be  known. 

Toast-water,  when  properl;  prepared,  which  it  seldom  is,  forms  a 
useful  beverage  in  the  sick-room.  It  is  slightly  nutritive,  owing  to  its 
containing  a  small  portion  of  gluten,  in  conjunction  with  fecula  and 
sugar.  It  is  one  of  the  oldesi';  and  one  of  the  best  diluent  demulcents  ; 
diluting  at  the  same  time  that  it  softens  the  acrimony  of  the  secreted 
juices  of  the  stomach,  in  febrile  diseases. 

Gracl,  whether  made  of  groats  or  of  oatmeal,  is  less  mild  and  do- 
L^nlcent  than  barley  water ;  and  it  is  more  likely  to  undergo  the  ace- 
tous fermentation  in  the  heat  of  the  stomach  ;  a  div^miistance  which 
is  greatly  favored  by  the  sugar  and  butter  which  is  sometimes  added 
to  it.  Unless  gruel  be  very  thin,  it  can  scarcely  be  regarded  as  dilu- 
;n>  ■!  when  thick,  it  is  too  heating  an  aliment  for  patients  laboring 
;a  It-    ..orile  symptoms. 

Tea,  in  the  form  in  which  it  la  usually  taken,  is  too  stimulant  and 
astringent  ij  bo  a  good  diluent;  and,  when  it  is  strong,  the  narcotic 
pro[)crty  whlcli  it  possesses  renders  it  improper  for  most  invalids, 
whatever  may  be  the  nature  of  tlioir  diseases.  As  it  is,  nevertheless, 
agreeable  to  most  palates,  and  very  refreshing,  it  may  bo  taken  in 
moderate  quantity,  provided  it  be  not  strong,  with(iut  any  hazard. 

Sage,  balm,  and  mii.it  teas,  are  often  s^ibstitutcd  for  common  tea. 
Each  of  them  undoubtedly  allays  the  irritability  of  the  stomach  in 
sonic  cases  ;  but,  as  general  beverages  in  disease,  they  are  less  useful 
than  toast-water.  Ilaspberry  vineyar,  lemonade,  tuTtid rind  tea,  apple 
tea,  and  simil;.:'  compound  diluents,  siiould  uever  be  admii:istered 
without  the  ^■  .>i..o.tu*;  of  the  phj'sieian.  If  a  patient  be  taking  aix  anti- 
nionial,  t!i;  y  v  \  :X(rite  vomiting  ;  if  a  mercurial,  griping;  and  they 
are  o'luaJiv  'ui  '<)..p  .t,ible  with  many  other  medicines,  and  with  many 
conditions  ol  .  •  siomach  ir.  disease.  They  are  a  description  of 
beverage  greatly  f^.jmmended  and  largely  distributed  by  (ho  Lady 
liountifuls  in  the  country,  and  hav  frequently  beei;  prod  ictivo  of 
serious  mischief. 

Coffee  is  more  heating,  and,  consequently,  less  adm!«sil'lc  chan  tea  ; 
it  may,  however,  bo  taken,  if  it  be  largely  combined  with  milk.     Cocoa 
j  and  chocolate  are  still  more  objectionable  than  either  tea  or  coflee  in 
I  the  sick-Torai. 

With  1*  if. -tv/*  the  Kumberof  Meals,  and  the  periods  best  adapted 
for  taking  th.  a,  it  /s  scarcely  requisite  to  remark,  that,  although  in 
health,  thre.'  moderate  meak,  at  proper  intervals,  are  customary,  and 
well  adapted  for  the  support  of  the  frame,  yet,  under  the  changed 


T 


570 


DOMESTIC  HANAOEHENT  OF  THE   SICK-ROOM. 


condition  of  the  system  in  disease,  it  would  be  improper  to  take  any 
regular  nuinber  of  meals,  or  to  observe  any  stated  periods  for  taking 
them :  hem  e  no  general  rules  can  apply. 

As  a  gemral  rule,  in  the  decline  of  diseases,  and  on  the  approach 
of  convaleso  ';nce,  when  the  desire  of  taking  food  returns,  the  best  time 
for  the  principal  meal,  dinnar^  is  about  two  hours  after  noon.  If  the 
breakfast  be  taken  at  nine  o'clock,  and  the  evening  meal  at  seven,  the 
hour  of  two  is  the  middle  period  of  the  day  ;  so  that,  when  dinner  is 
taken  at  that  time,  the  iiiteivais  between  breakfast  and  dinner,  and 
between  dinner  and  supper,  are  nut  only  equal,  but  neither  is  too 
short  to  limit  the  complete  digestion  of  the  previous  meal ;  nor  too 
long  to  injure  the  powers  of  the  weakened  stomach  by  protracted 
fasting. 

All  acute  diseases  require  more  or  less  abstinence,  especially  when 
the  object  of  the  treatment  is  to  lower  the  system ;  and  in  some 
chronic  affections,  abstinence  is  almost  essential.  If  this  be  true,  tbe 
necessity  of  the  stride  '  >bservance  of  the  directions  of  the  physic'an 
on  this  suliject  must  b  us.     It  is  one,  however,  which  is  not 

only  neglected,  but  is  oi  ;ombated  both  by  nurses  and  friends; 
and  indulgences,  which  are  supposed  to  be  of  too  trivial  a  nature 
to  cause  any  injury  to  the  sick,  have  often  been  followed  by  fatal 
effects. 

But,  although  abstinence  be  requisite  during  the  existence  of  an 
acute  disease,  yet  it  is  injurious  when  it  is  too  rigidly  maintained 
after  convalescence  is  actually  established ;  it  often  induces  a  new 
train  of  symptoms,  not  very  unlike  those  for  which  it  was  properly 
prescribed  and  the  removal  of  which  it  has  aided :  namely,  accel- 
eration of  the  pulse,  increased  impetus  of  the  heart,  headache,  and 
even  delirium.  .        , 

General  Diseases. 

Happily,  in  febrile  affections,  tiij  appetite  of  the  invalid  is  not  ini 
a  condition  to  desire  food ;  and  no  strouiirer  demonstration  can  be 
required  of  the  impropriety  of  forcing  it  upon  him  under  such  circum- 
stances. Simple  fluids,  such  as  diluents,  are  all  that  he  desires,  ali 
that  the  stomach  can  bear ;  and  such  alone  should  be  administered  in 
fever,  before  that  low  condition  of  the  system,  which  demands  tbo 
use  of  wine  or  other  stimulants,  supervenes.  In  these  cases,  when 
the  patient  desires  more  nourishment  than  is  usual,  animal  food  oiiglit 
not  to  be  given,  unless  by  the  direct  recommendation  of  the  physi- 
cian. Indeed,  in  general,  the  inclination  of  the  invalid  happily  re- 
volts from  animal  food,  as  much  as  experience  condemns  its  adminis- 
tration. 

While  febrile  symptoms  are  present,  farinaceous  matters,  little  nu- 
tritious, such  as  barley-water,  gruel,  arrow-i'oot  mucilage,  or  sago, 
acidulated  with  lemon-juice,  and  sweetened  to  the  taste  of  th(5  patient, 
are  most  suitable  ;  but  even  these  should  bo  given  in  small  quantity, 
and  at  considerable  intervals.  The  beverage  generally  most  agreeable, 
and  also  most  salutary,  to  those  suffering  under  fever,  is  cold  water. 


ike  any 
r  taking 

pproach 

est  time 

If  the 

ven.tho 

liuneris 

ler,  and 

r  is  too 

nor  too     9 

utracted  !  1 

\y  when    H 

III  some    H 

true,  the  '<•  B 

hysic'au  !|  | 

ti  is  not  i  1 

friends ; 

1  nature 

by  fatal 

■ 

36  of  an 

intainod 

9  a  now 

jroperly 
r,  accel- 

che,  and 

i 

1 

.3  not  in 

( 
1 

:  can  he  j 1 

ci renin- !;  ■ 

sires,  all    I 

stered  in  ,  I  ' 

inds  the  !  ■ 

:>s.  'whcii !  B 

>donght|B    ! 

0  i)hysi- 

i 
1 
1 

jpily  rc- 
adminis- 

ittle  nU' 

or  s>ago, 

patient, 

[imntity, 
jreeable, 

i  water. 

■  — 

i- 

DOMESTIC   MANAGEMENT  OP  THE   SICK-ROOM. 


571 


In  the  decline  of  fevers  even,  as  I  have  already  remarked,  although 
the  severity  respecting  diet  should  be  relaxed,  yet  much  danger  may 
result  from  mistaken  kindness  and  over-zeal,  in  urging  animal  and 
stimulant  food  at  too  early  a  period  of  the  convalescence.  Indeed, 
the  necessity  of  caution  at  this  time  is  greater  than  during  the  con- 
tinuance of  the  fever ;  and  the  more  acute  the  disease  has  been,  the 
greater  must  be  the  caution  in  the  convalescence,  especially  if  the 
treatment  has  been  of  an  evacuaiit  and  lowering  description. 

The  first  change  of  diet,  in  the  decline  of  fevers,  should  bo  to  an- 
other article  of  the  same  kind  of  food  which  wab  allowed  in  the  dis- 
ease; for  example,  from  simplo  arrow-rootmuciloyjieto  arrow-root  and 
milk,  or  to  some  other  of  the  farinaceous  compounds  ;  whilst,  at  the 
same  time,  aft-ses'  milk  may  be  given,  in  small  quantity  m\  the  morn- 
ing Rice,  one  of  the  farinacete,  is  generally  supposed  to  bo  astrin- 
gent, but  this  is  a  mistake.  It  forms  an  excellent  diet  in  all  cases  of 
early  but  decided  convalescence.  I>'  '  ould  be  well-boiled,  and  mixed 
either  with  broth  and  beef-tea,  or  gravy  which  has  been  cooled,  and 
the  fat  taken  from  it.  In  the  transition  to  animal  food,  beef-tea, 
chicken-broth,  and  miMon-broth,  and  other  liquid  animal  decoctions, 
should  1)0  first  resorted  to  ;  then  ivhile-fish,  simply  cooked  ;  for,  al- 
though fish  is  more  digestible  than  animal  food,  yet  it  affords  much 
less  stimulant  nourishment ;  it  is  therefore  better  fitted  for  the  early 
stage  of  convalescence.  When  convalescence  is  completed,  a  more 
generous  diet  is  admissible. 

With  respect  to  beverage,  water,  toaM-water  or  lemon- peel-water, 
is  sufficient,  until  the  medical  attendant  declares  that  a  little  wine  is 
requisite. 

In  convalescence  fromyeuer,  it  is  an  error  to  permit  the  patient  to 
get  up  too  soon.  He  should  not  leave  his  bed  until  his  strength  be 
considerably  advanced.  No  danger  can  result  from  too  strict  an 
observance  of  this  rule ;  whereas  much  risk  may  be  incu'  red  by  its 
fleglcct. 

If  the  head  has  been  much  affected,  every  mental  exertion  si. ould 
be  refrained  from  during  the  convalescence ;  and,  according  to  the 
degree  of  suffering  in  any  local  organ,  precautions  must  be  taken  to 
fTiiiird  that  part  of  the  frame  against  a  fresh  attack  of  disease. 

Eruptive  Fevers  require  more  precaution  in  convalescence  than  gen- 
eral fevers,  both  as  regards  diet  and  exposure  to  sudden  alternations 
of  heat  and  cold.  This  is  nioi'o  especially  essential  after  measles  and 
scarlet  fever. 

Measles  are  often  followed  by  a  distressing  cough,  and  other  symp- 
toms of  pulmonary  inflammation  ;  or  by  a  harassing  diaiThaa,  which 
wears  down  the  strength  ;  or  by  inflamed  eyes,  catarrh,  or  obstinate 
toothache.  In  infants,  canker  of  the  month  occasionally  makes  its 
attack  and  proves  fatal.  All  those  affections,  after  measles,  might 
generally  be  prevented  by  taking  care  not  to  allow  too  soon  a  return 
to  the  use  of  icnitnal  food,  or  too  early  an  exposure  to  cold  or  to  night 
air.  Even  in  summer,  flannel  should  be  worn  next  the  skin  for  some 
vreeks  after  the  disease  has  disappeared. 


wmu 


':•?■■«: 


I  'mi 


572 


DOMESTIC  MANAGEMENT   OF  THE   SICK-ROOH. 


Scarlatina  is  frequeutly  followed  by  dropsical  symptoms ;  which, 
however,  might  generally  be  avoided  by  the  same  attention  to  diet 
and  regimen  as  after  measles. 

Smnll-Pox,  when  severe,  and  especially  when  confluent,  is  very  apt 
to  awaken  info  iirtivity  the  dormant  seeds  of  scrofula,  if  any  heredi- 
tary taint  exists  in  the  constitution  ;  hence  abscesses,  ulcers,  and 
swelled  glands  make  their  appearance.  These  demand  the  aid  of 
the  piiysician  or  the  surgeon.  But  if  the  convalescent  be  pr()|)erly 
dieted,  and  recourse  bo,  had  to  a  change  of  air  as  soon  as  his  streuifUi 
will  permit,  these  evils  may  be  avoided.  ' 

Erysipelas  not  unfrequently  attacks  convalescents  from  small-pox 
and  other  eruptive  fevers.  When  it  occurs,  independent  of  any  prior 
disease,  the  same  attention  to  diet  and  regimen  is  requisite  as  in  other 
eruptive  fevers. 

Convulsions,  it  is  well  known,  are  not  unfrequently  the  result  of 
errors  in  diet,  in  individuals  with  an  irritable  condition  of  the  stom- 
ach and  bowels.  Advice  should  always  be  demanded  respecting  the 
diet  of  those  who  are  liable  to,  and  who  suffer  from,  convulsions  ;  but 
it  must  not  be  supposed  that  when  they  occur  in  children  and  have 
been  subdued,  a  system  of  starvation  is  necessary  to  prevent  their 
recurrence.  As  far  as  regards  convalescence  in  such  cases,  it  will 
bo  proper  to  bear  in  recollection  the  following  rules  : 

1.  When  the  patient  is  oiskfull  habit,  has  a  short  neck,  and  a  ten- 
dency to  discasos  ot  the  head,  the  diet  should  bo  spare.  The  use  of 
animal  food,  indeed,  in  such  a  habit,  should  be  loholh/  prohibited  in 
childhood,  and  very  sparingly  employed  l)y  adults  ;  whilst  vegetables, 
farinaceous  matters,  milk  and  weak  broths,  may  bo  allowed. 

2.  When  tho  habit  of  body  is  spare,  and  when  languor  and  chilli- 
ness are  present,  the  diet,  although  free  from  stimulus,  yet  should  bo 
nourishing,  and  consist  of  the  lighter  kinds  of  animal  food  ;  namely, 
poultry  and  fish,  with  a  moderate  share  of  vegetable  matters. 

3.  Under  ail  circumstances,  and  at  every  period  of  life,  fermented 
liquors  and  wine  should  be  either  wholly  avoided,  or  very  sparingly 
used,  in  almost  all  convulsive  diseases  connected  with  affections  of 
the  head. 

In  convalescence  from  some  varieties  of  convulsive  diseases,  tlio 
nature  of  tho  diet  must  depend  on  circumstances  which  cannot  be 
judged  of  by  the  attendants  of  tho  sick-room ;  hence  it  should  be 
referred  solely  to  the  medical  attendant.  In  St.  Vitus's  Dance 
(chorea),  for  example,  although  a  tonic  plan  of  treatment  may  have 
been  successfully  pursued,  yet  the  diet  may  be  required  to  be  raild, 
and  AvhoUy  free  from  stimulus. 

Attention  to  diet  in  Hysteria  is  most  important.  When  tho  disease 
is  connected  with  indigestion,  the  meals  should  be  moderate ;  and 
rest  in  the  horizontal  posture  should  be  indulged  for  an  hour  afters 
wards,  and  then  moderate  exercise  taken.  Fluid  food,  such  as  broths 
and  gruel,  are  improper;  yet  animal  food  should  be  eaten  only  onco 
a  day.     Tea  and  coffee  should  be  very  sparingly  taken ;  and  the  sim- 


DOMESTIC   MANAGEMENT  OF  THE   SICK-ROOM. 


573 


plest  beverajjea,  even  water  and  toast-water,  should  be  taken  in  groat 
moderation  alter  a  meal,  and  should  not  bo  diuiik  dining  dinner. 

In  convalescence  from  hysteria,  change  of  scene  and  air  are  abso- 
lutely requisite.  The  mind  should  bo  directed  to  solid  studies,  and 
everything  which  can  cherish  morbid  sensibility  of  the  nervous  system 
avoided. 

Dropsy.  —  An  opinion  was  long  maintained  that  fluids  are  to  be 
withhold  from  dropsical  patients.  No  opinion  was  i.ver  founded  ou 
more  erroneous  principles.  Dropsical  patients,  indeed,  should  be 
allowed  the  free  use  of  fluids.  With  respect  to  diet,  it  should,  gen- 
erally speaking,  be  light  and  unstimulating :  but  much  depends  on  the 
causes  of  dropsy.  There  is,  however,  less  necessity  for  a  rigid  ad- 
herence to  low  diet  in  this  than  in  other  inflammatory  aflections. 

In  Palsy,  abstinence  from  all  stimulating  food,  solid  or  fluid,  must 
be  rigidly  observed ;  and  the  restriction  should  not  be  discontinued 
in  convalescence.  A.t  the  same  time,  change  of  air  and  of  scene  is  al- 
ways of  decided  advantage.  In  every  instance,  an  easy  state  of  mind, 
and  freedom  from  every  source  of  irritation,  as  well  as  from  the  anxi* 
eties  of  business,  aro  indispensable. 

Gout  ond  Hiienmatism.  —  In  no  diseases  affecting  the  general  habit 
are  abstinence  and  i'o|)oso  moi'o  essential  during  the  attacks  than  in 
the  two  which  head  this  paragraph,  when  they  assume  an  a(!ute  form. 
When  they  occur  in  weakened  or  in  broken-down  habits,  it  is  too 
often  supposed  that  the  opposite  plan  of  diet  is  to  bo  pursued,  and 
thatstimulatingfood  and  a  liberal  supply  of  wine  should  be  indulged; 
but  nothing  is  more  likely  to  prove  injurious. 

When  the  paroxysm  subsides,  it  is  too  customary  In  permit  the  in- 
valid to  glide  into  his  usual  habits  with  respect  to  diet  and  regimen ; 
consequently  the  plethora  which  originated  the  disease  gradually  re- 
turns ;  and  the  same  plan  being  continued,  paroxysm  follows  after 
paroxysm,  at  shortening  intervals,  until  scarcely  any  interval  occurs, 
aud  life  is  sacrificed  on  the  altar  of  self-indulgence. 

For  some  weeks  after  the  paroxysm  of  gout  has  subsided,  in  a 
young  or  a  middle-aged  man,  animal  food  should  be  sparingly  taken, 
and  fermented  liquors  altogether  avoided. 

Chloror^",  or  Green  Sickness,  is  a  state  of  the  habit  which  seems  to 
depend  on  an  impaired  condition  of  the  blcod  itself.  Its  treatment 
is  well  understood,  and  recourse  to  medical  advice  should  never  be 
neglected  ;  otherwise  it  may  terminate  either  in  mcntiil  derangement 
or  in  sudden  death.  In  convalescence  from  it,  the  diet  should  be  mild 
and  light,  but  nutritious ;  the  exercise  should  be  much  within  the  lim- 
its of  fatigue,  and  consist  of  both  walking  aud  horse  exercise,  daily, 
in  tho  open  air :  the  body,  more  especially  the  lower  extremities^ 
should  be  warmly  clothed  ;  the  mind  ought  to  bo  amused  ;  all  seden- 
tary occupations  thrown  aside ;  and  confidence  placed  in  the  honor 
of  the  physician,  who  should  be  made  the  repository  of  any  mental 
auxioty,  especially  connected  with  the  tender  passion,  which  may  be 
preying  upon  the  vital  energy  of  the  body. 


574 


DOMESTIC   MANAGEMENT  OF  THE   SICK-ROOM. 


Affections  of  the  Head. 

Whatevek  roay  be  the  cause  of  Apoplexy,  no  disease  requires  more 
prompt  and  energetic  treatment :  the  alarming  nature  of  the  symp- 
toms is  always  sufficient  to  prevent  any  time  from  being  lost  by  at- 
tempts to  relieve  the  sufferer  without  medical  assistance.  Should  the 
attack  not  prove  fatal  at  the  time,  and  should  it  not  be  followed  by 
palsy,  still  the  utmost  caution  is  requisite  to  prevent  a  recurrence  of 
the  disease.  It  is  scarcely  necessary  to  insist  on  the  strictest  adhe- 
rence to  temperance,  both  as  to  meat  and  to  drink ;  and  the  impoi- 
tance  of  daily  exercise,  when  the  attack  is  over;  and  indeed  for  the 
remainder  of  life.  Prolonged  study  and  intense  thinking  must  bo 
given  up ;  the  violent  and  exciting  passions  should  be  subdued ;  and 
even  the  pleasurable  moderated. 

Inflammation  of  the  brain  is  one  of  those  diseases  which  require,  as 
observed  respecting  Apoplexy,  the  most  energetic  treatment.  When 
convalescence  has  fortunately  been  established,  the  attention  of  the 
physician  is  still  requisite,  during  several  weeks,  until  complete  re- 
covery be  fully  confirmed  ;  for  the  brain,  after  suffering  from  inflnm- 
mation,  is  very  apt  to  relapse  into  the  same  state,  from  the  excitement 
of  too  full  a  meal,  or  over-exercise,  or  even  slight  mental  exertions 
or  emotions.  On  this  account,  the  convalescent  must  be  kept  per- 
fectly quiet,  and  completely  free  from  the  smallest  excitement ;  and 
the  strictest  regimen  observed.  His  diet  should  not  only  be  mild 
and  unstimulating,  but  small  in  quantity. 

Inflammation  of  the  eyes  requires  the  same  caution  when  convales- 
cence is  secured  as  other  inflammatory  affections;  namely,  quiet, 
great  moderation  in  diet,  and  avoiding  exposure  either  to  much  light, 
heat,  or  cold,  or  whatever  can  stimulate  the  still  highly  excitable 
organ. 

Affections    of  the  Chest. 

Inflammation  of  the  Lon^s  {Pneumonia).  —  In  convalescence  from 
this  disease,  the  temperature  of  the  room  in  Avhich  the  patient  sits 
should  not  exceed  60°  F. ;  and  it  should  be  free  from  currents  of  air ; 
but,  at  the  same  time,  it  should  not  bo  close.  The  necessity  for  con- 
tinuing the  same  elevated  position  of  the  shoulders  when  in  bed, 
which  is  demanded  during  the  existence  of  the  disease,  remains  even 
when  the  convalescence  is  advauced.  The  patient  should  be  pre- 
vented from  talking,  and  from  exerting  any  muscular  motion  that  can 
accelerate  the  circulation.  The  diet  should  be  of  that  desoi'iption 
which  will  support  the  strength  without  exciting  or  producing  reple- 
tion. As  the  convalescence  advances,  and  exercise  is  permitted  by 
the  medical  attendant,  it  should  be  regular,  but  not  hurried  nor  vio- 
lent ;  and  evening  air  should  be  sedulously  avoided. 

Pleorisy. —  Inflammation  of  the  lining  membrane  of  the  chest  re- 
<^;  aires  the  same  attention  to  diet  and  regimen  during  convalescence 


IX>ME811C  MANAGEMENT   OF  THE   8I0K-ROOM. 


575 


fts  the  last-mentioned  disease,  except  that  a  greater  strictness  with 
repird  to  abstemiousness  in  food  is  requisite ;  the  least  deviation 
l»L'in<'  likely  to  bring  on  a  renewal  of  the  inflammation.  When  tho 
(lisciiso  assumosa  chronic  character,  and  when  the  object  is  to  remove 
fluid  effused  into  the  cavity  of  the  chest,  and  pressing  upon  the  lungs 
so  as  to  circumscribe  their  action,  the  same  degree  of  strictness  with 
lospoct  to  diet  is  not  necessary  ;  but,  as  in  this  condition  of  the  habit 
tho  physician  must  continue  bis  attendance,  the  regulation  of  tho  diet 
devolves  upon  him. 

An^inu.  —  In  that  condition  of  the  habit  which  is  connected  with 
a  predisposition  to  gout,  but  in  which,  instead  of  a  regular  paroxysm, 
tho  heart  and  the  pulmonary  organs  become  affected,  and  the  disease 
assumes  that  form  which  has  been  denominated  diaphragmatic  gout 
{Angina pectoris) ,  the  regulation  of  diet  is  of  vital  impoi'tance ;  and 
it  should  be  of  aa  low  a  standard  as  the  constitutional  powers  will 
admit.  It  should  not  bo  of  a  description  either  to  nourish  much,  or 
to  augment  or  to  cause  fulness  of  habit :  mild  animal  food,  in  mod- 
erate quantity,  may  be  allowed ;  but  tho  staple  should  be  of  a  farina- 
ceous kind  ;  every  stimulant,  whether  solid  or  fluid,  should  be  avoided  ; 
luid  wine  and  malt  liquors  regarded  as  poisons.  Tho  invalid  himself 
should  be  made  aware,  that  whatever  tends  to  excite  or  to  hurry  tho 
circulation  is  calculated  to  bring  on  a  paroxysm ;  nor  is  it  sufficient 
that  he  avoids  all  stimulating  viands  and  beverages  ;  he  should  also 
be  instructed  that  the  same  deleterious  effects  are  likely  to  follow  a 
full  meal,  even  of  the  most  proper  and  mildest  food. 

The  same  attention  to  diet,  both  as  regards  quantity  and  quality,  is 
essential  in  palpitations  depending  on  organic  disease  of  the  heart. 

Asthma.  —  In  no  affection  of  the  chest  is  attention  to  diet  so  impor- 
tant as  in  asthma.  Sir  John  Floyer,  who  himself  suffered  from  the 
disease,  recommends  almost  a  degree  of  abstinence  ;  which  is  correct 
in  reference  to  quantity  ;  but  the  diet,  although  of  a  light,  yet  should 
be  of  a  solid,  kind.  This  is  especially  necessary,  when  dyspepsia  is 
present  to  aggravate  and  excite  the  disease  of  the  lungs. 

In  Hooping^-coa^h,  the  diet,  whether  tho  patient  be  an  adult  or  a 
child,  should  be  of  tho  mildest  description ;  and,  perhaps,  no  nutri- 
ment is  so  well  adapted  to  support  the  tone  of  the  body,  without 
exciting  it,  as  milk.  In  infancy,  nothing  but  the  breast  should  be 
given;  the  system  of  the  nurse,  at  the  same  time,  being  kept  as  cool 
as  possible  by  mild  diet,  and  her  mind  in  a  tranquil  state.  If  convul- 
sions occur,  these  sometimes  depend  on  the  nature  of  the  milk  ;  in 
which  case  the  nurse  should  be  changed.  It  is  still  customary  with 
non-professional  persons  to  consider  change  of  air  essential  in  hooping- 
cough  ;  but  it  is  only  after  the  malady  has  run  its  course,  and  conva- 
lescence is  progressing,  when  the  cough  remains  as  a  habit,  that 
change  of  air  is  really  beneficial.  It  is  unnecessary  to  combat  tHe 
absurd  opinion,  that  a  chanj^e  even  to  a  worse  air  is  salutary. 


piffi^Klf^f 


576 


DOMESTIC  MANAGEMENT  OF  THE   8IOK-ROOM. 


n 


Affections   of  the   Stomach  and  Bowels. 


Altuovoii  acute  injlammation  off  he  stomach  rarely  occurs,  yet  there 
is  a  chronic  form  of  thut  disousc,  in  which,  during  its  actual  oxistcnco, 
nnd  also  in  convalescence  from  it,  much  of  tho  safety  of  the  invalid 
depends  upon  domestic  manaj^ement.  Every  source  of  excitement 
should  ho  avoided  ;  the  sicU-room  should  he  airy,  and  its  teinpcraturo 
that  of  summer.  Tiie  food  should  ho  of  the  blaudcst  kind,  given 
cold,  or  iced,  and  in  small  quantity  :  even  when  the  convalescence  is 
established,  tho  diet  should  consist  of  fariniiceous  matters,  mixed  with 
small  quantities  of  heef-tea,  or  weak  broths ;  and  this  severe  diet 
should  bo  persisted  in  for  a  considerablo  time  after  recovery. 

Enteritis. — "When  inflammatory  action  extends  to,  or  exclusively 
exists  in,  the  mucous  lining  of  tho'bowcls,  constituting  this  disease, 
the  diet,  during  the  early  stage  of  it,  should  be  confined  to  cold  water, 
or  iced  almond-emulsion  ;  after  which,  milk  and  barley-water,  or  weak 
chicken  or  veal-tea,  may  bo  given  in  small  quantities  ;  namely,  two  or 
three  tablcspoonfuls,  at  intervals  of  three  or  four  hours.  Nothing 
stronger  should  bo  ventured  upon,  unless  exj)ressly  ordered  by  tho 
medical  attendant. 

Atonic  Dyspepsia,  ov  simple  indigestion. — During  tho  attack,  absti- 
nence, to  a  certain  degree,  is  necessary  ;  but,  if  this  is  not  essential,  tho 
diet  should  bo  somewhat  stimulant,  but  simple;  namely,  a  small  cup 
of  moderately  strong  coffee,  with  littlo  sugar  or  milk ;  or  beef-tea, 
with  a  small  quantity  of  dry  toast;  and,  at?  tho  stomacli  begins  to 
retain  its  tone,  a  little  animal  food  of  easy  digestion,  such  as  mutton 
or  poultry. 

During  tho  intervals  of  tho  paroxysms  of  indigestion,  attention  to 
diet  is  of  the  first  importance.  As  a  general  rule,  tho  patient  should 
be  confined  to  a  spare  animal  diet,  with  a  moderate  share  of  well' 
boiled  vegetables,  and  a  considerablo  restriction  with  respect  to  the 
use  of  fluids. 

Dysentery,  which  implies  inflammation,  acute  or  chronic,  of  the 
same  membrane  as  in  enteritis,  but  confined  to  the  larger  and  lower 
bowels,  requires  the  diet  to  consist  of  the  mildest  farinaceous  matters, 
strictly  avoiding  all  solid  animal  food.  It  should  be  given  in  small 
quantity  at  a  time,  and  the  whole  allowance  for  the  day  should  ho 
moderate.  The  farinaceous  food  should  not  be  either  solid,  nor  yet 
altogether  fluid  ;  the  former  may  prove  injurious  as  a  mechanical  irri- 
tant ;  tho  latter  is  apt  to  excite  griping,  from  the  extrication  of  much 
flatus. 

Diarrhoea. —  Much  of  tho  domestic,  as  well  as  the  medical  manage- 
ment of  diarrhoea  depends  on  the  nature  of  the  attack,  and  its  causes ; 
but  too  much  attention  cannot  bo  paid  to  the  regulation  of  tho  diet. 
It  should  bo  both  small  in  quantity,  ond  mild  in  quality.  In  tho  early 
stage,  and  the  acute  form  of  the  disease,  barley-water,  arrow-root, 
made  with  water,  ricedr  grit  grael,  and  light  broths,  are  proper.     In 


DOMESTIC  MANAGEMENT  OF  THE  SICK-ROOM. 


s?: 


chronic  diarrhcca,  rice,  properly  boiled,  and  mixed  with  a  small  quan- 
tity of  beef-tea,  forms  an  excellent  diet,  as  it  nourishes  moderately, 
and  leaves  scarcely  any  feculent  matter  behind  it. 

Ill  Cholera,  convalescence  is  often  tedious ;  and  nothing  is  so  likely 
to  cmse  relapse  as  even  slight  irregularities  of  diet.  For  weeks  after 
the  leverish  symptoms  have  disappeared,  the  diet  should  consist  of  a 
very  moderate  quantity  of  vegetable  matter  only.  The  feet  should 
be  kept  especially  warm,  and  the  whole  body  clothed  in  flannel,  to| 
prevent  that  irregular  distribution  of  blood  which  so  strongly  charac- 
terizes the  disease. 

After  inflammation  of  the  lining  membrane  of  the  cavity  of  the 
belly  {peritonitis)  has  been  subdued,  the  invalid  should  still  observe 
the  strictest  diet  and  regimen.  He  should  return  very  gradually  to 
the  use  of  animal  food  and  wine.  The  bowels  should  be  moderately 
and  daily  opened,  the  feet  kept  warm,  and  the  skin  maintained  in  a 
healthy  condition  by  wearing  flannel  next  to  it,  for  a  very  considerable 
time  after  every  trace  of  the  disease  has  disappeared. 

Diseases  of  the  Liver. — In  all  cases  of  recovery  from  these  diseases,* 
whether  inflammatory  or  otherwise,  every  precaution  should  be  taken 
to  guard  against  the  deleterious  influence  of  alternations  of  tempera- 
ture and  also  of  damp,  by  clothing  in  flannel  next  the  skin.  Errors  in 
diet  should  be  avoided ;  and  fermented  liquors  and  stimulating  bever- 
age of  every  kind,  refrained  from.  When  pains  of  the  side  continue, 
after  all  the  other  symptoms  of  the  disease  have  disappeared,  the 
introduction  of  a  seton,  if  prescribed,  should  not  be  objected  to ;  as 
th«  greatest  benefit  has  often  followed  that  mode  of  countar  irritation- 

73 


'  i] 


k  .■'     .    ■-.>  .s 


1; 'IKfiiTr);; 


COOKERY   FOR   THE   SICK-ROOM. 


It  was  said  by  the  distinguished  Dr.  Rush,  in  his  lectures  before  his 
class,  that  a  physician  ought  to  spend  six  months  in  a  kitchen  before 
beginning  practice.  A  knowledge  of  dietetic  preparations  fitted  for 
the  sick,  and  for  those  recovering  from  disease,  however  apparently 
unimportant,  adds  much  to  a  physician's  power  over  his  patient,  and 
to  his  popularity  ard  usefulness. 

In  giving  nourishment  to  the  sick,  who  are  suffering  from  low  dis. 
eases,  it  is  an  important  rule  which  should  never  be  forgotten,  to  give 
but  little  at  a  time,  and  to  repent  that  often.  In  cases  of  great  prostra- 
tion from  disease,  life  may  at  times  be  endangered  by  a  delay  in  giv- 
ing nourishment  of  even  a  few  minutes  beyond  the  proper  time. 

Barley-Water. 

Pearl  barley,  two  ounces  ;  boiling  water,  two  quarts.  Boil  to  one 
half,  and  strain.  A  little  lemon  juice  and  sugar  may  be  added,  if 
desirable.     To  be  taken  freely  in  inflammatory  diseases. 

Rice-Water. 

Rice,  two  ounces ;  water,  two  quarts.  Boil  an  hour  and  a  half, 
and  add  sugar  and  nutmeg. 

Rice,  when  boiled  for  a  considerable  time,  becomes  a  kind  of  jelly, 
and,  mixed  with  milk,  is  a  very  excellent  diet  for  children.  It  has  in 
some  measure  a  constipating  property,  which  may  be  increased  by 
boiling  the  milk. 

Decoction  of  Bran. 

New  wheat  bran,  one  pint ;  water,  three  quarts.  Boil  down  one 
third,  strain  off  the  liquor,  and  add  sugar,  honey,  or  molasses,  accord- 
ing to  the  taste  of  the  patient.  A  bran  tea  may  be  made  by  using 
boiling  water,  and  suffering  the  mixture  to  stand  in  a  covered  vessel 
for  three  or  four  hours. 

Sage  Tea. 

Dried  leaves  of  sage,  half  an  ounce  ;  boiling  water,  one  quart  In* 
{nse  for  half  an  hour,  and  strain.     Add  sugar  and  lemon  juice  as 


COOKEUV  von  TlIK  SICKUOOM. 


D79 


required  by  the  piitient.     Balm  and  other  teas  are  made  in  the  samo 
manner. 

The  above  infusions  form  agreeable  and  useful  drinks  in  fevers,  and 
their  diaphoretic  powers  may  be  increast^d  by  adding  a  little  sweet 
spirits  of  nitre. 

Barley  Coffee. 

Roast  one  pint  of  common  barley  in  the  same  way  in  which  coffee 
is  roasted.  Add  two  large  spoonfuls  of  this  to  a  quart  of  boiling 
water ;  boil  five  miimtes.     Add  a  little  sugar. 

Lemon-Water. 

Put  two  slices  of  lemon,  thinly  pared,  into  a  teapot,  a  little  bit  of  the 
peel  and  a  bit  of  sugar.  Pour  in  a  pint  of  boiling  water,  and  cover  it 
close  two  hours. 

A  Refreshing  Drink  in  Fevers. 

Put  a  little  sage,  two  >"prigs  of  balm,  and  a  little  sorrel  into  a  stone 
jug,  having  first  washed  and  dried  them.  Peel  thin  a  small  lemon, 
slice  it,  and  put  a  small  piece  of  the  peel  in ;  then  pour  in  three  pints 
of  boiling  water.     Sweeten,  and  cover  it  close. 

Another. 

>iL  an  ounce  and  a  half  of  tamarinds,  three  ounces  of  cran- 
berries, and  two  ounces  of  stoned  raisins,  in  three  pints  of  water,  till 
the  water  is  reduced  to  two  pints.     Strain,  and  add  a  bit  of  lemon 

S)eel,  which  must  be  removed  in  an  hour,  as  it  gives  a  bitter  taste  if 
eft  too  long. 

A  Very  Pleasant  Drink. 

Put  a  teacupful  of  cranberries  into  a  cup  of  water,  and  mash  them. 
In  the  mean  time,  boil  two  quarts  of  water  with  one  large  spoonful 
of  corn  or  oat  meal  and  a  bit  of  lemon  peel ;  then  add  the  cranberries. 
As  much  fine  sugar  as  shall  leave  a  smart  flavor  of  the  fruit,  and  a 
wineglassful  of  sherry.  Boil  the  whole  gently  for  fifteen  minntes, 
and  strain. 

.   Crust  Coffee. 

Toast  slowly  one  or  two  slices  of  brown  or  white  bread,  pour  boil, 
ing  wat<ir  over  it,  and  drink  hot  or  cold,  according  to  preference. 

Infusion  of  Malt. 

To  one  pint  of  ground  malt  add  three  pints  of  scalding  water,  that 
is,  water  not  quite  brought  to  the  boiling  point;  infuse  two  hour?. 


M^i:|-J 


560 


COOKERY  FOR  THE  SICK-ROOM. 


and  strain.     Add  sugar  or  lemon  juice  as  desired, 
paration  in  inflammatory  fevers. 

Lemonade. 


An  excellent 


pre* 


Fresh  lemon  juice,  four  ounces  ;  thin  peel  of  lemon,  half  an  ounce; 
white  sugar,  four  ounces  ;  boiling  water,  three  pints.  Let  them  stand 
until  cold,  and  strain.  When  used  in  fevers,  a  little  nitrate  of  potash 
or  sweet  spirits  of  nitre  may  be  added.  It  may  be  further  diluted  to 
tht  taste  of  the  patient. 

Water  Gruel. 

Oat  or  corn  meal,  two  tablespoonfuls  ;  water,  one  quart.  Boil  for 
ten  or  fifteen  minutes,  and  strain,  adding  salt,  and  sugar  if  desired  by 
the  patient 

Milk  for  iDfants. 

Cows'  milk,  one  part ;  water,  two  parts  ;  sweeten  slightly  with  loaf 
sugar. 

It  is  necessarv  when  children  are  to  be  raised  by  hand  to  dilute  the 
milk.  The  above  proportions  may  be  altered  as  the  child  advances 
in  age. 

Rice  Gruel. 

Ground  rice,  one  heaping  tablespoonful ;  ground  cinnamon,  one 
teaspoonful ;  water,  one  quart.  Boil  gently  for  twenty  minutes,  add- 
ing the  cinns  mon  near  the  conclusion.  Strain  and  sweeten.  Wine 
may  be  added  in  some  cases. 

Panada. 

White  bread,  one  ounce ;  ground  cinnamon,  one  teaspoonful ; 
water,  one  pint.  Boil  them  until  well  mixed,  and  bdd  a  little  sugar 
and  nutmeg.     Wine  or  butter  may  also  be  added,  if  desirable. 


Compound  Salop  Powders. 

Salep,  tragacanth,  and  sago,  each  four  ounces ;  cochineal,  half  a 
dram  ;  prepared  oyster  shells,  one  ounce.  Mix,  and  divide  into  pow* 
ders  of  one  dram  each.  Stir  one  of  these  powders  into  a  pint  of 
milk,  and  boil  for  ten  or  fifteen  minutes.  To  be  drunk  freely  in  diar« 
rhcea  and  dysentery.  '' 

Another. 

Gum  arable,  tragacanth,  maranta,  sago,  tapioca,  each  two  drams. 
Mix  them  well  together,  and  boil  in  a  pint  of  milk,  flavored  with  nut- 
meg or  cinnamon.     To  be  used  as  a  diet  in  dysentery,  diarrhopa,  etc. 


'■«a 


Sago  Gruel. 

SvGO,  two  tablespoonfuls ;  water,  one  pint  Boil  gently  until  it 
thickens^  frequently  stirring.  Wine,  sugar,  and  nutmeg,  may  b« 
added,  according  to  circumstances. 

Arrow-Root  Gruel. 

Arrow-root,  one  tablespoonful ;  sweet  milk,  half  a  pint ;  boiling 
water,  half  a  pint.     To  be  sweetened  with  loaf  sugar.     Excellent  ali 
meut  for  children  when  the  bowels  are  irritable. 


Tapioca  Jelly. 

Tapioca,  two  tablespoonfuls ;  water,  one  pint.  Boil  gently  for  an 
hour,  or  until  it  assumes  a  jelly-like  appearance.  Add  sugar,  wine, 
and  nutmeg,  with  lemon  juice  t )  suit  the  tatste  of  the  patient,  and  the 
nature  of  the  case. 

Jelly  of  Irish  Moss. 

Irish  moss,  half  an  ounce ;  fresh  milK<  a  pint  and  a  half.  Boil 
down  to  a  pint.  Remove  any  Pediment  by  straiiiing,  and  add  the 
proper  quantity  of  sugar  and  lemon  juice,  or  peac.  water,  to  g' vo  it 
an  agreeable  flavor 

Isinglass  Jelly. 

Isinglass,  one  roll.  Boil  in  one  pint  of  water  until  it  is  dissolved. 
Strain,  and  add  one  pint  of  sweet  milk.  Put  it  again  over  the  fire, 
and  let  it  just  boil  up.  Sweeten  with  loaf  sugar,  and  grate  nutmeg 
upon  it.     When  properly  made,  it  resembles  custard. 

This  forms  an  excellent  diet  for  persons  recovering  from  sickness, 
and  is  well  adapted  to  the  bowel  complaints  of  children. 

Apple  Water. 

« 
Cut  two  large  apples  in  slices,  and  pour  a  quart  of  boiling  water 
on  them.     Or,  pour  the  same  amount  of  water  on  roasted  .pplea.     In 
two  or  three  hours,  strain  and  sweeten  slightly. 


Milk  Porridge. 

Wheat  flour,  corn  meal,  or  oatmeal,  two  tablespoonfuls ;  milk,  one 
pint;  water,  one  pint.  Mix  the  flour  or  meal  with  cold  water,  to 
form  a  thin  paste ;  put  the  milk  and  water  over  the  fire,  and  when 
they  come  to  the  boiling  point,  add  the  paste,  carefully  stirring. 


(i-:t 


M   ■« 


i&'4 


French  Milk  Porridge. 

Stir  some  oatmeal  and  water  together ;  let  the  mixture  stand  to 
clear,  and  pour  off  the  water.  Then  put  more  water  to  the  meal,  stir 
it  well,  and  let  it  stand  till  the  next  day.  Strain  through  a  fine  sieve, 
and  boil  the  water,  adding  milk  while  so  doing.  The  proportion  of 
water  must  be  small.  With  toast,  this  is  a  good  preparation  foi 
weak  persons. 

Ground-Rice  Milk. 

Boil  one  spoonful  of  good  rice,  rubbed  down  smooth,  with  a  pint 
and  a  half  of  milk,  a  little  cinnamon,  lemon  peel,  and  nutmeg, 
Sweeten  when  nearly  done. 

Boiled  Flour. 

Tie  up  as  tight  as  possible,  in  a  linen  cloth,  one  pound  of  flour; 
and,  after  frequently  dipping  it  in  cold  water,  dredge  the  outside  with 
flour  till  a  crust  is  formed  round  it,  which  will  prevent  the  water  from 
soaking  into  it  while  boiling.  Place  it  in  water  and  boil  until  it  be- 
comes a  hard,  dry  mass. 

Two  or  three  spoonfuls  of  this  may  be  grated,  and  prepared  in  the 
same  manner  as  arrow-root  gruel,  for  which  it  is  an  excellent  substi- 
tute. 

Vegetable  Soup. 

Take  one  turnip,  one  potatoe,  and  one  onion,  let  them  be  sliced 
and  boiled  in  one  quart  of  water  for  an  hour.  Add  as  much  salt  as 
is  agreeable,  and  jjour  the  whole  upon  a  piece  of  dry  toast. 

This  forms  an  agreeable  substitute  for  animal  food,  and  may  be 
given  when  the  latter  is  inadmissible. 

Beef  Tea. 

Lean  beef,  cut  into  shreds,  one  pound ;  water,  one  quart.  Boil  for 
twenty  minutes,  taking  oft'  the  scum  as  it  rises.  When  it  grows  cold, 
strain. 

Essence  of  Beef. 

Lean  beef  sliced.  Put  a  sufficient  quantity  into  a  porter  bottle  to 
fill  up  ila  body,  cork  it  loosely,  and  place  it  in  a  pot  of  cold  water, 
attaching  the  neck,  by  meansisxif  a  string,  to  the  handle  of  the  vessel. 
Boil  this  for  an  hour  and  a  ""naif  or  two  hours;  then  pour  oft'  the 
liquor  and  skim  it. 

To  this  preparation  may  be  added  spices,  salt,  wine,  brandy,  etc., 
according  to  the  taste  of  the  patient,  and  nature  of  the  disease. 


COOKERY  FOR  THE  SICK-ROOM. 


583 


Calf's-feet  Jelly. 

Take  two  calf's  feet,  and  add  to  them  one  gallon  of  water.  Boil 
down  to  one  quart.  Strain,  and  when  cold,  skim  off  the  fat.  Add 
to  this  the  white  of  six  or  eight  eggs  well  beaten,  a  pint  of  wine,  half 
a  pound  of  loaf  sugar,  and  the  juice  of  four  lemons,  and  let  them  be 
well  mixed.  Boil  the  whole  for  a  few  minutes,  stirring  constantl); 
and  then  pass  it  through  a  flannel  strainer. 

This  forms  a  very  nutritious  article  of  diet  for  the  sick,  and  for 
those  recovering  from  disease.  The  wine  may  be  omitted  or  added, 
according  to  choice. 

Chicken  Water. 

Takh  half  a  chicken,  divested  of  all  fat,  and  break  the  bones ;  add 
io  this  half  a  gallon  of  Wiit^r.  and  boil  for  half  an  hour.  Seasoki 
with  salt. 

Suet  Ptisan. 

Sheep's  suet,  two  ounces ;  milk,  one  pint ;  starch,  half  an  ounce. 
Boil  slowly  for  half  an  hour.  This  may  be  used  as  a  common  drink 
in  dysentery. 

Rennet  Whey. 

New  milk,  one  quart;  rennet,  a  large  spoonful.  Heat  the  milk,  and 
then  add  the  reimet.  Boil  until  the  curd  separates,  which  is  to  be 
taken  otf.     To  inany  persons,  this  forms  an  agreeable  nutriment. 

Vinegar  Whey. 

Milk,  one  pint;  vinegar,  one  tablespoonful.  Boil  for  a  few  inin« 
utes,  and  separate  the  curd. 

Tartar  Whey. 

Milk,  one  quart ;  cream  of  tartar,  one  dessert  spoonful.  Boil,  and 
separate  the  curd. 

Mustard  Whey. 

Bruised  mustard-seed,  one  tablespoonful ;  milk,  one  pint.  Boil 
together  for  a  few  minutes,  and  separate  the  curd. 

This  has  been  found  a  useful  drink  in  dropsy.  A  teacupful  may 
be  taken  at  a  time. 

•   Alum  Whey. 

Alum,  one  teaspoonful ;  milk,  one  pint.  Boil  together,  and  strain, 
to  separaite  the  curd. 


m 


T^r 


[ 

'■'ir 

584 


COOKERY  FOR  THE  SICK-ROOM. 


=1 


Orange  Whey. 

Milk,  one  pint ;  the  juice  of  an  orange  with  a  portion  of  the  peeL 
Boil  the  milk ;  then  put  the  orange  to  it,  and  let  it  stand  till  coagula> 
tion  takes  place.     Strain. 

Sweet  Whey. 

Skimmed  milk,  two  quarts  ;  a  piece  of  prepared  calf's  rennet.  Miji, 
and  put  in  a  warm  place  till  coagulation  takes  plac** ;  then  strain. 

Whey  with  Tamarinds. 

Milk,  boiling,  one  pint ;  tamarinds,  two  ounces.  Boil  them  to 
gether  till  coagulation  takes  place.  , 

Wine  Whey. 

Milk,  two  thirds  of  a  pint;  water,  one  third  of  a  pint;  Madeira, 
or  other  wine,  one  gill ;  sugar,  one  dessert  spoonful.  Place  the  milk 
and  water  together  in  a  deep  pan  on  the  fire,  and  at  the  moment 
when  it  begins  to  boil,  pour  in  the  wine  and  the  sugar,  stirr  ig  assidu- 
ously whilst  it  boils,  for  twelve  or  fifteen  minutes.  Lastly,  strain 
through  a  sieve.  This  is  excellent  in  all  forms  of  fever,  given  in 
small  quantities.  It  may  be  drunk  either  cold  or  tepid,  a  wineglassful 
at  a  time. 

Milk  and  Soda  Water. 

Heat  nearly  to  boiling,  a  teacupful  of  milk ;  dissolve  in  it,  a  tea- 
spoonful  of  refined  sugar;  put  this  into  a  large  tumbler,  and  fill  with 
soda  water.  This  is  an  excellent  mode  of  taking  milk  when  th3 
stomach  is  charged  with  acid,  and  is  oppressed  by  milk  alone. 

Sippets. 

On  an  extremely  hot  plate,  put  two  or  thr<  c  slices  of  bread,  and 
pour  over  them  some  of  the  juices  of  boiled  btof,  mutton,  or  veal,  if 
there  be  no  butter  in  the  dish.     Sprinkle  over  them  a  little  salt. 

Restorative. 

Take  two  calf's  feet,  one  quart  of  water,  and  one  quart  of  new 
milk ;  place  all  in  a  close-covered  jar,  and  bake  three  hours  and  a 
half.  When  cold,  remove  the  fat.  Any  desired  flavor  ma  be  given, 
by  adding  lemon-peel,  cinnamon,  or  mace,  while  baking.  Add  sugar 
nfterwards. 


Coffee  Milk. 

Boil  a  dessertspoonful  of  groiind  coffee  in  nearly  a  pint  of  milk,  for 
a  qnarter  of  an  hour,  then  put  into  it  a  shaving  of  isinglass,  and  clear 
it  Let  it  boil  a  few  minutes,  and  set  it  beside  the  lire  to  clarify. 
Sweeten  with  loaf  sugar. 

Nutritive  Fluid. 

Take  two  teaspoonfuL  of  lump  magnesia,  one  teaspoonful  of  sal- 
eratuiJ,  one  teaspoonful  of  salt,  two  teaspoonfuls  of  flour,  half  a  pint 
of  milk,  and  one  pint  of  water.  Put  the  milk  and  water  united  over 
the  fire,  and  rub  up  the  flour  with  a  little  cold  water  to  make  a  thiii 
paste.  Just  when  the  milk  and  water  bogin  to  boil,  stir  in  the  paste. 
This  will  make  a  thin  porridge,  which  should  boil  about  five  minutes. 
At  the  end  of  this  time,  remove  from  the  fire,  and  pour  into  a  pitcher. 
Now  add  the  magnesia,  pulverized,  and  mixed  with  the  saleratus  and 
salt.     Sweeten  to  suit  the  taste. 

This  may  be  drank  freely,  several  times  a  day,  so  as  to  produce  two 
evacuations  of  the  bowels  in  twenty-four  hours,  in  those  cases  of  dys- 
pepsia attended  by  acidity  of  the  stomach,  and  in  many  debilitated 
conditions  of  the  system  in  which  there  is  a  tendency  to  loss  of  flesh. 

This  is  one  of  the  leading  fluids  used  by  those  who  pursue  what  is 
called  the  "  Nutritive  System"  of  treating  disease,  and  is  really  a  val- 
uable preparation,  having  the  effect  often  to  increase  the  flesh,  even 
while  it  acts  as  a  cathartic. 


1  'i 


■i 


III 


vm 


m 


MEDICINES  AND  THEIR  PREPARATIONS. 


Materia  Medica. 


That  department  of  medicine  which  treats  of  remedies,  their  doses, 
modes  of  using,  and  influences  upon  the  constitution,  is  called  materia 
medica.  The  agents  employed  in  the  treatment  of  disease  are  taken 
from  three  kingdoms  of  nature,  —  the  vegetable,  the  animal,  and  the 
mineral. 

The  largest  portion  of  medicinal  substances  are  taken  from  the 
vegetable  world.  They  consist  of  leaves,  flowers,  seeds,  barks,  and 
roots.  These  lose  much  or  all  of  their  medicinal  powers  unless  gath- 
ered at  the  right  seasons  of  the  year,  and  are  properly  cured.  The 
different  parts  of  a  plant  are  to  be  gathered  when  their  peculiar  juices 
are  most  abundant  in  them. 

Tlie  Roots  of  Annual  Plants  are  best  supplied  with  their  juices  be- 
fore they  are  in  flower ;  they  should  be  gathered  at  this  time. 

Tlie  Roots  of  Biennial  Plants  should  be  gathered  in  the  autumn, 
after  their  first  year's  growth. 

The  Roots  of  Perennial  Plants  should  be  gathered  in  the  spring, 
before  vegetation  has  begun.    • 

Before  they  are  dried,  the  solid  parts  of  these  roots  are  to  be  cut  in 
slices,  after  being  washed,  and  the  small  fibres,  urJess  they  are  the 
parts  used,  are  to  be  thrown  away. 

Bulbous  Roots  are  to  be  gathered  at  the  time  their  leaves  decay. 
Their  outer  covering  being  rejected,  they  must  be  sliced,  strung  upon 
threads,  and  hung  in  a  warm,  airy  room  to  dry.  After  being  dried, 
roots  should  be  packed  in  barrels  or  boxes,  and  kept  as  free  as  possi- 
ble from  moisture. 

Barks,  whether  of  the  roots,  trunk,  or  branches,  must  be  gathered 
in  autumn,  or  early  in  the  spring,  when  they  peel  off*  most  easily,  and 
the  dead  outside  and  all  rotten  parts  being  separated,  they  must  be 
dried  in  the  same  manner  as  roots.  The  most  active  barks  are  gen- 
erally from  young  trees. 

Leaves  are  to  be  gathered  when  they  are  full  grown,  and  just  before 
the  fading  of  the  flower. 


MEDICINES  AND  THEIR  PREPARATIONS. 


587 


Those  of  biennial  plants  are  not  to  be  collected  until  the  second 
year.  For  drying,  they  should  be  thinly  spread  on  the  floor  of  a 
room  through  which  a  current  of  air  passes.  For  preservation,  they 
should  be  packed  in  ves  jels,  and  kept  free  from  moisture,  and  insectu. 

Flowers  must  generally  be  collected  about  the  time  of  their  open- 
ing,—  either  a  little  before,  or  just  after. 

They  should  be  dried  as  rapidly  as  possible,  but  not  in  the  sun,  and 
may  be  packed  away  in  the  same  manner  as  leaves. 

Fruits,  Berries,  etc.,  may  be  spread  thinly  upon  the  floor,  or  hung 
up  ill  bunches  to  dry. 

Articles  to  Accompany  a  Medicine  Chest. 

As  the  author  intends  to  prepare  a  Medicine  Chest  to  accompany 
this  volume,  it  is  well  to  mention  the  following  article's  as  necessary 
to  be  had  with  it : 

1.  A  Spatula  for  mixing  ointments  and  pills,  and  fo'  spreading 
plasters. 

2.  A  piece  of  smooth  marble  on  which  the  above  articles  may  be 
mixed,  divided,  and  spread. 

3.  A  glass  funnel. 

4.  A  domestic  syringe  for  injections. 

5.  Adhesive  or  sticking  plaster. 

6.  Lint. 

7.  Scales  and  weights. 

8.  A  glass  or  wedgewood  mortar  and  pestle. 

9.  A  graduated  wineglass  for  measuring  teaspoonfuls  and  table- 
spoonfuls  of  liquids. 

10.  A  minim  graduated  measure. 

11.  A  two-ounce  graduated  measure. 


1 


9  Dnm. 


no.  186. 


Mtnlm*. 


S  Onnc». 


FlO.  187. 


^  DnM. 


HnnH  xBAsuRa 


TWO-OUNGK  MBA8UKIL 


The  minim  measure  is  represented  by  Fig.  186,  and  contains  one 
fluid  dram,  or  sixty  minims,  which  is  divided  by  twelve  lines,  —  each 
line  representing  five  minims.  A  minim  is  considered  about  equal  to 
one  and  a  half  drops. 


"Mfl-fl 


588 


MEDICINES  AND  THEIR  PREPARATIONS. 


The  two  ounce  measure  is  represented  by  Fig.  187,  and  is  divided 
off  from  half  a  dram  upward. 

Doses,  Weights,  etc. 

Apothecary's  weights,  by  which  all  medicinal  preparations  ought 
to  be  weighed,  are  divided  into  pounds,  ounces,  scruples,  drams,  and 
grains. 

The  characters  marked  on  weights  and  graduated  measures,  are 
explained  as  follows : 


gj   one  ounce, 
f gj  one  fluid  ounce. 
gss  half  an  ounce. 
2j    one  dram. 


fSi  one  fluid  dram> 
Sss  half  a  dram, 
gj    one  scruple. 
^ss  half  a  scruplei 


The  grain  weights  are  stamped  with  punch  marks. 


20  grains. make  one  scruple. 
3  scruples  make  one  dram. 
8  drams  make  one  ounce. 

By  apothecary's  weight : 

lb     The  pound  is  equal  to  12  ounces. 
g        "     ounce  "  8  drams. 

By  apothecary's  measure : 


3 
B 


60  drops  make  one  fluii-dram. 
8  drams  make  one  fluid-ounce. 
16  ounces  make  one  pint. 


The  dram  is  equal  to  3  scruples. 
"    scruple       "      20  grains. 


0    The  pint  is  equal  to  sixteen  ounces. 
-  3        "    dram        "        ninety 'drops,  or  sixty  minims. 

The  marks  and  words  used  by  physicians  and  apothecaries  may  be 
a  little  more  fully  explained  by  the  following  table  : 

R  stands  for  recipe,  and  means  take. 

aa  stand  for  ana,  and  mean  of  each.  • 

Q>  stands  for  libra  vel  libra,  and  means  a  pound  or  pounds. 

g  stands  for  uncia  vel  uncine,  and  means  an  ounce  or  ounces. 

3  stands  for  drachma  vel  drachmcs,  and  means  a  dram  or  drams. 

^  stands  for  scrupulus  vel  scnipuli,  and  means  a  scruple  or  scruples. 

O  stands  for  octarius  vel  octarii,  and  means  a  pint  or  pints. 

f  g  stands  for  Jluiduncia  vel  Jluiduncice,  and  means  a  fluid  ounce  or  fluid 
ounces. 

f  3  stands  for  fiuidrachma  vel  fluidrachrtUB,  and  means  a  fluid  drachm  or  fluid 
drachms. 

m  stands  for  minimum  vel  minima,  and  means  a  minim  or  minims. 

Chart,  stands  for  chartula  vel  chariuke,  end  means  a  small  paper  or  papers. 

Ooch.  stands  for  cochlear  vel  cochlearia,  and  means  a  spoonful  or  spoonfub. 

CoUyr.  stands  for  coUyrium,  and  means  an  eye-water. 

Cong,  stands  for  conguit  vel  conguii,  and  means  a  gallon  or  gallons. 

Decoct,  stands  for  decoctum,  and  means  a  decoction. 

J^.  stands  for  Jiat,  and  means  make. 


Garg.  stands  for  gargarysma,  and  means  a  gargle. 

Gr.  stands  for  granum  vel  grana,  and  means  n  grain  or  grains. 

Gtt.  stands  for  gutta  vel  guttce,  and  means  a  drop  or  drops.  ■    , 

JIaust,  stands  for  haustus,  and  means  a  draught. 

Infus.  stands  for  infusum,  and  means  an  infusion. 

M.  stands  for  misce,  and  means  mix.  • 

Mass.  stands  for  massa,  and  means  a  mass. 

Mist,  stands  for  mistura,  and  means  a  mixture. 

Pit.  stands  for  pilula  vel  pilulce,  and  means  a  pill  or  pills. 

Pulv.  stands  for  pulves  vel pulveres,  and  means  a  powder  or  powders. 

Q.  S.  stands  for  quantum  sufficit,  and  means  a  sufficient  quantity. 

S.  stands  for  signa,  and  means  write. 

Ss.  stands  for  semis,  and  means  a  half. 

Domestic,  or  Approximate  Nensiires.— A  tablespoon  contains  about 
four  drams ;  a  teaspoon,  one  dram ;  a  dessertspoon,  three  drams ;  a 
wineglass,  two  ounces.      Spoons  vary  so  much  in  size,  that  they 
i  should  not  be  used  as  measures  in  giving  powerful  medicines. 

The  Approximate  Value  of  French  Decimal  Weights. 


One  centigramme  is  equal  to  \ 

Two  centigrammes        "  '  ^ 

One  demi-decigramme  "  1 

One  decigramme  "  2 

One  gramme  "  18 

One  gramme  and  three  decigrammes  is  equal  to  1 
Two  grammes  "  i 

Four  grammes  **  1 

One  decagramme  is  equal  to  2  drachms  and  36 
Three  decagrammes  and  two  grammes  is  equal  to  1 
Demi-kilogramme  ^  1 

Kilogramme  "2 


grain. 

grain. 

grain. 

grains. 

grains. 

scruple. 

drachm. 

drachm. 

grains. 

ounce. 

pound. 

pounds. 


At  Paris,  the  scruple  is  equal  to  24  grains ;  the  drachm,  to  72 
grains. 

Everywhere  else,  the  scruple  is  equal  to  20  grains ;  and  the  drachm, 
to  60  grains. 

The  following  table  shows  the  relative  doses  for  young  people  of 
different  ages : 


The  dose  for  a  person  of  middle  age  being 
That  of  a  person  from  14  to  21  years  will  be 
"        "       7  to  14 


M 
M 
« 

U 


u 
u 


of 

« 


4to7 

4 

3 

2 

1 


« 
« 


M 

(( 
M 


1  or  1  drachm. 
§  or  2  scruples. 
^  or  J  drachm. 
^  or  1  scruple. 
J  or  15  grains. 
^  or  10  grains. 
I  or  8  grains. 
T^  or  5  grains. 


In  administering  medicines,  it  is  always  well  to  begin  with  the 
smallest  dose  mentioned  and  gradually  increase  until  the  desired  in- 
fluence is  produced. 


wrwi 


m^ 


Tinotares. 


The  preparations  called  tinctures  are  made  by  grinding  or  bruising 
the  roots,  leaves,  or  barks  used,  to  a  coarse  powder,  placing  it  in  tlie 
proper  amount  of  either  alcohol  or  diluted  alcohol,  letting  it  stand 
from  seven  to  fourteen  days, — shaking  each  day, — and,  finally,  filter- 
ing through  paper.  A  large  proportion  of  tinctures  are  made  by  tak- 
ing one  cmnce  of  the  medicinal  substance  to  one  pint  of  the  spirit ;  and 
whenever  tinctures  are  spoken  of  in  this  Materia  Mcdica,  and  ip 
quantities  are  not  named,  the  above  proportions  are  to  be  prcsuiin-d. 
When  a  larger  proportion  of  the  medicine  is  to  be  used,  I  shall  simply 
indicate  the  proportions  in  the  fewest  words,  as  under  "Black  Cohosh, 
—  this  tincture,  four  ounces  to  the  pint  of  alcohol,"  meaning  thereby, 
that  the  tincture  is  made  by  using  four  ounces  of  the  root  to  the  pint 
of  alcohol.  Tilden  &  Co.'s  fluid  extracts,  which  are  the  most  reliable 
of  any  with  which  I  am  acquainted,  have  the  same  strength,  ounce 
for  ounce,  with  the  roots,  barks,  leaves,  etc.,  of  which  they  are  made. 
Tinctures  may  therefore  be  made  with  very  little  trouble,  by  substi- 
tuting, in  each  case,  the  same  number  of  ounces  of  their  fluid  extracts 
to  the  pint  of  alcohol,  which  I  name  of  the  gross  substance,  or,  when 
no  quantity  is  named,  one  ounce  to  the  pint. 

Infusions. 

Infusions  are  solutions  of  vegetable  medicines,  generally  obtained 
by  pouring  boiling  water  upon  the  ^mbstance,  and  letting  it  stand  till 
it  coOls.  When  a  more  prolonged,  application  of  heat  is  desired,  the 
vessel  may  stand  for  a  while  by  the  fire^  but  must  not  be  permitted  to 
boil.     The  vessel  should  usually  be  covered. 

As  in  the  case  of  tinctures,  I  have  uniformly,  while  writing  this 
Materia  Medica,  briefly  named  the  quantity  to  be  used  to  the  pint, 
whenever  it  varies  from  one  otmce. 

Acetic  Acid. —  This  is  a  clear  liquid,  without  color,  and  has  a  strong, 
sour  taste,  and  an  agreeable  smell.  When  held  to  the  nose,  its  fine, 
pungent  odor  often  relieves  headache.  A  piece  of  cambric  wetted 
with  it  and  applied  to  the  skin,  excites  heat  and  redness,  and,  very 
soon,  a  blister,  —  for  which  this  acid  may  be  substituted  in  inflamma- 
tory sore  throat,  and  other  cases  requiring  speedy  action.  Applied  to 
corns  and  warts,  with  a  camel's-hair  brush,  it  destroys  them.  One 
part  to  seven  of  water,  makes  a  good  vinegar. 

Citric  Acid. — This  acid  is  extracted  from  lemon,  or  lime  juice;  it  is 
also  present  in  the  cranberry,  currant,  strawberry,  raspberry,  tamarind, 
and  is  very  abundant  in  the  red  elderberry.  It  is  refrigerant,  and  anti- 
septic, and  is  chiefly  employed  as  a  substitute  for  lemonade.  Nine 
and  a  half  drams  of  the  crystals,  two  drops  of  oil  of  lemon,  and  one 
pint  of  water,  answers  a  good  purpose,  in  place  of  lemon-juice. 

Dilated  Nitric  Acid. — This,  in  the  undiluted  state,  passes  under  the 


^p^^plwf 


MEDICINES  AND  THEIR  PREPARATIONS. 


591 


name  of  aqua-fortis.  It  is  tonic  and  antiseptic.  Largely  diluted  with 
water,  it  forms  a  good  drink  in  fevers,  especially  typhus.  Taken  in 
large  doses,  it  is  a  powerful  poison.  One  dram  of  this  preparation, 
thirteen  ounces  of  soft  water,  and  one  ounce  of  simple  syrup,  make  a 
good  drink  in  fevers,  of  which  half  a  wineglass  to  a  wineglassful  is  a 
dose.     Excellent  in  cases  of  hooping-cough. 

Nltro-Murlatlc  Aclll. —  This  acid,  when  properly  diluted,  has  a  tonic 
and  stimulant  influence.  It  is  much  used  as  a  foot-bath  in  atl'ections 
of  the  liver,  and  in  deficient  secretions  of  the  bile. 

Diluted  Hydrochloric  Acid.  —  This  is  known  by  the  name  of  diluted 
muriatic  acid.  It  is  tonic,  antiseptic,  and  diuretic,  and  is  used  in 
typhus,  eruptions  of  the  skin,  and  with  other  articles,  as  a  gargle  in 
inflammatory  and  putrid  sore  throats.  Dose,  from  five  to  twenty 
drops,  in  a  wineglassful  of  water.  It  is  given  in  scarlet  and  typhoid 
fevers,  about  twenty  drops  being  put  into  a  bowl  of  barley-water  or 
gruel. 

Diluted  Hydrocyanic  Acid. — This  is  commonly  known  by  the  name 
of  prussic  acid.  It  is  sedative  and  antispasmodic,  and  is  useful  in 
spasmodic  coughs,  asthma,  hooping  cough,  nervous  affections,  hic- 
cough, palpitation  of  the  heart,  irritable  stomach,  and  dyspepsia. 
Dose,  from  two  to  five  drops,  in  a  glass  of  water  or  tea  of  Peruvian 
bark. 

Diluted  Sulphuric  Acid.  —  This  acid,  known  by  the  name  of  diluted 
oil  of  vitriol,  is  tonic,  antiseptic,  refrigerant,  and  astringent.  It  is 
useful  in  dyspepsia,  diabetes,  menorrhagia,  hsemoptysis,  eruptions  of 
the  skin,  hectic,  and  diarrhoea.  It  is  often  given  with  some  bitter  in- 
fusions, as  cascarilla,  columbo,  peruvian  bark,  or  quassia.  The  aro- 
matic sulphuric  acid  is  often  used  in  place  of  it,  being  sometimes 
considered  more  grateful  to  the  taste.  Dose  of  each,  from  five  to 
fifteen  drops. 

Tannic  Acid.  —  This  is  an  astringent  preparation,  and  passes  under 
the  name  of  tannin.  It  is  prepared  from  galls.  It  is  used  in  diar- 
rhoea, dysentery,  passive  hemorrhages,  and  diabetes.  Dose  of  the 
powder,  from  one  to  five  grains. 

Tartaric  Acid.  —  This  is  refrigerant  and  .antiseptic,  and  is  used  in 
inflammatory  affections,  fevers,  and  scurvy.  It  is  much  used  in  pre- 
pai'ing  what  is  called  lemon  syrup,  and  forms  an  agreeable  and  health- 
ful drink. 

Alcohol.  —  Alcohol  is  the  result  of  the  fermentation  of  the  juices  of 
many  vegetables.  It  is  the  intoxicating  constituent  in  whiskey,  rjm, 
brandy,  gin,  wines,  porter,  ale,  beer,  and  cider.  Its  principal  use  in 
medicine  is  in  the  preparation  of  tinctures,  essences,  and  extracts. 
One  part  of  pure  alcohol,  to  one  part  of  water,  forms  the  diluted  alco- 
hol of  the  shops. 

Almonds. —  The  Amygdalus  Communis,  or  almond  tree,  grows  in  the 
south  of  Europe  and  Asia,  and  yields  the  sweet  and  bitter  almond. 


/392 


MEDICINES  AND  THEIR  PREPARATIONS. 


Tho  oil  of  the  sweet  almond  is  used  as  a  demulcent,  in  coughs,  etc 
A  dose  is  a  teaspoonful.  The  oil  of  the  bitter  almond  is  poisonous, 
and  is  occasionally  used  as  a  valuable  sedative.  Its  taste  is  like  that 
of  a  peach  kernel.  Dose,  from  a  quarter  of  a  drop  to  a  drop.  It 
owes  its  poisonous  properties  to  hydrocyanic  acid.  Cakes,  etc.,  are 
sometimes  llavorcd  with  an  essence  jncpared  from  it. 

Hues. —  This  is  the  hardened  juice  of  the  leaves.of  several  species 
of  the  aloe  tree,  in  North  and  South  Africa,  in  tlie  south  of  P^urope, 
and  in  the  island  of  Socotra.  Aloes  is  purgative,  acting  chiefly  upon 
the  rectum,  or  lower  bowel,  in  which  it  frequently  produces  irritation, 
and  is  a|)t  to  aggravate  and  induce  piles.  It  is  much  used  to  excite 
the  flow  of  the  menses,  and  should  never  be  given  to  women  during 
pregnancy.  It  ^produces  griping  of  the  bowels,  whifth  may  be  dimin- 
ished by  combining  it  with  soap,  or  carbonate  of  potash. 

Aliiiii  {Alumen). —  The  chemical  name  of  this  is  sulphate  of  alu- 
mina  and  potassa.  L»  ordinary  doses,  alum  is  astringent  and  anti- 
spasmodic. In  large  do.:-?><  it  is  purgative  and  emetic,  and  is  used 
both  externally  and  internally.  It  is  often  used  in  solution  as  a  gar- 
gle in  sore  throat,  and  falling  down  of  the  uvula,  and  as  an  injection 
in  leueorrhoea.  In  doses  of  thirty  or  forty  grains,  it  acts  as  a  purga- 
tive, and  used  in  this  way,  is  useful  in  painter's  colic.  When  exposed 
to  heat  in  a  vessel  till  it  ceases  to  boil,  it  becomes  dry,  and  is  then 
called  burnt  alum,  which,  when  pulverized,  is  applied  with  advantage 
to  canker  spots  in  the  mouth,  and  to  proud  flesh. 

American  Hellebore  {Veratrum  Viride).  —  This  plant  grows  in  many 
parts  of  the  United  States,  usually  in  swamps,  wet  meadows,  and  on 
the  banks  of  mountain  streamlets.  The  root  is  the  part  used.  It  is 
slightly  acrid,  alterative  in  a  marked  degree,  very  decidedly  and  ac- 
tively expectorant  and  diaphoretic,  and  it  is  an  excellent  nervine, 
thoigti  not  narcotic.  But  its  most  marked  and  valuable  quality  — 
that  in  which  it  has  no  rival — is  its  sedative  action  upon  the  circula- 
tion. Li  suitable  doses,  it  can  be  relied  upon  to  bring  the  pulse  down 
from  a  hundred  and  fifty  beats  in  a  minute  to  forty,  or  even  to  thirty. 
In  fevers,  therefore,  in  some  diseases  of  the  heart,  in  acute  rheuma- 
tism, and  in  many  other  conditions  which  involve  an  excited  state  of 
the  circulation,  it  is  an  article  of  exceedingly  great  value,  because  it  is 
always  reliable.  It  has  recently  come  into  use ;  and  I  doubt  whether 
so  valuable  a  contribution  has  been  made  to  our  list  of  medicines  in 
a  hundred  years. 

Preparations.  —  Veratrum  is  used  chiefly  in  the  form  of  tincture, 
six  ounces  to  the  pint  of  diluted  alcohol,  or  of  fluid  extract.  The 
dose  of  each  of  these  preparations,  for  a  grown  person,  is  three  or 
four  drops,  every  hour  or  two,  in  a  little  sweetened  water,  and  gradu- 
ally increased,  if  necessary,  till  the  pulse  comes  down  to  sixty  or 
seventy.  If  taken  in  so  large  a  dose  as  to  produce  vomiting,  or  too 
much  depression,  a  full  dose  of  morphine  or  laudanum,  in  a  little 
brandy  or  ginger,  is  a  complete  antidote. 

Veratrin,  the  active  principle  of  veratrum,  is  also  used,  in  doses  of 
one-half  to  one-third  of  a  grain. 


MRDICINKS  AND  THEIU  PREPAUATIONS. 


593 


Ameriean  Ifutcmuanha  {Euphorbia  Ipecac).  —  This  plant  i«  peren- 
nial, and  growM  in  8iindy  Hoiis  in  the  Middle  and  Boutliern  HtateH. 
When  cut  or  broken  it  gives  out  a  milky  juice.  The  root  is  the 
medicinal  part.  It  is  emetic,  cathart.c,  and  diaphoretic.  Dose,  as  a 
cathartic,  ten  or  twelve  grains  ;  as  a  iiaphoretic,  three  or  four  grains, 
every  three  or  four  hours. 

AiiierUniii  Ivy  {Ampelopsis  QiiinquefoHa).  -  -  T\m  vine  grows  in  all 
part.s  of  the  United  States.  It  is  known  by  the  names  of  faisf  ^f<^P^ 
and  tfnld  woodbine.  It  is  alterative,  tonic,  a.stringent,  and  expecto- 
rant.    Used  in  scrofula  and  syphilis. 

^Vatcr  of  Animoiiia  {Liquor  Ammonia).  —  This  preparation,  called 
hartshorn,  o>*  spirits  of  hartshorn,  is  formed  by  the  union  of  water 
will)  ainmonia  gas.  It  has  a  powerful  amtnoniacal  odor,  and  an 
alkaline,  caustic  taste.  Taken  internally  it  is  stinmlant,  sudorific,  and 
antacid,  and  applied  externally,  it  is  rubefacient.  It  stimulates  par- 
ticularly the  heart  and  arteries,  without  very  much  exciting  the  brain. 
It  is  an  excellent  remedy  in  heartburn,  and  for  sick  lus'idache,  depend- 
oiir  on  sourness  of  the  stomach.  A  dos(!  is  from  ten  to  thirty  drops, 
lari,'ely  diluted  with  water.  United  with  oils,  or  with  alcohol  in  about 
eiiual  proportions,  and  applied  externally,  it  reddens  the  skin,  and,  if 
tiie  cloth  wet  with  it  bo  covered  with  oiled  silk,  or  with  flannel  to  pre- 
vent evaponition,  it  will  sometimes  quickly  raise  a  blister.  In  cases 
of  fainting,  it  is  frequently  applied  to  the  nostrils,  to  excite  the  brain, 
and  rouse  the  system. 

Cai'boiitite  of  Aiiiiiiiouia.  —  This  is  a  white,  moderately  hard,  crys- 
talline siiit,  —  having  a  pungent,  ammoniacal  smell,  and  a  sharp,  pen- 
etratihj^  1  u/,e.  When  exposed  to  the  air,  it  loses  some  of  its  ammo- 
nia, becomes  a  bicarbonate,  and  falls  to  powder.  It  is  stimulant, 
diaphoretic,  antispasmodic,  powerfully  antacid,  and,  in  large  Hoses, 
emetic,  internally,  it  is  more  often  used  than  water  of  ammc  na, 
and  for  similar  purposes.  Coarsely  bruised,  and  scented  with  oil  of 
lavender,  it  constitutes  the  common  smelling  salts,  so  much  used  in 
fainting  and  hysterics.  For  internal  use,  the  dose  is  from  five  to 
twenty  grains,  taken  in  the  form  of  pills,  every  two,  three,  or  four 
hours. 

Muriate  of  Ammonia  {Sal  Ammoniac). —  This,  also  called  hydro- 
chlorate  of  ammonia,  is  a  white,  translucent,  tough,  fibrous  salt,  in 
large  cakes,  about  two  inches  thick,  convex  on  one  side,  and  concave 
on  the  other. 

It  has  a  saline,  pungent  taste,  but  no  smell,  dissolves  in  one  part 
of  boiling  water,  and  three  parts  of  cold.  Taken  internally,  it  is 
stimulant  and  alterative.  It  is  a  valuable  remedy  in  chronic  bron- 
chitis, pleurisy,  and  inllammation  of  the  serous  and  mucous  mem- 
branes generally.  But  it  must  only  be  used  after  the  first  violence  of 
these  inflammations  has  abated.  Pulverized,  and  placed  over  a  spirit 
lamp  in  a  tin  cup,  the  fumes  which  arise  when  it  sublimes,  may  be 
inhaled  five  or  ten  minutes  once  or  twice  a  day,  with  great  advantage 
in  chronic  bronchitis,  and  in  chronic  inflammations  generally  of  the 

75 


u 


594 


MEDICINES  AND  THKIU  rUKrAHATIONvS. 


air  passages.  A  solution  composed  of  one  ounce  of  the  salt  dissolved 
in  nine  fluid  ounces  of  water,  and  one  of  alcohol,  may  be  us(;d  as  a 
wash,  for  bruises,  indolent  tumors,  and  ulcers. 

Solution  of  Aeet«t«  of  imiiioiiia  {Liquor  Amnionur  Arrfatis).  —  Thi* 
is  known  by  the  common  name  of  spirit  of  mindererus.  The  taste 
h  saline,  and  is  'ike* that  of  a  miAture  of  nitre  and  sugar.  It  is  a 
valuable  dia|)horetic,  and  is  much  employ<'d,  alone  o.  mixed  with 
Bweet  spirit  of  nitre,  two  parts  to  one,  m  fevers  and  inflaimnatioiis 
It  is  a  valuable  external  application  in  nuuups,  applied  hot  upon  a 
piece  of  flannel.  One  ounce  mixed  with  seven  ounces  of  rose-water, 
and  two  drams  of  laudanum,  forms  a  valnal)le  wash  for  the  eyes  iit 
chronic  ophthalmia.  The  dose  is  from  two  dnuns  t«»  half  a  tluid 
ounce,  juixi^d  with  sweetened  water,  every  two  or  three  hours. 

Aronititic  Spirit  of  Aiiiiiioiiri  (iS/nn'fus  Anunoiuw  Aroiiiafirus).-^ 
Taken  internally,  this  answers  the  same  purpose  uf  other  prepara- 
tions of  ammonia,  and  is  much  used  on  account  of  its  agreeable 
taste  and  smell.  It  is  valuable  as  an  antacid  in  sick  headache. 
Dose,  from  thirty  drops  lo  a  dram,  sutliciently  diluted  with  water. 

Anise  (Pimpinrl/a  Anisu/n).  —  This  is  a  perennial  plant,  and  grows 
in  Egypt.  Its  fruit  is  caUed  anise-seed.  It  is  aromatic^  and  cijrmina- 
tive.  it  is  uuH'h  used  to  allay  naus<^a,  flatulency,  and  colic,  particu- 
larly in  children.  It  is  fre(piently  added  to  other  medicines  to  make 
them  more  agreeable,  and  to  lessen  the  griping  elfects  of  physic. 

The  oil  extracted  from  tlie  seeds,  dissolved  in  alcohol,  an  ounce  of 
the  former  to  a  pint  of  the  latter,  forms  what  is  called  the  essence  of 
anise.  Dose  of  the  essence,  from  thirty  drops  to  a  dram  in  sweetened 
water.     Anise  forms  a  very  valuable  addition  to  cough  preparations. 

Arnica  {Arnica  Montana).  —  This  is  a  perennial  ])lant,  growing  ii» 
mois',  shady  places  in  Siberia,  etc.  It  is  often  call(>d  lco})ard's  bane. 
It  .'s  much  used  externaliy  as  a  stimulating  application  to  bruises- 
local  inflannnation,  etc. 

Preparations.  —  It  is  chiefly  used  in  the  form  of  tincture,  or  lluiii 
extract.  Dose,  ten  to  sixty  drops.  Half  an  ounc«!  of  tincture,  livt 
and  a  half  ounces  of  boiling  vinegar,  and  two  drams  of  carbonate  et 
arr.monia,  used  warm,  make  in  some  cases  a  valuable  fomentation 
It  is  one  of  the  leading  homoeopathic  remedies. 

Arr«W-rw>t.  —  This  is  prepared  from  the  Maranta  AruruJinacen,  a 
plant  of  the  W«;3t  Indies,  It  is  chiefly  used  in  forming  dietetic  pn*- 
parations,  and  belongs  to  the  first  or  su:'charin«'  group  of  (bod-art iclcs 
(see  page  (>6). 

Assafoptida.  —  This  is  the  hardened  juice  from  trie  root  of  a  Persian 
plant.  It  is  stimulant,  antispaarnodic,  and  expectorant,  and  is  rmu'h 
used  in  nervous  complaints.  A  dose  of  the,  powder,  is  from  live  to 
ten  grains,  and  of  the  tincture,  made  by  macerating  two  ounces  in  a 
pint  of  diluted  alcohol,  from  thirty  to  sixty  drops. 

Balm  {Melissa  Officinalis). —  Thii-;  is  a  perenaml  plant,  growing  in 
Euro|X'  and  this  country.     It  is  mo<ierately  stimulant  and  diaphoretic. 


MKI)ICIN'P:S  and  TIIKIK  I'UKI'AKATIONS. 


595 


The  warm  iiifusion  causes  perspiration,  and  is  used  to  relieve  painful 

incriptruatii)n. 

Riiliii  of  Ciillcad  {Popuhis  Candicaus).  —  This  is  a  tree  growiiig  in 
tht>  iKtrtht'rn  |)arts  of  our  country.  A  tincture  made  from  the  buds,  in 
tlor'fs  of  from  one  to  four  lluid  dianis,  is  useful  in  affections  of  the 
kidneys,  in  scurvy,  and  rheumatism.  Hteeped  in  lard  tijey  form  a  use- 
ful ointment  for  souic  purposes. 

Ridmoiiy  {ClieJone  Glabra). —  This  is  a  perennial  |)lant,  common  tc 
the  (  iiiicd  States.  It  is  tonii;,  cathartic,  and  vermifuge.  It  is  used 
in  indigestion,  debility,  and  d(  rangetucnts  of  th(^  liver.  A.  dose  of  the 
powfiert'd  leaves,  is  one  dram;  of  the  tincture,  two  lluid  dnim, ;  o\ 
the  (Iccoctiou,  t)tie  or  two  (luid  ounctes  ;  of  the  active  prisicjple  calleii 
chelonin,  one  to  twt)  grains.  A  decoction  of  balmony  combined  with 
tinetiire  of  assaf<elida,  forms  a  valuable  injcvtion  for  worms.  An 
ointment  made  from  the  fresh  leaves,  is  valuable  for  pih^s,  inllamed 
breasts,  tumors,  and  j)ainful  ukn^rs. 

nalsiiiii  <'o|»iiiYii.  —  T'r.is  is  obtained  from  a  South  American  tree 
called  the  Cofmifcm  Oj/icinalis.  it  is  a  clear  yellowish  Mnid,  about 
the  consistence  of  honey.  It  is  a  stimulating  diuretic,  and  is  much 
used  in  chronic  gonorrho-a,  gleet,  irritable  conditions  of  the  bhidder, 
and  chronic  bronchitis.  In  some  persons  it  causes  an  eruption  on  the 
skin,  with  itching,  etc. 

In  large  doses,  it  acts  as  a  cathartic. 

Balsiuii  Toln.  —  This  is  the  juice  of  the  tree  Myroxpernum  ToUd- 
ferum,  growing  in  South  America.  It  is  soft,  tenacious,  and  of  a 
pale  brown  color;  and,  lik.^*  bah^am  cropaiva,  is  iioluble  in  .dcohol, 
ether,  and  volatile  oils.  It  has  been  used  in  asthma,  cough,  bronchitis, 
etc.     Dose  fr,'>m  ten  to  thirty  grains,  in  mucilage  or  syrup. 

Ifcirberry  {Berberis  Vnf^nris).  —  This  shrub  grows  along  the  Atlan- 
tic coas'^,  from  Canada  to  Virginia.  The  parts  used  are  the  bark  and 
b'Tries.  It  is  tonic  and  laxative,  and,  in  doses  of  a  teaspoonful,  pcfw- 
dered,  is  useful  in  jaundice,  chronic  diarrhcea,  and  chronic  dysentery. 
A  decoetijui  of  the  berries  forms  an  agreeable  acid  drink  in  fevers, 
cholera  infai^tuin,  etc.,  and  as  a  gargle,  it  is  useful  for  ulcers  of  the 
mouth,  etc.,  as  <:■  wash,  fo?  chronic  inflammation  of  tin;  eytjs,  and  as  ao 
injection  for  leucvirrha;a. 

Betir-lwrry  {(Jva  ursi).  —  This  plant,  also  called  upland  cmnberry 
hay  a  wide  range,  being  found  in  the  northern  parts  of  Asia,  Europe, 
and  America,  ft  flowers  from  June  to  September,  and  ripens  \i» 
herries  in  the  winter.  The  leaves  are  the  only  medicinal  parts.  It  is 
astringent  and  tonic,  and  acts  particularly  upon  the  urinary  organs, 
for  c(»tnplain<s  of  which  it  is  particularly  used.  It  is  specially  valued 
us  an  antiiithic  in  gravel,  and  as  a  remedy  for  chronic  inflammation 
of  the  kidn<jys,  an<l  uheration  of  the  l)ladder,etc 

Preparations.  —  Fluid  extract,  dose,  one  third  of  a  dram  to  a  dram; 
solid  (extract,  dose,  five  to  fifteen  grains ;  tincture,  dose,  one  to  two 
ounces. 


fmm'  ' 


596 


MEDICINES  AN"  THEII^  ^ItEV-OATI?:* 


Brtyl»frrj'  (Mt/rica  Cerifera),  —  This  i*  fouml  in  damp  places,  in 
many  parts  ol"  tlic  United  States,  and  is  very  abundant  in  New  Jersey. 
The  barlv  of  tlie  root  is  the  part  used.  It  is  astringent  and  stimulant. 
Pulverized,  and  combined  with  powdered  blood-root,  it  forms  an  ex- 
cellent application  to  indolent  ulcers.  In  the  form  of  poidtice,  com- 
bined with  powdered  slip|K.'ry  elm,  it  is  a  useful  application  to  scrofu- 
lous tumors  or  ulcers.  The  decoction  is  a  good  wash  for  sore  mouth, 
and  sporgy,  lileeding  gums.  It  is  chio<ly  used  in  the  form  of  tincture, 
dose,  hal\  an  ounce ;  fluid  extract,  dose,  one  to  two  drama :  and  the 
active  prmciple  myricin,  dose,  two  to  ten  grains.^' 

Fia.  18». 


Fio.  188. 


BBAB-BBIllir. 


HAYBKRUr. 


Beef's  Galls  {Fel  Bovinum). —  This  being  dried  by  evaporation,  is 
sometimes  used  as  a  tonic,  and  laxative,  in  torpor  of  the  liver,  jaun- 
dice, indigestion,  and  costiveness,  in  doses  of  from  one  to  ten  grains. 
Three  drams  of  ox  gall,  one  dram  of  extract  of  conium,  two  drams 
of  sode.  soap,  and  one  ounce  of  sweet  oil,  make  a  valuable  prepara- 
tion, which,  when  applied  externally,  has  a  surprisingly  rapid  eflect  in 
reducing  enlargement  and  hardening  of  the  breasts,  glandular  tumors, 
particularly  enlargement  of  the  tonsils,  and  is  useful  in  hypert'ophies 
generally.  For  application  to  the  tonsils,  the  gall  may  be  rubbed  bp 
with  water,  to  the  consistence  of  an  ointment,  and  may  be  applied 
with  a  camel's-hair  brush. 

Benzoin.  —  This  is  the  hardened  juice  of  a  tree  of  Sumatra  and 
Borneo.  It  is  very  brittle,  of  a  reddish  brown  color,  and  is  soluhh?  ia 
alcohol  and  (>ther.  !t  is  chiefly  used  for  inhalation  in  chronic  laryn- 
gitis and  broiu'hif  is.  When  used  for  this  purptise,  it  may  bv.  added  to 
boiling  water,  and  the  vapor  be  inhaled;  or  it  may  be  burned  upon 
coals,  or  a  hot  shovel,  the  fumes  being  inhaled. 

Benzoic  Acill.  —  This  is  prepared  by  heating  benzoin,  and  cauj^ng 
it  to  sublime,  it  consists  of  silky,  feathery  crystals,  wliiuli  arc  white 
and  soft.  It  has  been  found  useful  in  the  |>liospliatic  variety  of  graviL 
A  convenient  way  of  giving  it  is  to  unite  one  part  of  it  with  four  parts 
of  phosphate  of  soda,  the  dose  of  which  is  from  ten  to  thirty  grains. 


',  w  ■.M''y! 


MRDICrNKS  AND  THEIR  PREPARATIONS. 


597 


Kl(3.  ISHl. 


Betliroot  {Trillium  Penduhm).  —  A  perennial  plant,  growing  in  rich 
Boils,  in  the  Middle  and  Western  States.  The  root  is  used,  and  is 
astringent,  tonie,  a«id  antiseptie.  It  is  useful  in  bleeding  from  the 
lungs  and  kidneys;  also  in  exeessive  menstruation,  cougli,  asthma, 
and  (lillicult  breathing.  Boiled  in  milk,  it  is  used,  in  the  western 
country,  in  diarrlia-a  and  dysentery. 

Prepandiom.  —  Fluid  extraet,  dose,  one  to  three  drams ;  Irilliin, 
do.'^e  four  to  eight  grains;  infusion,  dose,  two  to  four  ounees ;  decoe- 
tioii,  used  as  a  loeal  application  to  ulcers  and  sore  mouth,  and  as  an 
injection  in  lencorrlHea  and  gleet.  A  poultice  made?  from  tlie  root,  is 
useful  for  carbiuiclcs,  indolent  tumors,  buboes,  foul  uh-ers,  and  for 
iitinurs  oi  insects. 

Hitter •'•<M)t  (Apocynum  Androswmifolium).  —  An  indigeiu>us  plant, 
growing  in  rich  soi's  in  the  Uniicd  States  and 
Canada.  The  root  is  the  part  used,  and  is  laxa- 
tive, tonic,  diaphoretic,  and  alterative.  It  is  em- 
ployed in  chronic  allections  of  tin;  liver,  syphilis, 
scrofula,  intermittents,  and  tlu;  low  stage  of  tj- 
uhoid  fevers.  Forty  to  sixty  strains  will  c  iu»e 
vomiting  without  luuch  nausea. 

Preparations. —  Fluid  extract,  dose,  as  a  tonie, 
ten  to  twenty  drops;  as  a  diaphoetic,  lifteen  to 
twenty-five  drops;  as  an  emetic,  half  a  dram 
to  a  dram.  Solid  extract,  dct^v^  two  to  eight 
grains;  a|)ocynin,  the  active  print-iple  of  the  root, 
dose,  half  a  grain  to  two  grains;  tincture,  dose, 
BiTTKK-uooT.  ^^^.^^  ^^  tluce  dr'Mns;  infusit)n,  ilose,  a  wincglass- 

ful,  three  times  a  day. 

Risiiiiith,  —  The  principal  preparation  of  this  mcta!  used  in  m«'di- 
cinf,  i.s  the  frisiiifni/c  of  liisiiiiff/i,  also  called  ni/rufc,  siihiiifrafr,  and 
irliile  o.'iili'  oj  hisintif/i.  It  is  a  white  powiiiT,  without  smell  or  tsiste. 
U  is  used  for  various  irritable  iuid  painful  allections  of  the  stomach, 
when  there  is  no  acute  inlhunmation.  It  i.^  p  irticnhirly  useful  in 
ciiroiiic  diarrlKca,  u'ore  especially  the  diarrlwea  of  the  latter  sta^'cs  of 
ciiiisiiMiptioii,  —  orcr  i'^/iirh  it  lias  tiiorr  nuilrol  tliuii  uiiji  olhrr  kiuunn 
■fvmalij.  To  sliow  its  b(st  ellects  in  this  foruj  v)f  diarrlio-a,  it  should 
be  i;iven  in  large  doses,  not  less  than  twenty  to  thir'y  grains,  iMinieiU 
atcly  after  each  meal.  The  small  doses  usually  givi-n  are  (oiiipara- 
tiv<ly  useless,  (iiven  in  these  full  doses,  it  is  also  almost  u  specific 
ill  heartburn  and  water-brash.  The  unplt'asant  symptoms  spoki'i:  of 
ill  books,  U8  arising  from  large  doses,  an;  fabulous. 

Bltterswoft  {Solduinn  Dulcamara).  —  This  is  <*ommon  in  Eujopo 
and  North  Auk  .ica.  It  is  a  woody  vin<',  the  roots  and  stalks  of  which 
are  used  in  medicine.  It  is  slightly  narcoti(r,  and  has  alterative  and 
diaphoretic  pro|)ertie8.  It  is  used  in  scaly  an<l  syphilitic  allections  of 
the  skin,  'it  is  said  to  have  antephrodisiae  properties,  and  is  servicea- 
ble in  mania,  connected  with  strong  venereal  propensities. 

l^eparations.  —  Fluid  extraet,  dose,  half  a  tiram  to  a  <lram  :  s»olid 


: 


y 


extract,  dose,  three  to  eight  grains ;  infusion,  dose,  one  to  three  ounces, 
three  or  four  times  a  day. 

Bhick  Ahler  (Prinos  Verlicillalus). —  This  shrub  is  common  in  the 
United  States ;  its  bark  and  berries  are  used.  It  has  hcM'u  found  use- 
ful in  jaundice,  diarrhoea,  intermittent  fever,  and  oth<'r  diseases  con- 
nected with  debility.  Applied  locally  in  the  form  of  a  wash  or 
poultice,  and  given  internally,  it  is  popular  in  chronic  eruptions  of  the 
skin,  and  in  llabby,  ill-conditioned  ulcers,  and  mortification. 

Preparations.  —  Fluid  extract,  dose,  two  drams;  tincture,  dose,  two 
to  four  drams. 

Two  drams  of  i\w  fluid  extract  of  black  alder,  one  dram  of  the 
fluid  extract  of  goldiM  seal,  and  one  pint  of  water,  mixed,  nnd  taken 
in  doses  of  four  iluid  ounces,  three  or  four  times  a  day,  are  valuable 
in  dyspepsia. 

llluckhorry  {Iii(bus  Vitlosus). —  There  are  many  species  of  this 
growing  in  the  United  States.  The  bark  of  the  root  is  the  part  used. 
It  is  tonic,  and  strongly  astringent,  and  is  a  valual)le  remedy  in  diar- 
ri.;;'a,  dysentery,  cholera-infantum,  relaxed  condition  t»f  the  bowels  of 
children,  and  the  passive  discharge  of  blood  from  the  stomach,  bowels, 
ana  womb. 

Preparations. —  Fluid  extract,  dose,  half  a  dram  to  a  dram;  soli,- 
extracrt,  four  to  six  grains;  tinctun-,  dose,  two  to  four  drams;  inlii- 
.sion,  dose,  one  ounci*.  This  last  preparation  is  also  useful  as  an  injec- 
tion in  gleet,  leiicorrlui^a,  Ui.d  prolapsus  of  the  rectum  and  wouil). 
The  syrup  of  the  blackberry  root  is  also  a  valuable  prepariition  ;  so 
also  is  blackberry  l)ranily,  so  called,  which  is  the  juice  of  the  fruit 
mixed  with  brandy.     This  is  excellent  in  sunnner  complaints. 


Fia.  101. 


Fio.  192. 


:^^^'^ 


BLACK   COIKWII. 


BLUOIIUOOT. 


Bhrk  <'oIiomIi  {Cimirifufrn  Racemosa).  —  This  grows  in  rich  .soils 
throughout  the  United  Statics.  The  root  is  the  part  used.  It  is 
Blightly  narcotic,  sedative,  antispasmodic,  antiperiodic,  and  exerts  a 
marked  influence  over  the  nervous  system ;  being  useful  in  St.  Vitus'* 


MEDICINES  AND  TIIEIU  I'llEPARATIONS. 


509 


dance,  epilepsy,  nervous  excitability,  asthma,  delirium  tremens,  and 
many  spasmodic  affections.     It  has  an  especial  affinity  for  the  uterus. 

It  reduces  the  arterial  action  very  materially,  and  hence  is  useful 
in  palpitation  of  the  heart.  It  has  been  used  successfully  in  acute 
rheumatism,  but  more  particularly  in  chronic  rheumatism. 

Pre,)arations.  —  Fluid  extract,  dose,  half  a  dram  to  two  drams ; 
solid  extract,  dose,  four  to  eight  grains ;  tincture,  four  ounces  to  the 
pint  of  alcohol;  doso,  one  to  three  drams;  cimicifugiii,  the  active 
principle,  dose,  one  to  six  grains. 

Black  Willow  {Safi.r  Xi^-ni).  —  This  tree  is  found  ii  the  Northern 
States,  along  the  banks  of  rivei-s,  rspecially  in  New  York  and  Penn- 
sylvania, aiul  is  known  by  the  common  name  of  pussy  willow.  It  is 
a  bitter  tonic,  and  is  sonictinies  used  in  fever  and  ague.  A  decoction 
made  from  IIk;  buds,  is  said  to  be  a  powerful  antaphrodisiac,  and  is 
accordingly  useful  in  the  treatment  spermatorrhea. 

Itloodl'OOt  {Sdiiii-iiinana  Canadensis). —  A  perennial  plant,  growing 
in  liglit,  ri«'h  soils,  in  most  parts  of  the  United  States.  The  root  is 
the  part  used.  It  is  emetie,  narcotic,  expectorant,  alterative,  escha- 
rotic,  and  errhine.  It  is  used  in  typhoid  pneumonia,  bronchitis,  rheu- 
matism, dyspepsia,  etc.  Three  to  live  grains  stinmlates  the  digestive 
organs,  and  accelerates  the  pulse. 

Preparalions.  —  Fluid  extract,  dose,  five  to  fifteen  drops;  .solid  ex- 
tract, half  a  grain  to  a  grain  and  a  half;  tincture,  twenty  drops  to  a 
dram  ;  sanguinaria,  the  alkaloid  principle,  from  one  twentieth  to  one 
tenth  of  a  grain  ;  sanguinarin,  the  resinous  principle,  one  quarter  to 
one  grain. 

Four-grain  i)ills,  made  of  sanguinarin,  twelve  grains,  caulo|)hyllin, 
twelve  grains,  soliil  extract  of  cimicil'uga,  twelve  grains,  arc  said  to  be 
etficacious  in  amenorrh(i;a,  dysmenorrha^a,  and  other  female  disorders. 


Fio.  193. 


V\n.  104. 


BLUR  COHOSH. 


BLUa  VLAU. 


Blue  Cohosh   ( Cauhphyllum    Tlialictroides).  —  A  perennial   plant, 
growing  in  low,  moist  grounds  in  most  parts  of  the  United  States. 


Plll  V'] 


600 


MEDICINES  AND  THEIR  PREPARATIONS. 


The  root  is  the  part  used.  It  is  antispasmodic,  diuretic,  diaphoretic, 
alterative,  eramenagogue,  anthehnintic,  parturient,  and  tonic.  It  is 
used  in  rheumatism,  dropsy,  epilepsy,  hysterics,  cramps,  amenorrhoea, 
dysmenorrhtEa,  chorea,  leucorrhcea,  hiccough,  to  hasten  delivery,  and 
to  relieve  after-pains. 

Preparations.  —  Fluid  extract,  dose,  fifteen  to  forty  drops ;  solid 
extract,  dose,  one  to  five  grains ;  tincture,  dose,  half  a  dram  to  a 
dram ;  infusion,  dose,  two  to  four  ounces ;  caulophyllin,  the  active 
principle  of  the  root,  dose,  one  quarter  of  a  grain  to  two  grains. 

In  cast's  of  protracted  labor,  occasioned  by  fatigue  or  debility,  the 
infusion  is  said  to  be  fully  equal  to  ergot  ii.  hastening  delivery.  A 
wash  made  by  combining  one  ounce  of  fluid  cctract  with  one  ounce 
of  the  fluid  extract  of  golden  seal,  and  eight  ounces  of  water,  is  very 
excellent  for  apthous  sore  mouth. 

Blue  Flair  {Iris  Versicofor). —  A  perennial  plant,  growing  in  damp 
places,  in  most  parts  of  the  Ignited  States.  The  root  is  the  part  used 
for  medicinal  purposes,  it  i.>  cathartic,  alterative,  sialagogue,  and 
diuretic.  It  ai  ts  particularly  on  the  glandular  system  ;  in  large  doses, 
it  evacuates  and  exhausts  the  system,  acti,ig  on  the  liver,  and  fuUiil- 
ing  the  ])urposes  of  mer(;ury. 

Prepara/iuns. —  Fluid  extract,  dose,  twenty  to  sixty  drops;  solid 
extract,  one  to  four  grains  ;  tincture,  one  to  two  drams.  Iridin,  the 
active  and  resinous  principle,  dose,  half  a  grain  to  four  grains.  Fjquul 
parts  of  blue  Hag,  mandrake,  and  priekly-ash  bark,  mixed,  and  given 
in  five  to  ten-grain  doses,  every  two  or  three  hours,  will  act  as  a  pow- 
erful alterative,  and  cause  free  salivation,  without  making  the  breath 
oflensive  or  injuring  the  gums.  'J'hree  grains  of  iridin,  live  grains  d'' 
leptandrin,  and  twenty  grains  of  bitartrate  of  potassa,  lV)rm  an  excel- 
lent cathartic;  in  dropsy,  producing  free  watery  stot)ls. 


Blue  V\\\  {ILfdrarii-f/ri  PUiila). —  This  mercurial  preparation,  ij;en- 
erally  known  by  llie  eoiumon  name  of  blue  mass,  or  0/iie  pi/f,  is  made 
by  rubbing  mercury,  confetrtionof  roses,  and  pulverized  li([uoric(vroot 
together  until  all  the  mercurial  globides  (llsa|)pear.  Tlx;  mass  is  di- 
vided into  pills  when  wanteti.  It  is  the  mildest  of  all  the  mercurial 
preparations,  and  the  least  liable  to  produce  salivation  or  irritation 
o{  the  system.  But  even  this  should  be  usckI  sparingly,  and  with 
caution. 

The  blue  mass  is  alterative  and  cathartic,  and  is  considerably  given 
to  stimulate  the  action  of  the  liver,  and  to  produei!  an  alterative  ciVect 
upon  the  digestive  organs.  The  leptandra  and  the  podophyllum  have 
become  its  rivals,  and  will,  I  sincerely  hope,  finally  take  its  place. 

Bonesct  [Eupatorium  Pc.rfoUatum).  —  An  indigenous  plant  growing 
in  most  parts  of  the  United  States.  The  to|)s  and  leaves  are  medic- 
inal. It  is  tonic,  diaphoretic,  expectorant,  and,  in  large  doses,  or 
when  taken  as  a  warm  infusion,  emetic,  and  aperient. 

Preparations.  —  Fluid  extract,  dose,  one  to  two  drams;  solid  extract, 
dose,  five  to  twenty  grains ;  tincture,  dose,  one  to  two  ounces ;  infu- 
Kion,  dose,  one  to  three  ounces.     Eupatorin,  dose,  one  to  three  grains. 


'  y""^ff 


MEDICINES  AND  THEIR  PREPARATIONS. 


601 


Two  scruples  of  eupatorin,  one  scruple  of  xanthoxylin,  and  one  grain 
of  strychnia,  mixed,  and  made  into  twenty  powders,  is  excellent  for 
torpor  of  the  liver,  or  kidneys,  and  for  rheumatism ;  one  powder  being 
taken  three  or  four  times  a  day. 


Fio.  195. 


Fio.  196. 


UUN'EMKT. 


liUCIItT. 


Bncliu  {Baro.wia  Crcnata).  —  It  grows  at  the  Cape  of  Good  Hope. 
Tho  leaves  are  the  medicinal  portion;  they  are  stimulant,  diuretic, 
antispasmodic,  and  tonic.  Buchu  is  chieHy  given  in  complaints  of 
the  urinary  organs,  attended  with  increased  urie-aeid  gravel,  chronic 
inllanunation  or  morbid  irritation  of  the  bladder,  urethra,  and  prostate, 
and  retention,  or  incontinence  of  urine. 

Pre/Kinttions. —  Fluid  extract,  dose,  half  a  dram  to  two  drams; 
tincture,  dose,  two  to  six  drams  ;  infusion,  one  to  six  ounces.  A  com- 
bination of  fluid  extract  of  buciiu,  half  an  ounce ;  acetate  of  potash, 
two  drams ;  and  water,  cigiit  ounces,  taken  in  doses  of  four  ounces, 
three  or  four  times  a  day,  is  a  valuable  diuretic. 

This  combination,  however,  may  be  improved  by  the  addition  of  a 
little  sweet  spirits  of  nitre. 

Itiickliorn  llrnke  (Osmiinda  Reg-fifis).  —  This  is  a  fern  growing  in 
moist  grounds  in  most  parts  of  the  United  States.  The  root,  which 
is  the  medicinal  part,  siiould  be  gatlu^red  in  the  latter  part  of  May,  and 
in  August,  and  very  carefully  dried,  to  prevent  moulding.  It  is  mucil- 
aginous and  tonic,  and  is  used  in  coughs,  diarrhcca,  and  dysentery,  and 
as  a  tonic  while  getting  up  from  exhausting  dis(!ase.  One  root  infused 
ill  a  pint  of  hot  water  for  half  an  hour  will  convert  it  into  a  thick  jelly 
This  mucilage  may  be  sweetened  with  sugar,  and  freely  taken. 

Buektliuni  {RJiamnus  Catfuirticus).  —  This  plant  grows  in  Europe, 
where  it  is  much  esteemed  by  practitioners.  The  berries  and  juice 
are  actively  medicinal.  It  is  a  powerful  cathartic,  producing  large 
watery  disciz^rges.  It  is  seldom  used  alone  on  account  of  the  severity 
of  its  action. 

Preparations.  —  Fluid  extract,  dose,  one  dram  j  >/rup  of  buckthorni 
made  by  uniting  four  ounces  of  fluid  extras  t  with  twelve  ounces  of 
simple  syrup,  dose,  two  drams. 


.I'lKrl 


.    ■  I.J 


i«   *::;.!■  «iii 


602 


MEDICINKS  AND  THEIR  PREPARATIONS. 


Bui^leweed  {Lycojnts  Virginicus).  —  This  grows  in  shady  an 
places  throughout  a  greater  part  of  the  United  States.      The 


and  wet 
whole 
Iierb  is  used.  It  is  a  mild  narcotic,  sedative,  sub-astringent,  and  styp^ 
tic.  It  is  a  valuable  remedy  in  bleeding  from  the  lungs,  incipient 
consumption,  and  pneumonia.  It  quiets  irritation,  and  allays  cough, 
and  nervous  excitement. 

Preparations.  —  Fluid  extract,  dose,  one  to  two  drams ;  infusion, 
dose,  two  to  four  ounces. 

Burdock  {Lappa  Minor). —  A  native  of  Europe,  and  growing  in  tht 
United  States.  The  root  is  used,  which  is  useful  in  scurvy,  syphilia, 
scrofula,  gout,  leprosy,  and  disease  of  the  kidneys.  It  needs  to  l« 
used  for  a  long  time.  It  is  said  to  be  useful  for  persons  aniicted  with 
boils,  stye,  etc.  An  ointment  prepared  from  it  is  serviceable  in  some 
diseases  of  the  skin,  and  obstinate  ulcers. 

Preparuliuns.  —  Fluid  extract,  dose,  one  dram;  solid  extract,  dose, 
five  to  twenty  grains;  tincture,  dose,  half  an  ounce  to  an  ounce. 

Burgundy  IMtcll.  —  This  is  the  concrete  juices  of  the  Norway  pine, 
abies  ezcel.sa,  growing  in  Europe  and  Northt-rn  Asia,  and  of  the  silver 
fir  tree  of  Europe,  abies  picca.  It  gently  excites  the  skin,  and  is  used 
chiefly  in  the  form  of  plasters,  either  alone  or  mixed  with  other  gums 
and  resins. 

Bntternut  {Juglans  Cinerca).  —  This  is  a  forest  tree,  growing  in 
various  parts  of  the  continent,  known  also  by  the  names  of  oilnut, 
and  white  walnut.  The  inner  bark  of  the  root  is  used,  and  is  a  mild 
cathartic, — being  useful  in  cases  of  constipation.  It  is  much  employed 
by  families,  as  a  domestic  remedy,  in  intermittent  and  remittent  fevers. 
It  evacuates  the  bowels  without  debilitating  them. 

Preparations.  —  Fluid  extract,  dose,. one  to  two  drams;  solid  ex- 
tract, dose,  live  to  twenty  grains;  jnglandin,  the  active  principle,  dose, 
one  to  five  grains.  A  very  good  pill  is  made  by  mixing  one  and  a 
quarter  drams  of  the  solid  extract  of  butternut,  three  c  .larters  of  a 
dram  of  the  solid  extract  of  jalap,  and  ten  grains  of  so  p,  and  divid- 
ing the  whole  into  sixteen  i)ills.  Froin  two  to  live  may  be  taken  for 
a  dose. 

Calcined  Deer's  Horn  {Cornu  Cervinrc  Ustum). —  The  horns  of  the 
deer  are  said  to  be  in  velvet  between  August  and  December,  and  dur- 
ing this  period,  those  which  fall  are  collected,  coarsely  rasped,  and 
placed  in  an  iron  vessel,  which  is  tightly  covered,  and  placed  in  an 
oven,  or  elscnvhere,  and  subjected  to  a  heat  of  200°  F.,  which  is  con- 
tinued until  the  rasped  horn  becomes  of  the  color  of  roasted  collea 
When  cooled,  it  is  reduced  to  powder  by  trituration,  and  preserved  in 
olosely  stopped  vials.  It  is  a  powerful  styptic,  taken  in  teaspoonful 
doses,  every  half  hour ;  or,  a  teaspoonful  added  to  a  gill  of  hot  water, 
anH  a  tablespoonful  of  this  taken  every  five  or  ten  minutes.  It  has 
much  efficacy  in  flocdings  from  the  womb,  and  in  excessive  menstm- 
ation. 

Ciilonidl  {Hydrargyri  QUoridum  Mile).  —  This  is  prepared  from 
mercury,  sulphuric  acid,  and  common  salt     It  is  alterative,  antisyphi' 


MEDICINES  AND  THEIU  PUEl'AUATIONS. 


(yly3 


Via   lit: 


litic,  and  anthelmintic,  and,  in  large  doses,  purafative.  It  is  much 
used  in  venereal  diseases,  and  chronic  att'cctions  of  tlie  liver,  combined 
with  opium ;  in  dropsies,  combined  with  scpiill,  foxglove,  and  elate- 
riutn ;  and  in  rheumatism  and  leprosy,  combined  with  antiiuonials, 
guaiacum,  and  other  sudorifics.  In  tlie  beginnini^  of  ft.'vers  and  other 
c-(»iii|)laints,  it  is  often  combined  with  purgatives,  as  gamboge,  scam- 
nioiiy,  jalap,  and  rhubarb.  (liven  in  small  dos(?s,  not  large  enough  to 
purge,  it  gradually  excites  salivation.     Dose,  from  one  to  ten  grains. 

The  tendency  of  this  article  to  produce  salivation,  to  iiijinn^  the 
giiiiis,  loosen  the  teeth,  etc.,  has  given  rise  to  much  prejiulic*;  ugainst 
it  ill  the  public  mind;  and,  indeed,  it  must  be  confessed  that  it  has 
been  used  by  many,  from  time  immemorial,  with  great  indiscretion. 
In  the  hands  of  sensible  and  prudent  men,  it  is  very  serviceable  in 
some  cases;  but  the  podophyllum  and  leptandra  have  so  tine  an  action 
upoii  tlie  liver,  ihat  they  arc  fast  taking  tlii'  plaee  of  calomel  and  other 
mercurials,  and  possibly  may  in  time  wholly  supersede  them.  I  have 
prescribed  calomel  but  two  or  three  times  in  this  book,  and  am  willing 
to  see  it  banished  from  the  materia  medica,  as 
soon  as  the  careful  investigations  of  science 
shall  lind  cause  to  decree  its  expulsion. 

Ciiiiiplior.  —  This  is  obtained  from  an  ever- 
gree','.  tree,  growing  in  the  East  Indies,  —  the 
laurus  caiiip/tora.  It  is  a  white,  shiny,  crystal- 
line substance,  extrac^ted  from  the  wood  and 
roots  of  the  above  named  tree,  by  boiling  them, 
and  is  subsequently  purified  by  sublimation. 
It  has  a  penetrating,  peculiar  diftusible  odor, 
and  a  pungent,  cooling  taste.  It  is  moderately 
stimulant,  diaphoretic,  and  antaphrodisiac.  Dose, 
from  one  to  ivn  grains. 

Ciiiindii  Biilsiiiii.  —  This  is  the  fluid  obtained 
from  th'.;  fir  balsam,  ahics  balsamea,  of  Canada, 
Maine,  etc.  It  is  a  stimulating  diuretic,  and,  in  large  doses,  cathartic. 
A  dose  is  from  ten  to  twenty  drops,  two  or  three  times  a  day,  in  pills, 
or  in  emulsion.  It  forms  a  part  of  several  ointments  and  plasters.  It 
is  used  to  mount  objects  in  microscopic  investigations. 

€iiUtula  VhwhAW^  {]iJrii^eron  Caniulrnse). —  An  annual  plant,  grow- 
ing in  the  Northern  and  Middle  States.  It  is  diuretic,  tonic,  and 
astringent,  and  has  been  found  useful  in  dro|)sieal  complaints,  and 
tliarrhoja.  The  dose  o(  the  |)owder  is  from  thirty  grains  to  a  dram; 
of  the  infusion,  from  two  to  four  fluid  ounces  ;  of  tin;  solid  extract, 
from  five  to  ten  grains ;  to  be  repeated,  in  each  case,  every  two  or 
three  hours. 

Canella  {Canella  Alba).  —  This  is  the  bark  of  a  South  American 
tree,  and  is  an  aromatic  stimulant,  and  a  gentle  tonic,  and  useful  in 
debility  of  the  stomach. 

Caraway  (Carum  Carui).  —  This  biennial  plant  grows  in  Euro|)e. 
The  seeds  are  the  part  used,  and  are  aromatic  and  carminative  ;  they 


CAMI'HOlt  TItBK. 


"II' 


are  uh«(1  in  wind  colic,  and  to  improve  the  flavor  of  other  medicine. 
The  dot»e  \n  from  ten  to  sixty  grains.  The  dose  of  the  oil  of  caraway, 
extracted  from  the  seeds,  is  from  one  to  ten  drops. 

Ciinlaiiioiii  {Afpinia  Cardamomum). —  This  plant  grows  on  the 
mountains  of  Malabar.  The  seeds,  which  are  the  medicinal  parts,  are 
aromatic,  and  carminative,  and  are  used  to  expel  wind,  and  to  (luvor 
medicines.  Dose,  from  ten  grains  to  two  drams.  The  volatile  oil 
obtained  from  them  has  similar  properties. 

Ciistnirillil. —  This  medicine  is  the  bark  of  the  West  India  shrub 
croton  efeuleria.  It  has  an  aromatic  odor,  and  a  warm,  spicy  tasic 
It  is  a  pleasant  aromatic  and  tonic,  and  is  used  in  dyspepsia,  dirouii 
diarrhfjea  and  dysentery,  wind  colic,  and  other  debilities  of  the  stoiii- 
ach  and  bowels.  It  counteracts  the  tendency  of  cinchona  to  product' 
nausea. 

Preparations.  —  Fluid  extract,  dose,  twenty  to  thirty  drops;  tincture, 
dose,  one  dram;  infusion,  dose,  one  to  three  drams.  An  alkaline  infu- 
sion, composed  of  Huid  extract,  three  ounces  ;  carlx)nate  of  potassa, 
two  drams;  and  water,  ten  ounces,  is  excellent  in  weak  stomach,  with 
acidity.     Dose,  one  dram. 

Ciistor  (Castoreum).  —  A  peculiar  substance  obtained  from  the  bea- 
ver. It  is  antispasmodic  and  emmenagogue.  It  is  used  in  tv]  lus, 
hysterics,  epilepsy,  retention  of  the  menscis,  and  in  many  other  kt- 
vous  diseases.  Dose,  from  ten  to  twenty  grains.  A  medicine  i  no 
great  value. 

Castor  Oil  {Oleum  Ricini). —  This  is  obtained  by  expression  from 
the  seeds  of  the  castor  oil  bush,  riciniis  communis.  WIkmi  exposed  to 
the  air,  it  turns  ranciil,  and  spoils. 

As  a  mild  cathartic,  this  oil  is  extensively  used,  particularly  among 
chiltlren.  It  is  an  exceedingly  nauseous  medicine,  but  may  be  ren- 
dered less  ollensive  by  being  mixed  with  a  few  drops  of  oil  of  wiiitei- 
green,  peppermint,  or  cinnailion  ;  and  its  bad  taste  may  be  nearly 
destroyed  by  rubbing  it  up  to  a  thick  bat?ter  with  carbonate  of  mag- 
nesia. Or,  It'  boiled  a  few  minutes  with  a  little  swet^t  milk,  sweetened 
with  loaf  sugar,  and  flavored  with  essence  of  cinnamon  or  peppcr- 
mint^  it  may  be  easily  taken.  Dose,  for  an  adult,  one  to  tliree  table- 
spoonfuls;  Ibi  ri  child,  one,  two,  or  three  teaspoonfuls,  according  tc 
its  age. 

Ciitei'hu.  —  This  is  a  solid  extract,  made  from  the  wood  of  the 
acacia  calechn,  •  tree  growing  in  Asia.  It  is  in  dark,  brown,  and 
brittle  pieces,  and  is  soluble  in  alcohol.  It  is  a  powerful  astringent, 
and  is  used  in  chronic  diarrhoea,  and  chronic  dyst-ntery.  It  makes  a 
useful  gargle  in  some  forms  of  sore  mouth,  in  elongated  uvula,  spongy 
gums,  and  sore  nipples.  The  dose  of  the  powder  is  from  ten  to  thirty 
grains,  and  of  the  tincture,  from  one  to  two  teaspoonfuls. 

Catnip  ( Nepcta  Calaria).  —  A  native  of  Europe,  and  widely  natural- 
ized in  this  country.  The  tops  and  leaves  are  the  medicinal  part,  and 
are  carminative  and  diaphoretic  when  drank  as  a  warm  infusion.     It 


lHli:i!:'li'iT 


MEDICINES  AND  THEIR  PUErARATlOXS. 


n05 


is  useful  in  fevers,  in  wind  colic,  nervous  heada(;he,  hysterics,  and  ner« 
vourt  irritability. 

Preparations.  —  Fluid  extract,  dose,  two  to  four  drams;  infusion, 
dof",  two  to  four  ounces.  Fluid  extract  of  catnip,  tM'o  ounces ;  anc^ 
the  lluid  extract  of  sati'ron,  one  ounce  and  a  half,  united,  make  a 
popular  remedy  for  colds,  and  the  rashes  of  children.  In  nervoua 
toinplaints,  a  combination  of  fluid  extract,  of  catiiij),  six  drams  ;  Huid 
extract  of  valerian,  four  v.rams ;  and  fluid  extract  of  scuUcap,  four 
drams,  is  a  valuable  remedy.     Dose,  one  to  three  drams. 

riiyciiiie  Pepper  ( Capsicum  Annuum).  —  This  plant  grows  in  hot 
fliiiiafc's,  and  is  known  by  the  common  name  of  red  pepper.  The 
hcrry,  which  is  the  part  used,  has  an  intensely  hot  and  pungent  taste. 
It  is  a  powerful,  diti'usible  stimulant,  and  is  about  the  only  stimulus 
which  the  stomach  will  bear  in  certain  forms  of  dyspepsia.  It  is  use- 
ful ill  all  cases  of  diminished  vital  action,  and  is  frccjuently  united 
with  other  medicines,  either  to  promote  their  action,  or  to  Icsseei  the 
severity  of  their  operation.  It  is  much  used  in  colds,  hoarsetiess,  etc., 
as  it  promotes  a  free  discharge  of  mucus  and  phlegni.  Taken  in 
small  doses,  it  has  a  fine  cHect  upon  the  mucous  membrane  of  tin; 
stomach  and  bowels,  lessening  very  nmch  the  severity  of  piles,  and 
sometimes  curing  them.  It  may  be  sprinkled  daily  upon  the  foot 
taken  in  the  form  of  eayeime  lozenges ;  it  is  frecjuently  useful  as  n 
gurgle  in  sore  throats,  scarlet  fever,  etc.  Dose  of  the  powder  from 
one  to  ten  grains. 

Prcparalions. —  Fluid  extract,  dose,  five  to  fifteen  drops;  tincture, 
close,  half  a  dram  to  a  dram,  used  in  low  forms  of  fever,  and  gastric 
insensibility  ;  infusion,  dose,  one  to  three  drams.  A  valuable  gargle 
in  scarlet  fever  may  be  made  by  combining  fluid  extract  of  cayenne, 
one  ounce  ;  common  salt,  one  dram ;  boiling  vinegar,  one  pint ;  buil* 
ing  water,  one  pint 

Celandine  ( Ghelidonium  Majus).  —  This  plant  is  indigenous  to 
Europe,  and  is  extensively  naturalized  in  the  United  States.  It  is  a 
drastic  purge,  producing  watery  stools,  and  is  equal  to  gamboge  ;  it  is 
useful  in  anections  of  the  liver,  and  particularly  in  those  of  the  spleen. 
Ill  the  form  of  a  poultice  it  is  effective  in  scrofula,  indolent  ulcers, 
skin  diseases,  and  piles. 

Preparations.  —  Fluid  extract,  dose,  ten  to  twenty  drops  ;  solid  ex- 
tract, dose,  five  to  ten  grains ;  tincture,  dose,  half  a  dram  to  a  dram  ; 
infusion,  dose,  two  and  a  half  to  five  drams.  A  very  good  hydra- 
gogue  cathartic  is  made  by  compounding  two  and  a  half  dnnus  of 
fluid  3xtract  of  celandine,  with  half  a  dram  of  (hiid  extract  of  hen- 
bane, one  ounce  of  "sulphate  of  |K)tassa,  one  grain  of  tartar  emetic, 
six  ounces  of  elder  water,  and  ounce  of  syrup  of  scjuill. 

Clidlk.  —  On  account  of  its  gritty  particles,  it  is  unfit  for  medicinal 
use  until  it  has  been  levigated,  after  which  it  is  called  prepared  chalk. 
This  is  the  only  form  in  which  it  is  used  in  medicine.  It  is  an  excel- 
lent antacid,  and  is  admirably  adapted  to  diarrhoea,  accompanied  with 
acidity.     The  most  convenient  form  of  administering  chi..  k  is  that  of 


60H) 


MKDICINKS  AND  TIIKIK  rURI'AKATIONS. 


the  chalk  mixture,  which  conniHts  of  prepared  chalk,  half  an  ounce; 
HUgar  and  powdered  gutn  arable,  two  drams  each  ;  cinnamon-water 
and  water,  four  fluid  ounces  each,  and  rubbed  tog«!ther  in  a  mortar 
till  tliey  are  thoroughly  mixed.  Dose,  a  tablespoonful  frctjuently  re» 
pcated. 


Fio 

100. 

>*t;>   ' 

*'"''; 

'v 

■    ■» 

- 

- 

i,        ."    - 

/ 
/ 

t 

'^              I 

CATENMK  FKPPKB. 


CUAMUMILB. 


riDiiiioiiiilP  (Anthrmis  Nobilis).  —  This  perennial  plant  grow?  in 
Europt',  and  its  flowers  are  considerably  used  in  medicine,  the  whitest 
of  which  are  best.  They  are  gently  tonic,  and  are  generally  used  in 
cold  infusion,  in  cases  of  weak  stomach,  dyspepsia,  etc.  In  large 
doses,  the  warm  infusion  will  act  as  an  emetic. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram;  solid 
extract,  dose,  four  to  twenty  grains ;  infusion,  dose,  half  an  ounce  to 
an  ounce.  For  dyspepsia,  wind  in  the  stomach,  etc.,  thirty  pills  may 
be  made,  by  combining  one  dram  of  solid  extract  of  chamomile  with 
five  grains  of  the  solid  extract  of  rhubarb,  and  ton  grains  of  assa- 
f(£tida,  and  taken,  one  pill  at  a  time,  two  or  three  times  a  day,  with 
advantage. 

Charcoal  (Carbo  Li^ni).  —  Prepared  charcoal  is  antiseptic  and  ab- 
sorbent, and  is  employed  with  great  advantage,  in  certain  forms  of 
dyspepsia,  attended  with  bad  breath,  and  putrid  eructations ;  it  has  a 
good  effect  in  correcting  the  fetor  of  the  stools  in  dysentery :  it  is  con- 
siderably  used,  and  with  much  advantage  as  an  ingredient  in  poul- 
tices.    I)ose,  when  taken  internally,  from  one  to  four  teaspoonfuls. 

Clilorofonn  ( Chhroformum).  —  This  is  an  anaesthetic,  used  to  pro- 
duce insensibility  during  surgical  operations.  A  teaspoonful  or  more 
is  poured  upon  a  handkerchief,  which  is  held  to  the  patient's  nose, 
but  not  so  closely  as  to  prevent  the  admission  of  air.  The  numerous 
sudden  deaths  which  have  occurred  from  its  use,  prove  it  to  be  an 
unsafe  agent,  and  it  is  now  seldom  employed  by  careful  surgeons. 
Taken  internally  it  is  sedative  and  narcotic ;  applied  externally,  com- 
bined with  other  articles,  it  is  useful  in  painful  affections,  as  nervous 


■m^"p«(ll 


MEDICINES  AND  THEIR  rUKI'AKATtONS 


6o: 


headache,  rheuniatinrn,  iiuurulgia,  t't(!.     The  iloho  wru'a  taken  ir.ter. 
imlly,  ii  from  ten  to  sixty  drup^,  ici  (lax-seed  tea. 

Ciniltliiion.  —  This  is  the  hark  of  trees  growing  in  Ceylon,  Malabar, 
and  Sumatra.  It  is  a  very  grateful  aromatic,  being  warm  and  cordial 
to  the  stotriaeh  ;  it  is  ai.so  carminative  and  astringent. 

It  is  not  often  prescribed  alone,  but  is  cljieliy  used  as  an  aid  to  lesa 
pleasant  medicines,  and  cnt<'rs  into  a  great  nimibcr  of  preparations, 
jt  is  peculiarly  adapted  to  drirrhcra  ;  and  in  treating  this  ct>inplaint 
it  is  often  joint'd  with  chalk  and  stringents.  Dose  of  the  bark,  fr.>m 
ten  to  twenty  grains.  The  oil  has  properties  similar  to  those  of  tho 
bark. 

CiiSMiii  Hiuls.  —  This  spice  is  a  producrt  of  China.  It  consists  of  tho 
calyx  surrounding  the  young  germ  of  one  or  more  species  of  cinna- 
mon. Cassia  buds  have  some  resemblance  to  cloves,  and  are  com- 
pared to  small  nails  with  roimd  heads.  They  may  be  used  for  the 
«iatne  purposes  as  the  cinnamon  bark. 

CJleuvers  ( Galium  A/nirine).  —  An  annual  plant,  common  to  this 
country  and  Europe,  having  an  acid,  astringent  taste.  The  whole 
herb  is  used  in  infusion,  as  a  cooling  diuretic,  in  scalding  of  the  urine, 
inllammation  of  the  kidneys  and  bladder,  in  gravel,  suppression  of  the 
urine,  etc. 

It  is  also  used  in  fevers,  and  all  acute  diseases.  The  infusion  ia 
made  by  adding  two  ounces  of  the  herb  to  a  pint  and  a  half  of  warm 
water.  It  should 'stand  three  or  four  hours,  and  be  drank  freely  when 
told.  Equal  parts  of  elder-blows,  cleavers,  and  maiden-hair,  infused 
in  warm  water,  make  a  refreshing  drink  iu  scarlet  fever,  and  other 
eraptive  diseases. 

Cloves  ( Caryophyllns  Aromaticvs).  —  The  flowers  of  this  tree,  a 
native  of  tropical  climates,  collected  before  they  are  fully  develojMid, 
form  cloves.  They  arc  highly  stimulant  and  aromatic,  and  are  used 
to  give  tone  to  the  digestive  organs,  particularly  when  flatulency 
exists,  and  to  relieve  nausea  and  vomiting.  They  are  more  generally 
employed  to  improve  the  taste  and  modify  the  action  of  other  medi- 
cines. The  dose  in  powder  is  from  five  to  ten  grains.  The  oil  of 
cloves  has  similar  properties ;  dose,  two  to  five  drops.  A  little  cotton 
moistened  with  the  oil,  and  pressed  into  a  decayed  tooth,  will  fre- 
quently relieve  the  toothache. 

Cochineal  ( Coccus  Cacti).  —  An  insect  found  in  Mexico,  inhabiting 
lifl'erent  species  of  cactus.  They  are  gathered  for  use  by  detaching 
them  from  the  plant  with  a  blunt  knife,  and  dipping  them,  enclosed 
in  a  bag,  into  boiling  water.  Cochineal  is  anodyne,  and  has  been 
used  with  advantage  in  hooping-cough  and  neuralgia.  It  is  much 
used  for  coloring  tinctures,  and  ointments,  and  the  color  called  car- 
mine is  prepared  from  it.  A  tincture  is  prepared  by  macerating  two 
ounces  of  cochineal,  in  one  pint  of  alcohol,  for  seven  days,  and  filter- 
ing through  paper.     Dose,  from  twenty  to  thirty  drops,  twice  a  day. 

Cod  Liver  Oil  {Oleum  Morrhuae).  —  This  oil  is  obtained  from  the 


1 


r 


60H 


MEDICINES  AND  TIIEIU  I'HEPAUATIONS. 


liverw  of  codlis-h,  and  is  nutritive  and  altorativo.  It  is  a  popular  rem- 
cdy  ill  consuinptioii  and  stTofula,  and  in  those  complaints  gtMicruily 
in  which  thrre  i.s  impaired  digestion,  assiniilation,  and  nutrition. 
Done,  a  tahh'spor>iiful  tiiroe  tisnes  a  day. 

Inability  to  digest  'his  oil,  to  eat  lat  ineatn,  or  to  lake  fats  in  any 
lorn),  is  an  unfavorablv  indication  in  eonsumption. 

rollodioil. —  This  is  <.'nn-cofion  dissolved  in  ether.  It  is  applied 
with  a  i-ainerh-hair  brush,  to  cuts,  burns,  wounds,  h'ech-bites,  vtc, 
over  whicli  it  f,>rrus  a  thin  peilieic  or  skin,  protecting  the  injured  part 
Jroin  the  atino^iphere.  It  .sjiouid  be  kept  in  well  stopped  bottles,  to 
prevent  its  evaporating  and  becoming  unfit  for  use. 

Colocyiltli  {Cun/mis  Cohxiintkis). —  A  native  of  northern  Africa. 
The  pari  used  in  medicine  i?;  the;  fruit,  deprived  of  its  rind.  It  is  a 
|)owerfu'.  drastic,  hydragoguc  cathartic;  causing  by  it.s  harsh  action, 
griping,  vomiting,  and  soiMctinies  bloody  discharges;  from  the  severity 
of  its  operations,  it  is  rarely  used  ahnu;.  I'sefut  in  dropsy,  derange- 
nicnts  of  tlx^  biaiii,  and  for  overcoming  torpid  conditions  of  the  diges- 
tive and  l)iliary  organs. 

Pn'/)an//if)ns.  —  Solid  extract,  dosi',  two  to  thirty  graina;  compound 
extract,  (h)se,  two  it)  thiity  grains. 

i'oloillho  {('onui/i/s  Palmaliia). —  A  perennial  clim!)ing  plant,  grow- 
ing ill  east  Africa,  and  cultivated  in  the  ]sle  of  l-^ance.  It  is  a  pure, 
bitter  tonic,  and  is  used  in  dyspepsia,  bilious  vomitings  which  att^'nd 
pregnancy,  anti  during  recovery  from  exhausting  diseases. 

Preparations. —  Fluid  extract,  dose,  twenty  to  sixty  drops;  solid 
extract,  dose,  four  to  ten  grains;  tincture,,  dose,  one  to  four  dranin; 
infusion,  dose,  three  drams  to  an  ounce.  A  compouiui  infusion  made 
by  uniting  on«^  dniu  of  fluid  extract,  four  drams  of  orange  peel,  and 
one  ounct;  of  wafer,  ia  useful  in  a  weak''ned  state  of  the  bt)wel.<, 
showing  itself  in  ft  diarrh<pa.  Dose,  two  dram.H  every  hour.  Fluid 
extract  of  Colombo,  one  ounce;  Huid  extract  of  ginger,  two  Jmnis, 
and  water,  one  piiiT,  al.so  make  a  useful  compound  for  the  same  per- 
pose.  Fluid  extract  of  Colombo,  one  dram  ;  fluid  extract  of  rhubarb, 
one  dram;  Huid  extract  of  ginger,  half  a  dram;  watcfj  one  pint, — 
this  is  useful  for  a  like  purpose.  The  following  is  also  a  very  gocxl 
preparation  for  a  ssimilar  use  :  Huid  extract  of  Colombo,  half  an  o'liice't 
Huid  extract  of  oascarilla,  two  drams ;  tincture  of  orange  pc«'l,  two 
drams;  syrup  of  cinnamon,  one  ounce  ;  '  'ter,  six  ounces.  I>os(,  one 
dram  every  hour. 

CoUstout  (Tussiiag-o  Farfara).  —  A  native  of  Europe,  and  natursd- 
izcd  in  this  country,  especially  in  the  Northern  States.  It  grows  in 
wet  places,  aiui  low  meadows.  The  leaves  are  principai'y  used. 
Tlicy  are  emollient,  demulcent,  and  slightly  tonic;  usetl  in  congll^, 
a^thma,  and  hooping-c(iugh  ;  and  externally  in  the  form  of  poultice 
for  scrofulous  tumors. 

I'oiiifroy  {Si/mp/ii/liiin  Offirhmlc). —  A  perennial  European  plant, 
•ultivated  in  this  country.     The  root  is  the  part  used      it  is  den»ul- 


=J 


'^mw 


cent,  and  oliglitly  astringent,  and  is  serviceable  In  diseases  of  the 
mucous  tisHiied,  and  in  scrofulous  habits ;  also  in  diarrhcea,  dysentery, 
coughs,  bleeding  from  the  lungs,  whites,  etc.  It  may  be  taken  as  an 
infusion,  or  as  a  syru|),  one  ounce  to  a  pint  of  water;  the  dose  being 
one  to  four  fluid  oun(!es,  three  to  four  tinfies  a  day.  The  fresh  root 
bruised  forms  a  valuable  application  to  ulcers,  bruises,  fresh  wounds, 
•ore  breasts,  and  white  swellings. 

Common  Silk- Weed  {Asdepias  Syriaca).  —  This  is  a  perennial  plants 
coiiiiiKni  thi()n«,'hont  ihi-.  United  States.  It  gives  out  a  milky  juice 
upon  ()eing  woiuuied,  and  hence  is  often  called  milk-weed.  The  root 
is  (liiiretie,  alterative,  emmenago<ijue,  and  anodyne;  and  is  sotnetimef* 
nsrd  ill  dropsy,  retention  of  urine,  suppressed  nuMistruation,  s(;rofula, 
;iii<i  iht'iimatisin  Dose  of  the  powder,  from  eii^ht  to  tvventy-hve 
f^'iuiiis;  of  the  decoction,  from  one  to  three  fluid  ounces. 

CoppiT  {Cuprum).  —  The  following  are  the  principal  salts  of  copper 
used  in  medicine. 

Siihiicetnte  of  Topper  (Cupri  Subacff/is).  —  This  is  known  by  the 
iiiiiiie  ol"  vcnlit»ris,  and  is  used  as  a  detcr^i-nt  and  escharotie;  it  is 
a|)plied  to  warts  and  fungous  growths,  and  to  foul  ulcers  and  ring- 
worm. When  reduced  to  a  line  powdc^r,  by  trituration  in  a  porcelain 
ii.ortpr,  the  liner  parts  of  this  an;  .siiparated,  and  called  prepared  sul)- 
acetate  of  copper ;  this  is  the  preparation  used  for  the  purposes  above 
nurned. 

Siilphilte  of  Topper  (Cupri  Sulplms).  —  In  small  doses,  the;  sulphate* 
of  copper  is  astringent  and  tonic  ;  in  large  ones,  a  prompt  emetic.  It 
is  given  in  smail  doses  in  hysterics,  epile[)sy,  and  intermittent  fevers  ; 
and  in  large  doses,  to  produce  speedy  vomiting  in  croup,  and  to  eject 
poisons  from  the  stomach.  A  wc^ak  solution  is  sometimes  used  for 
syphilitic  ulcers,  and  as  an  injection  in  gleet.  Dose,  as  a  tonic,  one 
quarter  of  a  grain  to  two  grains,  in  pill ;  as  a  rapid  vomit,  from  two 
to  ten  grains,  in  two  ounces  of  water.  Tln^  medicines  which  are  in- 
computihle  with  copper,  are  alkalies,  earths,  and  their  carboinitcs, 
borax,  salts  of  lead,  acretate  of  iron,  and  astringent  vegetable  infu- 
sions, decoctions,  and  tinctures. 

CoiTosive  Sublhiiiite.  —  This,  in  chemical  language,  is  the  bichlo 
ride  of  mercury.  It  is  on<'  of  the  milder  mercurial  preparatiinis. 
although  when  taken  in  large  doses,  it  is  a  violent  poison,  and  oper- 
ates wry  (piickly.  It  is  hiss  apt  to  salivate  than  any  other  mercurial, 
except  blue  pill.  It  is  much  used  as  a  renK;dy  in  .syphilis,  particu- 
larly in  the  secondary  stage,  in  which,  in  many  cases,  it  din^s  much 
good.  It  is  also  popular  in  many  skin  diseases,  as  leprosy.  When 
employed  for  this  pur|M)ne,  it  is  generally  associated  with  alterative 
and  diiiphoretii*  medicines,  such  as  the  compound  decoction  or  syrup 
of  sarsapariila,  preparations  of  yellow  dock,  etc.  In  order  to  avoid 
its  irritating  elli'cts,  it  is  often  united  with  opium,  or  extract  of  coniuni. 
Dissolved  in  water,  it  is  valuable  as  a  wash  in  some  skin  diseas4's.  It 
is  an  ingredient  in  nniny  of  the  quaitk  nostrums  which  are  extensively 

77 


rr 


010 


;  MEDICINEa  AND  THEIR.  PREPARATIONS 


Fio.  200. 


advertised,  and  was  the  active  principle  in  Swaini's  Panacea,  which 
had  HO  vast  a  sale  a  few  years  since,  and  gave  snch  a  princely  fortune 
to  its  proprietor.  One  ounce  of  corrosive  siibrnnatc,  dissolved  in  one 
quart  of  ah'ohol,  is  a  complete  l)e(l-l>ug  exterminator. 

Cuttoii  {(lossf/piuin  Ilvrbaceum).  —  Cotton  is  cliieHy  employed  in 
cases  of  recent  burns,  and  scalds,  —  :in  iipplication  of  it,  which  sur- 
geons have  learned  from  |)opular  use.  It  (liiiiiiiishcs  the  inflarnina- 
tion,  prevents  blistering,  and  hast<Mis  the  cure.  It  is  applied  in  tliin 
and  successive  layers.  'I'he  iimcr  bark  of  the  root  is  said  to  be  em« 
incuagoguc,  |)arTuricnt,  and  ahortirc.  A  decoction  of  it,  made  by 
boiling  four  ounces  of  the  iimcr  bark  of  the  rout  in  a  (piart  of  water, 
down  to  a  pint,  is  said  to  be  given  in  wiucglassfid  doses  by  the  female 
slaves  of  the  South,  for  the  purpose  of  producing  al)ortion.  It  i»  ex- 
cellent in  chlorosis. 

Prfparatioii. —  Fluid  extract,  dose,  four  drams. 

CniiK'.sbJll  {(Icraninm,  Mornialum). —  An  indigenous  plant,  growing 
In  all  parts  of  the  United  States,  in  the  open  woods.  The  root  is  the 
medicinal  part.  It  is  a  |)o\verful  astringent, 
similar  to  kino,  and  catechu,  and  a  valuabh^ 
substitute  for  those  articles,  because  less  ex- 
pensive. It  forms  an  excellent  gr.'He  in  sore 
throats  and  ulcerations  of  the  mouth,  and  is 
valuable  for  treating  those  discharges  arising 
from  debility,  after  the  ex(Mting  causes  are 
removed.  It  has  no  nn|)leasant  taste,  and  is 
therefore  well  adapted  to  infants,  a:i(l  persons 
of  delicate  stomachs.  As  an  injection,  it  is 
used  in  gleet,  and  whites. 

Preparaliom.  —  Fluid  extract,  dose,  half  a 
dram  to  a  dram  ;  solid  extract,  dose,  three  to 
fifteen  grains;  gerauiin,  the  active  principle, 
dose,  one  to  tiv<^  grains;  tincture,  dose,  two 
and  a  half  to  four  drams;  infusion,  ciosc,  ou(? 
to  two  ounces.  A  valuable  astringent  wash 
for  sore  mouth,  etc.,  and  as  an  injection  in  leucorrhn'a,  etc.,  is  inadt^ 
by  unitii  g  fluid  extract  of  cranesbill,  half  an  ounce  ;  fluid  extract  of 
black  cohosh,  half  an  ounce ;  fluid  extract  of  gokhui  seal,  half  an 
ounce  ;  fluid  extract  of  witch-haz(rl,  half  an  ounce  ;  and  water,  one 
quart.  Cieraniin,  dioscorein,  and  caulophyllin,  united  in  c(jual  parts, 
and  given  to  an  adult  in  six-grain  doses,  every  fifteen  or  twenty  niin- 
utes,  have  an  excellent  effect  in  diarrluea  and  cholera-morbus,  when 
there  is  nmch  pain  and  rumbling  of  the  bowels. 

Crawlpy  (Com//f)r/a'ca  Odontnrhizn). —  A  perennial  plant,  growing 
on  barren  iiills  and  hard  clay  soils  iii  New  York.  The  root  is  the 
part  used.  It  is  sedative  and  dinphoretic,  and  is  used  in  inflamma- 
tory diseases,  and  in  typhoid  fever;  also  in  flatulency,  cramps,  hectic 
fever,  and  night  sweats.  When  the  liver  requires  to  i>e  acted  upon, 
it  should  be  combined  with  rfwndrak4>  ot  Caiyt^'rijroot.     The  powdered 


^"■* 


C'UA.Ntl<ilILL. 


root  should  ho.  kc|)t  in  \V('ll-sto|)p('(l  vials  ;  its  dose  is  from  twenty  to 
thirty  grains,  iu  warm  water,  every  hour  or  two. 

rn'osote  (Creosotum).  —  This  is  ohtaim-d  l)y  the  distillation  of  tar. 
It  is  irritant,  narr»)tii',  sty|)tic,  antiseptic,  and  modcrairly  i-sciiarotic. 
It  has  been  ^'ivvn  in  diai)etes,  epilep.sy,  liysteiies,  n(Mirali,'ia,  bleeding 
from  the  limg'*,  and  chronic  broi  chilis.  It  is  an  excellent  remedy  for 
arri'sting  nausea  and  vomiting,  when  not  dependent  on  inllanmiation. 
The  dose,  when  given  internally,  is  one  or  two  drops,  it  is  nn)st  t-asily 
taken  in  the  form  of  pill,  in  some  forms  of  bronchitis,  the  vapor  of 
creosote  is  inhaled  with  advantage.  It  may  st)metimes  be  applied 
with  exei'llent  elUct,  to  indole.nt  or  ill-conditioned  ulcers,  in  which  ease, 
two,  four,  or  six  drops  may  be  dissolved  in  an  ounce  of  distilled  water. 
In  some  eas<*B  tin;  solution  is  mixed  with  poultices.  One  or  two 
drops  of  pure  creosote,  introduced  into  a  .loilow  tooth  t)n  a  litth;  cot- 
ton, is  generally  a  speedy  remedy  for  toothai-he,  but  great  c^are  must 
be  taken  that  it  does  not  come  in  contact  with  the  tongU(!  or  cheek. 

frotoil  Oil  {Oltuni  l^f^lii). —  This  is  obtained  from  the  seeds  of  the 
Crclon  Tiijiiiini.iX  plant  growing  in  the  Kast  Indies.  It  is  a  powerful 
cathartic,  producing  watery  stools,  and  is  used  in  torpidity  of  the 
bowels,  dropsy,  apoplexy,  mania,  inllanuuation  of  the  brain,  hydro- 
cephalus, coma,  and  wherever  a  pow(>rful  nvulsive  action  is  needed 
to  call  <he  blood  away  from  the  brain.  A  drop  placed  on  the  tongue 
of  a  p(.r-«-ri  in  the  comatose  state,  will  generally  operate.  Two  to  six 
drops,  k.  bed  upon  the  skin,  product;  an  eruption  or  pimples  in  twelve 
hours.  In  thi.s  way,  it  is  used  in  diseasis  of  the  throat  and  chest,  and 
some  other  afleetions.  If  the  skin  is  very  sensitive,  let  it  be  combined 
with  an  etjual  (juantity  of  sweet  oil. 

Ciibebs  (Ciibebfe).  —  A  climbing  perennial  plant,  growing  in  the 
East  indies.  The  berries  ar«;  the  medicinal  part.  They  are  stimu- 
lant purgative,  and  diuretic,  acting  particularly  upon  the  tirinary 
org-ans,  and  arresting  dist-liarges  frr<:,j  the  water  pipe,  and  much  ased 
in  tlve  tnatmrnt  of  gonorrhn'»  ;»nd  gleet.  It  should  not  be  used  dur- 
ing acti"vi*  ynHamr'tatiuii,  D<»t*e  o'  ^H)wdered  cubebs,  from  thirty  to 
sixty  grains. 

Pr'^parations.  —  Flni«f  extraef,  ^lo^r,  half  a  dram  to  a  dram  and  a 
half;  ethereal  fluid  ext^raet,  dose,  one  to  two  drams  ;  solid  (extract, 
doHe,  two  to  twenty  grains' ;  iin<'ture,  dose,  one  to  two  drains.  A 
compound,  made  of  /luid  exlrart  of  cubebs,  five  drams;  fluid  extract 
of  t-fifot,  one  and  a  half  drams  ,  eimiamon  water,  half  a  <lram  ;  and 
powder«'d  loaf  sugar,  one  dram,  may  be  taken  witii  advantage  in 
goiiorrhrea,  gleet,  and  leueorrti-ea  ;  dort4-,  one  drani. 

ruhrr's  HiH)t  {/jy/fandra  Virninim). —  A  |M.'rennial  plant  growing 
throujrhout  tfie  United  H'ates  in  lime^ioiie  di»tricts.  and  flowering  in 
July  and  August.  Tlie  ro</t  is  the  inejiK-inal  |w*rt  It  is  lre<piently 
eiilled  Mark  root.  When  dried,  it  \*  tonic,  eholagogiie,  and  laxative, 
and  is  a  very  valuable  remedy  in  affection*  of  the  liver,  as  it  acts 
upon  thif  *>rgan  with  euTgy,  without  purgation.  It  is  also  useful  in 
typhoid  ffvrrs,  and  in  dyspepsia,  diarrhoea,  and  dysenU'ry.     A  powder 


* 


612 


MEDICINES  AND  THEIR  PREPARATIONS. 


is  made  from  it,  containing  itfl  active  principle,  and  called  ieptandrin, 
which  has  u  fine  cH'cct  in  diarrhcca,  cholera  infantum,  typhoid  fever, 
some  forms  of  dysjM'psia,  and  in  all  diseases  connected  with  derange- 
ments of  the  liver. 

Preparations.  —  Fluid  extract,  dose,  one  third  of  a  dram  to  a  dram ; 
leptandrin,  tiie  active  principle,  dose,  in  acute  cases,  one  fourth  of  a 
grain  to  one  grain  ;  in  chronic  cases,  one  to  two  grains ;  tincture,  two 
ounces  to  a  pint  of  iilcohpl,  dose,  one  dram  to  one  ounce. 

Daiidelioil  [Taraxacum,  Dens-Leonis).  —  This  perennial  herb  is  diu- 
retic, aperient,  and  tonic.  It  is  generally  tliouglit  to  act  especially 
upon  the  liver.  Used  in  dyspepsia,  diseases  of  the  liver  and  spleen, 
an<l  in  debiiitatr'd  and  irritable  conditions  of  th(^  stomach  and  bowels. 

Preparalions. —  Fluid  extract,  dose,  one  to  two  drams;  coinpomul 
fluid  extract,  dose,  one  to  two  drams  ;  fluid  cxtraitt  of  dandelion  and 
senna,  dose,  one  to  two  ilrams  ;  solid  extrai't,  dose,  ten  to  twenty 
grains  ;  infusion,  two  ouno's  to  ouo.  pint  »)f  wat«'r,  dose,  fotir  to  six 
ounces.  In  (ln)j)si('al  all'ections,  the  lollowins^  compound  infu.-ion  will 
be  found  useful  :  lliiid  extra(;t  of  dandelion,  six  drams  ;  lluid  extract 
of  rhubarb,  oiw.  and  a  half  drams;  fluid  extract  of  henbane,  twenty- 
four  drops;  bicarbonat**  of  soda,  half  a  dram;  tartrate  of  potasi^ii, 
three  drams;  water,  three  and  a  half  ounces;  take  one  third,  threo 
times  a  day.  For  jaundice,  and  diseases  of  the  liver  and  kidneys, 
the  following  pills  have  much  eflicacy.  Solid  extract  of  dandelion, 
one  dram'  solid  extract  of  oloodroot,  one  dram  ;  leptandrin,  one  scru- 
ple ;  podophyllin,  five  grains;  oil  of  peppermint,  live  minims;  to  be 
divided  into  fifty  piiu;,  and  one  or  two  taken  three  times  a  day. 


Fia.  201- 


Fio.  208. 


nSAULT  HIUHTflHADI 


IMM»Wf>OD 


Sleailly  ^ijrlitsliiule  (Atmpa  BeWuitmna). —  A  {perennial  pinnt,  grow* 
ing  in  Kurope  and  iliis  eomitry,  and  having  a  faint  o«}or,  nnd  a  suvet, 
nauseous  taste.  It  is  nar<-oti(!,  diaphonntt-,  and  diuretic;  is  a  V!*h*ablo 
remedy  in  eonvulsions,  neuralgia,  hm>pung-ci»u'i;h,  rhemuatistn,  «»vU, 
paralysis,  and  it:any  diseases*  having  tin-jr  seal  in  tlit  nerv()u>  j^-Hivin. 
It  has  been  much  praised  as  a  preventive  of  scarlet  fevcR.  'iKHiiiil  it« 
powers  for  this  purpose  are  doubtt'ul. 

Preparations.  —  Fluid  (txtract,  dose,  five  to  ten  dr»H«s  ;  soM  extract, 
dose,  one  quarter  to  one  grain  ;   tincture,  two  oum'«a>  to  a  pini  of 


^mW' 


>'¥}, 


diluted  alcohol,  dose,  from  fifteen  to  thirty  drops.  The  solid  extract  is 
used,  mixed  with  lard  or  with  other  substances,  as  a  local  application 
for  relieving  pain,  dilating  the  pupil  of  the  eye,  for  removing  stricture 
of  the  urethra,  the  anus,  rigidity  of  the  mouth  of  the  womb,  etc. 

Dopvood  {C(nmus  Florida). —  This  is  a  small  tree  growing  most 
abundantly  in  the  Middle  States.  The  bark  is  used  as  a  medicine. 
It  is  tonic,  astringent,  antiperiodic,  and  stimulant.  It  increases  the 
frecjuency  of  the  pulse,  and  elevates  the  temperature  of  the  body.  It 
lias  been  svibstitufed  for  peruvian  bark  in  intermittent  fevers.  Dose 
of  lh(!  powdered  bark,  from  ten  to  sixty  grains. 

Vrcparalions. —  Fluid  extract,  dose,  lialf  a  dram  to  two  drams: 
solid  extract,  dose,  live  to  ten  grains ;  tincture,  four  ouik^cs  to  a  pint 
of  alcohol,  dose,  one  to  four  drams;  infusion,  two  ounces  to  a  pint  of 
water;  dose,  half  an  ounce  to  two  ounces;  cornin,  the  active  principle, 
dose,  one  to  ten  grains. 

Hwiirf  Elder  {Aralla  llispida). —  A  perennial  under-shrnb,  growing 
from  New  Kngland  to  Virginia.  The  bark  of  the  root  is  diuretic  and 
aherativc.  An  infus^ion  made  from  it  is  used  in  gravel,  suppression 
of  urine,  and  dropsy ;  to  be  taken  in  wineglassful  doses,  three  or  four 
times  a  day. 

Elder  {Sambucus  Canadensis], —  The  flowers,  i)erries,  and  inner 
bark  of  the  elder,  are  used  in  medicine.  A  warm  infusion  of  the 
flowers  is  diaphoretic,  and  gently  stitnulant.  A  cold  infusion  is  diu- 
retic, alterative,  and  cooling;  used  in  erysipelas,  liver  alVeciions  of  chil- 
dren, rheumatism,  scrofula,  and  sornt!  syphilitic  diseases.  The  bark, 
|)ounded  with  lard,  forms  a  useful  ointment  for  burns  and  scald*",  and 
some  diseases  of  the  skin. 

Elrcanipiilie  (Inula  Helcnium). — .This  percmiial  plant  is  \\  native  of 
KnrojK!  and  .lapan,  and  is  cultivated  in  this  country.  The  riK>t  is 
stirinilutit,  tonic,  diuretic,  and  (expectorant,  and  is  used  in  chronic 
iifrections  of  the  lungs  and  air  passages.  It  is  siiid  a  tit  -oetioo  from 
the  root  forms  a  good  application  for  the  iti  h.  and  other  *kui  diseases. 
Dose  of  the  powdiTcd  root,  from  a  scruple  to  a  dram;  of  the  iufusimi, 
«rie  or  two  fluid  ounces. 

Eleetro-Miiffiietism. —  Within  a  few  yetu-s,  electro-magm'tisni  has 
b<M'ii  eiiipU)yed  «!xterjsively  as  \\  remedial  iigent,  particuUtly  in  the 
various  forms  of  nervous  disor(ler>.  Tliat  it  is  a  valu.«t)l»"  a^ent  in  th<* 
tn-atment  of  disease,  few  thinking  physicians  doubt  ;  y»'t,  like  um>t 
«ther  new  things  in  iiiedieitie,  it  has  had  its  enthusiastic  admirers, 
who  hav(!  claittied  for  it  reuuHlial  powers  beyond  what  it  really  has, 
ttial  who  have  applied  it  to  purposes  beyotjd  its  sphere  of  usefulnt^jw. 
Various  instruments  have  been  constructed  for  applying  this  retneaht. 
but  no  one  has  ap|M>aretl  to  m«'  so  well  adapti>d  to  its  purpose,  as  tiMii 
I    manufactured  by  Messrs.  Hinds  &  Williams,  of  this  city. 

fcverfcvi  [Pj/rclhium  Parthenium). —  In  warui  infusion,  this  herb  is 
valuable  in  recent  colds,  Hatulency,  worms,  irregular   menstruation, 


JU 


614 


MEDICINES  AND  THEIK  rUEI'AUATlONS. 


hy»toricH,  and  suppression  of  the  urine.  The  cold  infuMiou  la  a  tenia 
A  poultice  made  of  llie  leaves,  sootlicH  and  alleviates  pain. 

Fi)(WOlt  {Srrnphiifnria  jS'otfosa).  —  The  leave.s  and  root  are  diurelic, 
alterative,  and  anodyne,  and  in  some  places  are  used  in  liv<'r  com- 
plaints, scrofula,  dropsy,  and  diseases  of  the  skin.  Applied  externally 
in  the  form  oi'oinlmcnl,  or  fomentation,  it  is  said  to  be  useful  in  piliM, 

1)ainful  tumors,  hruises,  ringworm,  and  inilauuuatiou  of  the  hreasts. 
)o»o.  of  the  infusion,  from  two  to  four  fluid  omices,  three*  times  a  day. 

.  FiilX'sn'tl  {Liiium  Usihitissimum).  —  This  is  demulcent  ai^l  luitri- 
tive,  and  is  mncli  used  in  coughs,  bronchial  diseases,  inllanmiution  of 
the  urinary  <ir<;;uis,  bowels,  and  lunj^s  ;  chielly  lakcn  in  \\\v  form  of 
flaxseed  tea.  The  infusion  is  sonuMimes  used  as  an  injection  in  dy* 
eatery  and  piles.      Linseed  t)il  is  prepared  from  llaxseed. 


Flu.  iiOS. 


Kl(».  Z>H- 


At 

1 

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in)Xiii.iiVK 


Poiftlovj'  (Diiiiliilis  l*iir/tiin'a).  —  A  biennial  plant,  i^rowing  in  tho 
lempeiale  pJirl-  nf  Mmope.  Tin'  leaves,  in  proper  doses,  are  sedativi; 
and  diurelic,  rcducidg  the  pulse,  and  increasing  the  flow  of  urine,  hi 
large  doses,  they  i're  a  narcotic  poison.  The  medicine  has  been  nmcli 
vised  in  inilaMunaturv  diseases,  palpitation  of  the  heart,  and  in  dropsy 
conn«'ct<'(l  with  disciised  heart  or  kidneys.  W'Imii  taken  for  sonic 
time,  it  is  liable  to  accumulate  In  the  system,  and  suddenly  to  mani 
fest  poisonous  and  ;ilarniing  symptouis,  a:i  if  a  large  dttse  had  been 
taken.  The  American  hellelKMc  is  fast  supplanting  it  as  a  remedy. 
Dose  of  the  powderci!  leaves  of  foxglove,  from  one  to  (hree  grains; 
of  the  tincture,  from  eight  to  twelve  drops. 

Fnistwn'd  {Ilr/uuifhfiniim  Canadcnst-).  —  This  herb,  also  known  by 
the  name  of  rockr«>se,  is  tonic,  astringent,  and  alterative,  and  has  Immmi 
considerably  used  in  scrofula;  combined  with  turkey  corn,  and  (pieen'i 
root,  it  is  said  to  have  eileeted  cures  in  secondary  .syphilis.  A  decoe- 
tiou  forms  a  useful  gargle  in  uh-erations  of  the  mouth  and  throat  in 


"""'/■■' ^SWT^lT 


MKDICINKS  AND  THEIU  PUEl'AUATIONs! 


G15 


scarlet  fever,  and  otiier  diseases,  and  as  a  wash  in  scrofulous  inflam- 
mation of  the  eyes.  Dose  of  the  fluid  extract,  one  to  two  drams, 
three  or  four  times  a  day. 

U\\\\s. —  These  are  the  unhealthy  excrescences  found  growing  on 
the  young  houghs  of  the  dyer's  oak,  t/nerrus  infcrtorin,  growing  in 
Asia.  They  are  powerfully  astringent.  In  the  form  of  infusion,  or 
decoction,  tuade  in  ihe  proportion  of  half  an  ounce  to  a  pint  of  water, 
they  are  us«!ful  as  an  astringent  gargle,  wash,  or  injection  ;  and  fmely 
powdered  galls,  on(^  part  to  ••ight  parts  of  lard,  malic  a  valuahh;  oint- 
njcnt  for  bleeding  pih's.  Dose  of  powdered  galls,  from  ten  to  twenty 
grains. 

Caiilllhoico.  —  The  hardened  juic(!  of  trees  growing  in  Siani  and 
Cochin  t'hina.  This  ginn-rcsin  is  a  hy<lrag()gue  calliartic,  acting 
severely  and  harshly  up«)n  l\\o  bowels,  and  henct;  ix  not  oft(Mi  used 
aloii''.  On  account  of  the  severity  of  its  action,  it  is  improper  to  use 
jt  during  inilannnation  of  the  stomach  or  bowels,  piles,  pregnaimy, 
diseased  womb,  or  excessive  menstruation,  ('ombined  with  cream  of 
tartar  and  jalaj),  it  is  a  valuable  nujiedy  in  dropsy.  The  dose  is  one 
or  two  grains. 

iiiUVu'  {Allium  Snliruin).  —  Tlu^  bulb  is  tlit;  part  u.xed.  It  is  stimu- 
lant, diuretic,  expectorant,  and  nd)ef:ieicnt ;  useful  in  coughs,  hoarse- 
ness, hooping-cough,  and  in  the  nervous  spasmodic^  coughs  of  children. 
Dose,  from  twenty  grains  to  three  drams;  dose  of  the  juice,  mixed 
with  sugar,  half  a  tcaspoonful  to  a  teaspoonful. 

The  bruised  bulbs  are  sometimes  usefully  applied  us  a  poulticf* 
to  the  chests  of*  young  irhildren  having  inllanunation  of  the  lungs, 
and  as  drafts  to  the  feet  in  inilannnation  of  the  brain,  fevers,  etc. 

(•eiithlii  {(I'rntiana  Lulea). —  Ft  grows  among  the  Alps,  Apeimines, 
and  Pyrenees.  The  root  is  the  part  used,  and  is  brought  \o  this  coun- 
try from  (iermany.  This  medicine  has  long  maintained  its  reputa- 
tion, having,  it  is  said,  derived  its  name  from  (rcniius,  king  of  Illyria. 
It  is  a  pure  and  simph^  bitter,  exciting  tin;  appetite,  and  mvigorating 
the  digestivt;  powers.  It  imiy  be  used  in  all  cases  dep(Mid(Mit  on  pure 
debility.  It  is  much  employed  in  dyspepsia,  and  during  recovery 
from  exhausting  diseases. 

JVi/iiiralious.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram;  com- 
pomul  lluid  extract,  dose,  half  a  dram  to  a  dram  ;  solid  extra<"t,  dose, 
three  to  lifte<'n  grains;  tincture,  four  ounces  to  one  pint  of  diluted 
alcohol,  dose,  two  to  fiv(!  tirai.is.  A  valualile  preparation  is  made,  by 
uniting  liuid  extract  of  rhubarb,  two  ounces  ;  lluid  extract  of  gentian, 
'half  an  ounc«! ;  diluted  alcohol,  two  pints;  dose,  half  an  ounce  to  two 
ounces. 

iiiu^t'r  {Ziiifribrr  Offitiiiali).  —  This  is  a  native  of  Ilindostan,  and 
is  cultivateti  in  all  parts  of  India.  The  root  is  the  part  used.  It  is  a 
grateful  stimulant  and  carminative,  and  is  much  used  for  dyspe|)sia, 
wind  in  tlur  stoma<-h,  coli<!,  gout,  etc.  It  is  an  excellent  addition  to 
bitter  infusions,  and  is  much  U8(!d  to  disguise  the  taste  of  nauseous 
medicines.     Dose,  from  ten  to  thirty  grains. 


. .  i^i 


616 


MEDICINES  AND  THEIR  PREPARATIONS. 


Preparations. —  Fluid  extract,  dose,  half  a  dram  to  a  dram ;  tincture, 
four  ounces  to  one  pint  of  diluted  alcohol,  dose,  two  to  four  drams ; 
infusion,  dose,  one  to  two  ounces ;  syrup,  dose,  one  to  two  drams. 

GinNen^i;  {Paruuc  Qidnquifolium).  —  A  perennial  plant,  growing  in 
the  Middle  and  Southern  State's.  It  is  a  mild  tonic  and  stimulant, 
and  has  some  reputation  for  improving  impaired  appetite,  and  for 
nervous  debility,  weak  stomach,  «'tc.  Some  persons  are  in  the  habit 
of  chewing  it,  and  it  is  considerably  used  in  this  way.  Dose  of  the 
powdered  rcmt,  from  ten  to  sixty  grains  ;  of  the  infusion,  from  two  to 
four  fluid  ounces. 

Glycerin. —  This  is  the  sweet  or  sugary  portion  of  oils,  and  is  ob- 
tained from  them  during  the  manufacture  of  lead  plaster.  It  is  demul- 
cent and  antiseptic,  and  has  been  recently  recommended  and  used,  to 
some  t;xtent,  in  place  of  cod  liver  oil,  in  consumption.  It  has  been 
still  more  used,  however,  as  a  soothing  and  emoli(>nt  external  applica- 
tion in  skin  diseases,  and  also  in  place  of  lard  in  the  preparation  of 
ointments.  , 

Gold.  —  The  chief  sort  of  gold  used  in  medicine,  is  the  chloride  or 
muriate  of  gold  and  soda.  It  is  diur<;tjc  and  alterative.  It  is  used 
in  scrofula,  skin  diseases,  goitn?,  scirrhous  tumors,  opthalmia,  dropsy, 
and  syphilis.  The  dose  is  from  one  thirtieth  to  one;  twelfth  of  a  grain, 
and  is  given  dissolved  in  water,  or  made  into  pill  with  starch  or  gum 
arable. 

Golden  Seal  {IJi/drastis  Canadensis).  —  A  perennial  plant,  growing 
throughout  the  United  States,  particularly  in  the  West.  The  root  is 
the  medicinal  part.  It  is  a  tonic,  having 
especial  action  upon  diseased  mucous  tis- 
sues, and  is  partictularly  beneficial  during 
recovery  from  exhausting  diseases.  It  is 
used  in  dyspepsia,  chronic  atlections  of  the 
nervous  coats  of  the  stomach,  erysipelas, 
and  remittent,  intermittent,  and  typhoid 
fevers.  United  with  geranium,  it  has  a  line 
cH'ect  in  chronic  diarrhcea  and  dysentery. 

Preparations.  —  Fluid  extract,  dose,  half  a 
dram  to  two  drams ;  solid  extract,  dose,  two 
to  five  grains;  hydrastin  (resinoid), dose, one 
half  to  five  grains;  hydrastin  (neutral), dose, 
two  to  six  grains ;  hydrastina  (alkaloid), 
dose, one  to  five  grains;  tincture,  dose,  three 
ounces  to  one  pint  of  diluted  alcohol,  dose, 
half  an  ounce  to  an  ounce  and  a  half.  For 
various  forms  of  sore  mouth  and  ulcerated 
sore  throat,  the  following  is  a  useful  gargle : 
fluid  extract  of  golden  seal,  half  an  ounce ; 
fluid  extract  of  blue  cohosh,  half  an  ounce ; 
fluid  extract  of  witch-ha/el,  half  an  ounce;  pulverized  alum,  one  dram; 
honey,  three  drams ;  water,  one  pint     As  a  stimulant  for  a  sluggish 


Fio.  205. 


OOI.DKM  BBAL. 


n-v  '  %'l 


MBDICINB8  AND  THEIB  PRKPARATI0M8. 


617 


dram; 
luggisb 


liver,  and  as  a  tonic  in  enfeebled  mucous  membrane  in  epidemic  dys- 
entcry,  and  other  complaints,  the  following  powders  arc  valuable: 
hydrastiri,  twenty  grains ;  leptandrin,  twelve  grains ;  podophyllin,  two 
grains ;  pulverized  cayenne,  two  grains ;  sugar  of  milk,  or  pulverized 
loaf  sugar,  one  dratn ;  rubbed  together  thoroughly  in  a  mortar,  and 
divide  into  twenty  powders ;  give  one  every  two  hours. 

Ground  Ivy  (Nepeta  Glechoma). —  A  perennial  herb,  common  to 
the  Uniti'd  States  and  Europe ;  in  some  places  known  as  gill-over- 
the-{j;r<tuud.  The  leaves  are  the  part  used,  which  are  stirrmlant,  tonic, 
and  pectoral ;  considert^d  useful  in  jaundice,  asthinri,  and  diseases  of 
the  kidneys  and  lungs. 

Gnniacuni.  —  This  medicine  is  the  shavings  or  chips  of  the  wood  of 
a  tree  growing  in  the  West  Indies,  also  resin  obtained  from  the  same 
tree.  It  is  Htiniulant  and  alterative,  and  is  used  in  chronic  rheuma- 
tism, diseases  of  the  skin,  scrofula,  and  venereal  com|)laints.  The 
tincture  of  the  resin  is  valuable  as  an  emuienagogue.  Dose  of  the 
tincture,  frotn  one-half  to  two  teaspoonfuls,  to  be  taken  with  milk. 
Tlic  wood  is  much  used  us  an  ingredient  in  alterative  preparations  of 
Harsaparilla,  et^. 

Gum  Arabic.  —  This  is  the  hardened  juice  of  trees  growing  in 
Egypt,  Arabia,  and  other  tropical  countries,  being  several  varieties 
of  the  acacia.  It  is  demulcent,  and  a  combustive  nutritive,  and  is 
much  used  in  forming  mixtures  for  hoarseness,  cough,  sore  throat, 
gonorrhaui,  inflammation  of  the  bladder,  strangury,  bronchitis,  and 
irritations  of  mucous  membrarjes  generally.  Mucilage  of  gum  arable 
is  a  preparation  made  by  dissolving  four  ounces  of  powdt'red  gum  in 
a  pint  of  boiling  water. 

Gum  Hemlock.  —  This  is  the  hardened  juice  of  the  hemlock,  Abies 
Canadensis,  a  tree  growing  in  Canada  and  Maine.  This  gum  is  a 
mild  rubefacient,  and  like  burgundy  pitch,  chiefly  used  to  make  plas- 
ters, etc.,  for  which  purpose  it  is  very  valuable.  A  tincture  of  the  gum 
iH  diuretic  and  stimulant  The  oil  of  hemlock  is  valuable,  in  combi- 
nation with  other  oils,  in  preparing  liniments.  The  bark  is  astringent, 
and  is  much  used  in  tanning  leather. 

Ilteniu stasis. —  This  word  is  used  to  imply  the  retention  of  the 
venous  blood  in  the  limbs  by  ligatures.  A  cord  or  corrunon  haiulker- 
cliief,  is  tied  round  the  upper  part  of  the  arms,  or  thighs,  and  a  piece 
of  wood  being  slipped  under  the  cord,  is  twisted  round  until  the  cord 
is  so  tightened  as  to  prevent  the  return  of  the  venous  blood,  but  not 
to  prevent  the  outward  passage  of  the  arterial  blood.  In  this  way, 
the  blood  passing  out  continually  in  the;  arteries,  and  not  returning 
by  the  veins,  the  vessels  of  the  limbs  become  filled  to  their  utmost 
capacity,  and  a  great  quantity,  for  the  tinie  being,  is  withdrawn  from 
the  trunk,  —  greater  than  any  surgeon  would  dare  to  remove  with  the 
lancet.  This  process  is  useful  in  bleedings  from  the  lungs,  stomach, 
and  womb,  and  inflammation  of  the  brain,  lungs,  bowels,  etc.,  and 
tn  whatever  case  it  may  be  tliought  desirable,  for  the  time  being, 


FT 


61b 


MEDICINES  AND  TUEIU  PREPARATIONS. 


I'tii.  w. 


to  lesarn  thn  blood  in  thu  huad  or  trunk,  without  debilitating  the 
patient. 

Ilttir-ciip  Wosa  {Polf/trirhvm  Juniperum). —  An  evergreen  plant  grow- 
ing on  poor  sandy  soils  in  llie  Nortliern  States.  A  strong  infusion  of 
it  is  powerfully  tliuretie.  In  dropsieal  eases,  two  tluid  oiuiees  of  the 
infusion  should  be  taken  «'V(!ry  half  hour.  It  is  useful  in  fevers,  in- 
flarnmatioMs,  gravel,  etc. 

Ilanlliuck  (Spirau  Totncnfosii). —  This  is  a  beautiful  shrub,  vmu- 
moil  in  tin;  United  States.  Its  h-aves  are  of  a  dark  green  eolor  above, 
and  whiter  underneath.  It  is  toiiie  and  astringent,  and  is 
much  used  in  ehronie  diarrlKea.  eliolera  inliiMtuiii,  etc.  It 
agrees  well  with  tin*  stciiiiacli,  and  is  deservedly  a  popular 
runu;dy  in  siuuiner  eoinpliiints  of  ehildrcii. 

A  (luid  extract  of  it  is  prepared  by  Tilden  cV  ("o. ;  <l()se, 
four  (o  twenty  drops,  it  is  nuich  w^rd  in  the  i'onii  of  infu- 
uion.  Th«'  green  herb  boiled  in  milk  forms  a  v;tliial)le  pre- 
paration in  chronic  diarrh(ra,  when  attended  with  much 
debility. 

Iliinllciif  <i<tl(l4>ii-Koil  (So/idd'i'o  Rii'if/d). —  A  pereiuiial 
plant,  growing  throughout  the  IJtiited  States,  especially  on 
the  western  prairies.  It  is  tonie,  astringent,  and  styptic,  and 
useful  to  arrest  bh-cding  from  the  nose,  huigs,  stomach,  and 
bowels.  The  powder  and  infusion  are  used,  both  ('xternally 
and  internally. 

HeUmias  {Ilr/otiins  Dioirn).  —  This  herb  is  eonnnon  in  the  United 
States,  and  is  known  by  the  name  of  ,Fafse  Vniconi  plant.  The  root, 
which  is  the  part  used,  is  tonic,  diuretic,  and  vermifuge.  In  large 
doses,  it  is  emetic,  and  when  used  fn'sh,  sialagogue.  In  fiv«?  or  ten 
grain  doses,  three  times  a  day,  it  relieves  «lyspepsia,  restores  the  appe- 
tite, expels  worms,  and  relieves  colic.  It  is  a  valuai)le  wond)  tonie, 
gradually  removing  debility  of  that  organ,  and  curing  whites,  pain- 
ful menstruation,  and  a  tendency  to  habitual  abortion.  Dose  of  the 
deeoction,  from  two  to  four  fluid  ounces.  The  detroetion  is  said  to 
kill  inse(rts,  i)ugs,  etc. 

Prepanifums. —  Fluid  extract,  dose,  one  to  three  drains;  heloiiiii, 
the  aeliv«!  principh;,  dose  half  a  grain  to  a  grain. 

Ileilbiiiie  (Ilyoscyamus  Ni^er).  —  This  plant  grows  abundantly  in 
Great  Britain,  and  on  the  continent  of  Europe,  and  is  rare  in  this 
country.  All  the  parts  are  active.  It  is  narcotii',  gently  aceele'ratiiig 
the  circulation,  increasing  the  general  warmth,  occasioning  a  sense  of 
heat  in  the  throat,  and  after  a  time  inducing  sleep.  It  is  often  u.sed 
in  the  place  of  opium,  because  it  does  not  bind  the  bowels.  Used  in 
rheumatism,  gout,  bronchitis,  asthma,  consumption,  hooping-cough, 
hysterics,  and  spasmodic  attections  generally. 

Preparations. —  Fluid  extract,  dose,  ten  to  twenty  drops;  so'id  ex- 
tract, dose,  half  a  grain  to  a  grain  ;  tincture,  two  ounces  to  one  pint 
of  diluted  alcohol,  dose,  half  a  dram  to  a  dram  and  a  half ;  hyoscya* 


IIAUDIIAUK. 


— 

mill,  tin 

gia,  rhe 
followin 

drains ; 

1  one  (Ira 

grnin  pi 

:     iiixii 

Mlils   III 

MEDICINES  AND  TIIEIU  I'UKPAKATIONS. 


61U 


niin,  tin"  active  principle,  dose,  oiio  eighth  to  half  a  ^rain.  In  noural- 
cia,  rhi'umatisiii,  St.  Vitn/s  dance,  painful  menstruation,  etc.,  the 
jollowinj^  may  be  found  useful  ;  solid  extract  of  hyoscyatmis,  two 
(Iraiiis  ;  solid  extract  of  valerian,  two  drams;  solid  extract  of  aconite, 
one  dram  ;  sulphate  of  <piinia,  one  dram.  Mix,  and  divide  into  two 
gniin  pills;  one  pill  every  two  or  three  lumrs. 

Illjril  ri'illllM'lTy  (Vil)iiniinn  ()/ni/ns).  —  This  shni!)  pfr(»ws  in  rich 
siils  in  Canada,  and  in  the  northern  I  nite<l  States,  'i'he  bark,  whic^h 
is  tlie  medicinal  part,  is  antispasmodic,  bciu^  used  in  cramps,  spasuiH, 
asthma,  hy-itcrics,  and  is  usclid  lor  those  who  are  subject  to  convul- 
sion^ during  pnirnancy,  iind  at  the  time  of  cliildbirth.  It  is  |iupul.irly 
liiiDwn  by  the  naiiie  of  ( 'nnii/i  /iiirh:  A  decoction  or  infusion  of  the 
bark,  may  be  ii~.ed  in  lablespoonrul  doses,  two  or  tliiee  times  a  day. 
Do.-''  of  tin-  cMract.  from  one  to  live  ij;rains;  in  womb  tronldes,  it 
tiiav  be  united  wiili  caiilophyllin,  cimicifui;in,  alctri<lin,  senecin,  and 
UM-lepidin  :  and  in  llatiilent  colic,  spasmodic  pains  of  the  stoniacii 
iind  bowel.-,  it  mav  be  combined  with  dioscorein. 


t  r 

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Ki<t.  atT. 


Fio.  »«. 


HBXnANR. 


IIOIIKIKIl'Ml. 


IlorollOlllltl  {Miinihium  Vitli^dn'). —  This  well  known  perennial  herb 
i<  a  native  of  I'lnropc,  and  lias  become  naturalized  in  this  country. 
It  is  tonic,  aperient,  pc«':oral,  and  sudorific.  It  is  deservedly  |)opidar 
ill  (loiiicstic  practice,  Un  colds,  asi lima,  throat-ails,  bronchitis,  and  other 
pectoral  all'ectiims,  attended  with  coui;h.      It  is  much  used  in  candy. 

Prr/)(irii/iii)is.  —  l<'luid  extract,  dose,  half  a  dram  to  one  dram  ;  Holid 
extract,  dose,  live  to  ten  grains;  tincture,  tw«)  ounces  to  oik;  pint,  of 
alcohol,  dose,  half  an  onnct^  to  an  ounce;  syrup,  three  ounces  fluid 
extract  to  one  pint  of  simple  syrup,  dose,  three  to  six  driiins. 

Hops  (Ilnmuliis  Liipiilm).  -The  conert  of  this  well-known  plant 
are  tonic,  hypnotic,  antlitliic  and  anthelmintic.  They  are  chieHy 
used  for  promoting  slee)-.  and  relieving  pain  and  irritability  of  the 
nervous  system.  Hops  arc  valuable  in  the  form  of  fomentation,  either 
alone,  or  in  combination  with  boneset,  and  other  bitter  herbs.     An 


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MEDICINES  AND  THEIR  PREPARATIONS. 


ointment  of  hops  and  stramoniuvn  leaves  is  sometimes  used  ia  salt* 
rheum,  and  upon  painful  tumors  and  ulcers.  A  pillow  stuffed  with 
hops,  dipped  in  hot  water,  and  placed  under  the  head  of  the  patient, 
relieves  pain  and  procures  sleep. 

Lupulin  is  the  yellow  powder  obtained  by  threshing  the  hops,  and 
is  preferable  to  the  hop  itself.  It  is  a  powerful  antaphrodisiac,  com- 
posing the  genital  organs,  and  quieting  painful  erections,  in  gonor- 
rhoea, etc. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram  ;  solid 
extract,  dose,  five  to  twenty  grains  ;  tincture,  two  and  half  ounces  to 
one  pint  of  alcohol,  dose,  three  to  six  drams ;  infusion,  four  drams  to 
one  pint  of  water,  dose,  two  to  four  ounces;  lupulin,  dose,  six  to  iev 
grains;  tincture  of  lupulin,  two  ounces  to  one  pint  of  alcohol,  dose,  one 
to  two  drams,  in  sweetened  water  ;  fifteen  to  twenty  grains  of  lupulin, 
well  rubbed  up  with  white  sugar  in  a  mortar,  is  very  efficacious  in 
priapism,  chordee,  and  spermatorrhoea. 

Horsemint  {Monarda  Punctata).  —  This  well-known  plant,  which  is 
common  to  the  United  States,  is  stimulant,  carminative,  and  diuretic 
A  warm  infusion  may  be  used  in  flatulence,  nausea,  and  vomiting. 
If  the  body  be  kept  cool  while  taking  it,  it  will  act  as  a  diuretic.  The 
oil  of  horsemint,  is  used  for  similar  purposes  with  the  plant.  Dose, 
from  two  to  six  drops  on  sugar.  Dose  of  the  essence,  from  ten  to 
forty  drops  in  sweetened  water.  The  oil  is  frequently  used  as  an  in- 
gredient  in  liniments. 

Ilorserndish  ( Cochlearia  Armoracia).  —  The  fresh  root  of  this  well 
known  perermial  is  stimulant,  diuretic,  antiscorbutic,  and  rubefacient 
It  is  useful  in  rheumatic,  paralytic,  scorbutic,  dropsical,  and  dyspeptic 
affections.  It  is  said  that  a  warm  infusion  of  the  fresh  root  in  cider, 
drank  freely  every  night,  will  cause  perspiration,  and  a  free  flow  of 
urine,  and  will  consequently  cure  dropsy.  The  Jfresh  root  grated  in 
vinegar,  and  eaten  with  meat  at  dinner,  strengthens  the  stomach,  and 
promotes  digestion. 

Houseleek  ( Sempervivum,  Tectorum).  —  The  bruised  leaves  of  this 
perennial,  form  a  cooling  application  to  burns,  stings  of  insects,  ery- 
sipelas, and  other  inflammations ;  valuable  also  for  ringworm,  shingles, 
and  other  skin  diseases. 

Hydrangea  {Hi;drangea  Arhorescens). —  This  grows  abundantly  in 
the  Southern,  Middle,  and  Western  States.  Its  root  is  medicinal.  It 
is  diuretic,  and  has  been  much  praised  for  its  power  of  relieving  the 
excruciating  pain,  caused  by  the  passage  of  stone  through  the  urethra, 
as  well  as'  for  infallibly  removing  such  stones  from  the  bladder,  pro- 
vided they  are  not  already  too  Targe  for  passage  through  the  water 
pipe.  As  many  as  one  hundred  and  twenty  calculi  have  been  known 
to  pass  off  from  one  person,  under  the  use  of  this  remedy.  A  con- 
centrated decoction,  or  the  fluid  extract  prepared  by  Tilden  &  Co., 
may  be  taken  in  teaspoonful  doses  several  times  a  day,  —  care  being 
taken  not  to  push  the  medicine  to  the  extent  of  dizziness^  or  oppres- 
sion of  the  chest. 


Hyssop  (Hyssojms  Officinalis).  —  This  is  a  native  of  the  continent 
of  £uro|>e,  and  is  cultivated  in  this  country.  The  tops  and  leaves  are 
the  parts  used.  They  are  stimulant,  aromatic,  carminative,  and  tonic. 
The  infusion  has  been  much  employed  in  chronic  bronchitis  of  old 
people,  and  those  of  debilitated  habits.  It  makes  the  raising  of  mucus 
more  easy.  The  infusion  may  be  combined  with  sage  and  alum,  and 
sweetened  with  honey.  The  fresh  leaves  bruised,  and  applied  exter- 
nally, relieve  the  pain,  and.  disperse  the  spots  and  marks  caused  by 
contusions. 

keliiiul  Moss  (Cetraria  Islandica).  —  This  plant  is  found  in  the 
northern  latitudes,  both  of  the  oltl  and  new  world,  and  is  abundant 
on  the  mountains,  and  in  the  sandy  plains  of  New  England.  It  re- 
ceived its  name  from  -its  prevalence  in  Iceland,  m  which  country,  as 
well  as  in  Lapland,  it  serves,  in  consequence  of  the  gum  and  starch 
it  contains,  as  food  for  the  inhabitants.  It  is  demulcent,  tonic,  and 
nutritious,  and  is  well  fitted  to  relieve  afTections  of  the  mucous  mem- 
brane of  the  lungs  and  bowels,  connected  with  debility  of  the  digestive 
organs;  it  is  given  therefore  in  chronic  bronchitis,  and  other  afl'ections 
of  the  chest,  attended  with  copious  expectoration,  especially  when 
the  matter  discharged  is  purulent ;  also  in  dyspepsia,  chronic  dys- 
entery, and  diarrhoea.  It  is  usually  employed  in  the  form  of  decoc- 
tion ;  and  is  much  used  in  the  common  article  of  diet,  called  blane 
mange. 

Ice  IMtint  {Monotropa  Uniflora).  —  This  perennial  plant,  found  in 
various  purts  of  the  country,  is  snow  white,  resembling  frozen  jelly, 
and  is  juicy  and  vender,  dissolving  in  the  hands  like  ice.  The  flowers 
are  in  shape  like  a  pipe;  it  is  hence  called  the  pipe  plant  The  roOt 
is  the  medicinal  part,  and  is  tonic,  nervine,  and  antispasmodic.  It 
has  also  been  considered  sedative  and  diaphoretic ;  and  the  powder 
has  been  sometimes  used  in  the  place  of  opium.  It  is  said  to  be 
valuable  in  epilepsy,  chorea,  and  other  spasmodic  affections.  Dose 
of  the  powdered  root,  from  thirty  to  sixty  grains,  two  to  three  times 
a  day. 

Indian  Hemp  {Apocynum  Cannabinum).  —  This  perennial  plant  re- 
sembles bitter-root,  and  grows  in  similar  situations.  The  root  is 
powerfully  emetic,  and  in  decoction,  diuretic,  and  diaphoretic.  It 
diminishes  the  frequency  of  the  pulse,  and  produces  drowsiness.  It 
has  great  efficacy  in  dropsy. 

Preparations.  —  Fluid  extract,  dose,  as  a  tonic,  five  to  fifteen  drops, 
as  an  emetic,  twenty  to  sixty  drojis ;  solid  extract,  dose,  one  to  five 
grains ;  tincture,  dose,  one  to  two  drams,  as  a  tonic,  half  an  ounce  to 
an  ounce,  as  an  emetic ;  infusion,  half  an  ounce  to  a  pint  of  water, 
dose,  half  an  ounce  to  two  ounces. 


Indian  Turnip  {Arum  Triphyllum).  —  This  is  a  perennial  plant, 
growing  in  damp  places  in  North  and  South  America,  and  known  by 
the  name  of  dragon  root.  The  root  when  chewed,  is  excessively  acrid, 
producing  a  bitmg  sensation  which  may  be  somewhat  relieved  by 


'^ 


milk.  The  fresh  root  is  acrid,  expectorant,  and  diaphoretic,  and  has 
been  used  in  asthma,  hooping-cough,  chronic  bronchitis,  chronic  rheu- 
matism, and  colic,  and  externally,  in  scrofulous  tumors,  scald  head, 
and  other  skin  disorders.  Dose  of  the  grated  root,  in  syrup  or  mucil- 
age, ten  grains,  three  or  four  times  a  day. 

Iodine  {Ibdinum).  —  This  is  prepared  from  the  ashes  of  kelp,  or  sea- 
weed, and  is  in  small  bluish-black,  shining  scales.  It  is  alti'rativc, 
tonic,  and  somewhat  diuretic.  It  has  been  chiefly  employed  in  dis- 
eases of  the  absorbent  and  glandular  system,  particularly  scrofula, 
goitre,  and  glandular  tumors  generally.  Dose,  in  substance,  half  a 
grain,  two  or  three  times  a  day,  in  form  of  pill ;  in  form  of  tincture, 
five  to  ten  drops. 

Iodide  of  Potiissium  {Poiassii  lodidum).  —  This  is  one  of  the  pre- 
parations of  iodine,  and  is  sometimes  improperly  called  hydriodate  of 
potassa.  It  is  formed  by  decomposing  the  iodide  of  iron,  by  carbon- 
ate of  potassa.  It  is  used  for  the  same  purposes  as  iodine,  but  chiefly 
as  an  alterative  in  tertiary  syphilis,  for  which  it  is  a  specific ;  also  in 
some  forms  of  chronic  rheumatism,  and  in  leprosy.  Dose  of  the  salt, 
from  two  to  twenty  grains.  It  is  much  combined  with  bitter  tinc- 
tures, and  particularly  wuth  the  compound  preparations  of  sarsapa- 
rilla,  yellow  dock,  and  queen's  root.  The  acids  and  metallic  salts  are 
incompatible  with  it. 

Ipecacuanlin. —  This  is  a  small  perennial  plant,  growing  in  moist 
woods,  in  several  countries  of  South  America.  The  root  is  the  jjart 
used.  It  is  a  very  valuable  emetic,  in  large  doses ;  in  smaller  doses, 
it  is  sudorific  and  expectorant.  Used  to  produce  vomiting  in  the 
commencement  of  fevers,  inflammatory  diseases,  swelled  testicles,  and 
before  the  paroxysms  of  ague ;  and  to  excite  nausea  in  dysentery, 
asthma,  hooping-cough,  varior.s  hemorrhages,  and  inflammation  of 
the  lungs;  and, combined  with  opium, to  produce  diaphoresis  in  rheu- 
matism, gout,  and  febrile  complaints.  Dose,  as  an  emetic,  from  fifteen 
to  thirty  grains ;  to  excite  nausea,  from  one  to  three  grains ;  and  to 
produce  diaphoresis,  two  to  six  grains,  with  one  grain  of  opium. 

Preparations.  —  Fluid  extract,  dose,  as  an  expectorant,  five  to  ten 
drops ;  as  an  emetic,  half  a  dram  to  a  dram ;  tincture,  half  an  ounce 
to  an  ounce  and  a  half;  wine  of  ipecac,  three  ounces  to  one  pint  o! 
sherry  wine,  dose,  a  quarter  to  half  a  dram,  as  an  expectorant ;  two 
and  a  half  to  five  drams  as  an  emetic.  The  following  is  a  useful  ex- 
pectorant for  young  children :  fluid  extract  of  ipecac,  two  drams ; 
syrup  of  tolu,  five  drams ;  mucilage  of  gum  arable,  one  ounce  ;  sherry 
wine,  three  drams, —  mix.     Dose,  one  dram. 

Iron  (Ferrum).  —  As  this  is  the  most  abundant,  so  it  is  the  most 
useful  of  all  the  metals.  It  is  widely  diffused  through  the  mineral, 
the  vegetable,  anc.  the  animal  kingdoms.  It  is  an  essential  constitu- 
ent in  the  blood  <  f  man,  and  as  a  medicine  it  has  great  value,  being 
a  powerful  tonic.  In  most  cases  where  the  blood  is  thin  and  reduced, 
iron  is  our  best  remedy ;  it  raises  the  pulse,  promotes  the  secretions, 
and  gives  color,  body,  and  nutritive  qualities  to  the  blood.     It  is  mucli 


^f^^^yl 


used,  in  some  one  of  its  prepared  forms,  in  chronic  aneemia,  chlorosis, 
hysterics,  whites,  rickets,  chorea,  dyspepsia,  neuralgia,  and  particularly 
consumption.  The  following  are  most  of.  the  chemical  preparations 
of  iron  used  in  medicine. 

Ammoiiio-Citrrtte  of  Iron  {Ferri  Ammonio-Citras). —  This  is  in  the 
form  of  thin  scales,  of  a  beautiful,  garnet-red  color,  and  has  a  slightly 
acid  taste.  It  is  very  soluble  in  water.  Its  great  solubility  gives  it 
lome  advantages  over  the  citrate.  The  dose  is  five  grains,  three  timea 
a  day,  in  solution. 

Black  Oxide  of  Iron  {Ferri  Oxiduni  Nigrum).  —  This  is  a  dark, 
grayish-black  powder,  unchangeable  in  the  air,  and  having  magnetic 
properties.  It  is  a  valuable  chalybeate,  and  may  be  given  in  five  to 
fifteen-grain  doses. 

Citrate  of  Iron  (Ferri  Citras).  —  This  is  a  valuable  preparation  of 
iron.  It  is  soluble  in  water.  Usually  given  in  the  form  of  pill,  in 
two  to  five  grain  doses,  three  times  a  day. 

Citrate  of  Iron  and  Quinia  (Ferri  et  Quinm  Citras).  —  In  the  form 
of  shining  scales,  garnet-colored,  and  soluble  in  water.  An  excellent 
antiperiodic  and  tonic.  Given  in  intermittents,  when  the  blood  is  low, 
etc.    Dose,  five  to  ten  grains,  two  or  three  times  a  day. 

Citrate  of  Iron  and  Strychnia.  —  Dr.  James  R.  Nichols  &  Co.,  of 
this  city,  were  the  first  to  introduce  this  combination  of  strychnia 
with  iron,  to  American  physicians.  It  is  a  valuable  preparation,  and 
is  constantly  winning  the  favor  of  the  profession.  It  combines  the 
properties  of  iron  and  strychnia,  and  has  proved  an  efficacious  remedy 
in  atonic  dyspepsia,  absence  of  tlie  menses,  St.  Vitus's  dance,,  green- 
sickness, hysterics,  etc.  It  is  a  beautiful  salt,  looking  like  citrate  of 
iron,  except  that  it  is  a  little  darker.  Three  grains  of  the  iron  are  com- 
bined with  one  sixteenth  of  a  grain  of  strychnia. 

Hydratcd  Oxide  of  Iron  (Ferri  Oxidmn  HydrcUum).  —  This  is  in 
a  reddish-brown,  moist  mass,  not  much  used  in  medicine,  except  as 
an  antidote  to  the  poison  of  arsenic,  for  which  it  is  very  valuable.  It 
should  be  given  in  tablespoonful  doses,  often  repeated. 

Iodide  of  Iron  (Ferri  lodidum).  —  The  iodide  of  iron  is  a  crystalline 
lubstance,  of  a  greenish-black  color,  and  styptic  taste.  It  has  tonic, 
alterative,  diuretic,  and  emmenagogue  properties.  It  is  employed 
chiefly  in  scrofulous  complaints,  swelling  of  the  glands  of  the  nee!:, 
chlorosis,  absence  of  the  menses,  and  leucorrhoea.  In  obstinate  syph- 
ilitic ulcers,  and  in  secondary  syphilis,  occurring  in  scrofulous  and 
debilitated  subjects,  it  has  been  used  with  success.  Dose,  three  grains, 
gradually  increased  to  eight.  It  should  never  be  givep  in  the  form 
of  pill. 

Lactate  of  Iron  (Ferri  Lactas). —  This  has  the  general  medicinal 
propv-rties  of  the  ferruginous  preparations.  It  increases  the  appetite 
in  a  marked  degree,  and  has  been  used  with  decided  benefit  in  chlo- 
rosis. Dose,  one  to  three  grains,  three  times  a  day.  The  dose  may 
be  gradually  increased.    Given  in  the  form  of  solution,  pill,  or  lozenge. 


634 


MEDICINES  AND  THEIR  PREPARATIONS. 


Phmphate  of  Iron  (Ferri  Phosphas).  —  This  is  a  slate-colored  pow< 
cler,  insoluble  in  water.  It  is  a  ^raluable  remedy  in  consumption, 
cancer,  and  nervous  diseases,  accompanied  by  a  low  state  of  the 
blood.     Dose,  one  or  two  grains,  three  times  a  day. 

Per  8alt  of  Iron  {Mansers  Styptic).  —  This  is  a  most  valuable  styp. 
tic,  and  is  used  with  success  in  restraining  violent  bleedings.  It  pro- 
duces no  irritant  effects  upon  the  tissues,  and  may  be  used  with  safety 
both  in  slight  and  extensive  surgical  operations.  Physicians  should 
have  it  by  them,  and  will  find  it  very  serviceable  in  sudden  emergen- 
cies of  bleeding.  It  is  prepared  in  solution  and  in  the  form  of  dry 
salt,  by  Dr.  James  R.  Nichols  &  Co.,  of  this  city.  The  solution  is  the 
most  convenient  and  eligible  form,  and  may  lie  applied  as  prepared. 

Powder  of  Iron  {Ferri  Pulvis).  —  This  is  whet  is  often  called  iron 
by  hydrogen,  or  Qudvenne's  iron.  It  is  an  irapalpaple  powder,  and  of 
an  iron-gray  color.  If  black,  it  is  worthless.  It  \s  used  in  anaemia, 
and  in  all  those  conditions  characterized  by  deficiency  of  coloring 
matter  in  the  blood.  The  best  metallic  iron  for  medicinal  use.  Dose, 
from  two  to  six  grains,  several  times  a  day ;  to  be  given  in  the  form 
of  pill. 

Precipitated  Carbonate  of  Iron  {Ferri  Subcarbonas).  —  This  is  a 
reddish  powder,  insoluble  in  water.  It  is  tonic,  alterative,  and  em- 
menagogue,  and  is  used  in  neuralgia,  chorea,  chlorosis,  anemia,  epi- 
lepsy, scrofula,  etc.  Dose,  five  to  thirty  grains,  three  times  a  day,  to 
be  taken  in  a  little  water. 

Protoxide  of  Iron  {Ferri  Protoxidum).  —  This  is  of  a  dark  blue 
color,  and  has  a  tendency  to  absorb  oxygen  from  the  air,  which  con- 
verts it  into  the  sesquioxide.  It  is  a  valuable  preparation  of  iron. 
Dose,  from  two  to  six  grains,  three  times  a  day. 

Solntion  of  Protoxide  of  Iron. —  The  protoxide  of  iron  being  more 
readily  absorbed  and  assimilated,  and  agreeing  better  with  the  stom- 
ach, than  any  other  preparation  of  this  metal,  has  led  to  a  general  desire 
for  this  salt  in  some  eligible  form,  protected  from  the  chemical  changes 
to  which  it  is  so  liable.  This  desire  has  been  met  by  Dr.  James  R. 
Nichols  &  Co.  of  this  city,  who,  by  a  new  method  of  chemical  ma- 
nipulation, have  prepared  an  unchangeable  solution  of  it,  in  the  form 
of  an  elegant  syrup,  which  is  permanent  in  form,  pleasant  to  the  taste, 
and  free  from  the  inky  flavor  peculiar  to  iron  preparations.  Dr.  Nich- 
ols, one  of  the  most  reliable  practical  chemists  in  the  country,  has 
conferred  a  benefit  upon  the  profession  by  preparing  this  syrup.  1 
have  had  the  pleasure  of  Tsing  it,  with  peculiar  satisfaction.  Dose, 
from  one  to  two  teaspoonfuL ,  three  times  a  day. 

Solntion  Protoxide  Iron,  with  Rlinbarb  and  Colunibo.  —  This  is  a 
composition  of  protoxide  of  iron  with  vegetable  tonics ;  a  combina- 
tion long  desired,  but  just  now,  for  the  first  time  effected,  by  Dr. 
James  R.  Nichols  &  Co.  of  this  city.  As  a  remedy  in  many  forma 
of  dyspepsia,  it  must  prove  of  great  value. 

Solution  Protoxide  Iron,  witli  (Quinine. — This  has  become  a  remedy 


MEDICINES  AND  THEIR  PREPARATIONS. 


625 


of  established  reputation.  Quinine  combined  with  iron,  particularly 
with  the  protoxide,  must  have  great  advantages  as  a  chalybeate  tonic. 
This  is  one  of  the  reliable  preparations  of  Dr.  Nichols.  Each  table* 
spoonful  contains  half  a  grain  of  quinine. 

Solation  Protoxide  Iron,  with  Iodide  of  Potassa.  —  In  this  prepara- 
tion, the  valuable  alterative  properties  of  iodide  of  potassium,  are 
connected  with  iron.  It  is  therefore  alterative  and  tonic,  and  may  be 
Ui«ed  in  scrofulous  and  other  weakened  conditions  of  the  system,  ft 
ia  a  remedy  of  decided  merit.  Three  grains  of  the  iodide  of  potas- 
sium are  contained  in  each  tablespoonful.  This  is  also  prepared  by 
Dr.  James  R.  Nichols  &  Ca 

Sulphate  of  Iron  {Ferri  Sulphas).  —  This  is  in  the  form  of  transpa- 
rent crystals,  of  a  pale,  bluish-green  color,  and  efflorescent  in  the  air. 
It  has  a  styptic  taste,  and  is  soluble  in  about  twice  its  weight  of 
cold  water,  but  insoluble  in  alcohol.  It  is  astringent  and  tonic.  In 
large  doses,  it  produces  nausea  and  griping  of  the  bowels.  Useful  in 
scrofula,  and  as  an  astringent,  in  passive  hemorrhages,  sweats,  dia- 
betes, chronic  mucous  catarrh,  leucorrhoea,  and  gleet.  As  a  tonic,  it 
18  useful  in  dyspepsia. 

Syrap  of  Iodide  of  Iron  ( Syrupus  lodidi  Ferri).  —  This  is  an  ele- 
gant preparation  of  iodine  and  iron,  and  is  given  in  all  debilitated 
conditions  of  the  system,  when  there  is  a  taint  of  scrofula.  Dose, 
from  twenty  to  fifty  drops,  well  diluted,  at  the  moment  of  taking,  with 
water. 

Syrup  of  Iodide  Iron  and  Hangfauese.  —  This  is  of  a  light  straw 
color,  prepared  from  protosulphate  of  iron,  protosulphate  of  manga- 
nese, and  iodide  of  potassium.  It  is  a  remedy  of  unsurpassed  effi- 
cacy in  aneernic,  scrofulous,  syphilitic,  and  cancerous  affections.  It 
is  considered  superior  to  the  syrup  of  iodide  of  iron.  This  is  another 
of  Dr.  J.  R.  Nichols  &  Co.'s  valuable  preparations.  Dose,  from  ten 
to  sixty  drops. 

Tartrate  of  Iron  and  Potassa  {Ferri  et  Potasses  Tartras). — This  is  in 
the  form  of  beautiful  shining  scales,  of  a  dark  ruby  color,  of  a  slight'y 
chalybeate  taste,  and  very  soluble  in  water.  It  is  one  of  the  milcl- 
est  of  the  salts  of  iron,  and  is  considerably  use^  in  scrofula,  weak- 
ness of  the  bowels,  general  debility,  etc.  It  is  much  used  of  late,  as 
a  remedy  for  syphilis,  both  externally  and  internally.  The  dose  is 
ten  to  thirty  grains  in  solution. 

Tincture  of  Muriate  of  Iron  ( Tinctura  Ferri  Chhridi).  —  This  has 
a  reddish-brown,  yellowish  color,  a  sour  and  very  styptic  taste,  and  an 
odor  like  muriatic  ether.  It  '\9  one  of  the  most  active  and  certain  pre- 
parations of  iron,  generally  agreeing  with  the  stomach,  and  much 
employed  for  purposes  for  which  iron  is  used.  It  is  useful  in  scrofula, 
gleet,  and  leucorrhoea  ;  also  in  hemorrhages  from  the  womb,  kidneys, 
and  bladder,  of  a  passive  character.  Dose,  from  ten  to  thirty  drops, 
gradually  increased  to  one  or  two  drams,  two  or  three  times  a  day. 
It  should  be  given  diluted  with  water. 
^  79 


mmm 


Talerianatd  of  Iron.. — .This  salt  is  in  the  forrn  of  a  dark-red  pow. 
der,  having  a  faint  odor,  and  a  taste  of  valerianic  acid.  It  is  soluble 
in.  alcohol,  and  .insoluble  in  water.  Given  in  hysterical  affections, 
complicated  with  chlorosis.     Dose,  one  grain,  several  times  a  day. 

Isinglass  {Ichthyocolla).  —  A  gelatinous  substance,  prepared  from 
the  bladder  of  iishes.  It  is  soluble  in  alkaline  solutions,  and  diluted 
acids.  In  boiling,  it  (dissolves,  and  forms  a  jelly  upon  cooling,  in  which 
form  it  is  chiefly  used  as  a  nutritive  diet  for  the  sick. 

Jalap  {Ipomcea  Jalapa).  —  This  is  a  Mexican  plant.  Its  root  is  an 
active  cathartic,  producing  liquid  stools,  more  or  less  griping.  United 
with  cream  of  tartar,  it  becomes  a  hydragogue,  and  is  useful  in  dropsy. 
The  dose  is  from  fifteen  to  thirty  grains. 

Preparations.  —  Fluid  extract,  dose,  a  quarter  to  one  dram ;  solid 
extract,  dose,  three  to  eight  grains ;  tincture,  two  ounces  to  the  pint 
diluted  alcohol,  dose,  one  to  two  and  a  half  drams ;  jalapin,  the  active 
principle,  dose,  one  to  two  grains. 

Juniper  (Juniperis  Communis).  —  This  evergreen  shrub  is  a  native 
of  Europe,  and  is  naturalized  in  some  parts  of  this  country.  The 
berries,  which  are  the  part  used,  are  wrinkled,  of  a  dark-purple  color, 
about  the  size  of  a  pea.  They  are  gently  stimulant  and  diuretic,  and 
have  been  used  in  scurvy,  and  inflammation  of  the  bladder,  chiefly  in 
connection  with  more  active  diuretics.  The  oil  of  juniper  obtained 
from  the  berries  is  used  for  similar  purposes.  Five  minims  of  the  oil, 
mixed  with  one  fluid  dram  of  sweet  spirits  of  nitre,  and  given  three 
times  a  day,  is  valuable  in  dropsy.  Dose  of  the  berries,  from  one  to 
two  drams ;  of  the  oil,  from  five  to  fifteen  drops. 

Kino.  —  This  is  the  hardened  juice- of  an  Ea,'t  Indian  tree,  P^cro- 
carpus  Marsupivm.  There  are  several  varieties  of  it.  It  is  a  power- 
ful and  « aluable  astringent,  and  is  much  used  in  diarrhcea,  not  atten- 
ded with  inflammation.  Opium  is  often  united  with  it,  and  it  is  a 
favorite  addition  to  chalk  mixture.  It  is  also  used  in  chronic  dysen- 
tery, leucorrhcea  and  diabetes.  It  may  be  used  in  the  form  of  powder, 
infusion,  or  tincture.  Dose  of  the  powder,  ten  to  thirty  grains ;  of  the 
tincture,  one  or  two  fluid  drams ;  the  infusion  is  useful  as  an  injection, 
in  leucorrhcea  and  gonorrhoea.  The  powder  is  sometimes  sprinkled 
with  advantage  on  indolent  and  flabby  ulcers. 

Ladles'  Slipper  ( Oypripedium  Pubescens).  —  The  fibrous  roots  are 
the  parts  used  of  this  plant.  It  is  tonic,  nervine,  and  antispasmodic, 
and  is  employed  in  nervous  headache,  and  other  nervous  afl'ections,  a? 
excitability,  hysterics,  neuralgia,  etc. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram ;  solid 
extract,  dose,  five  to  fifteen  grains ;  tincture,  two  ounces  to  a  pint  of 
diluted  alcohol,  dose,  half  an  ounce  to  an  ounce ;  cypripedin,  the 
active  principle,  dose,  two  to  four  grains.  The  following  is  a  useful 
preparation  for  producing  sleep,  in  wakeful  and  excited  conditions: 
fluid  extract  ladies'  slipper,  one  ounce ;  fluid  extract  pleurisy  root, 
«ne  ounce;  fluid  extract  skunk  cabbage,  one  ounce;  fluid  extract 


scullcap,  or)e  ounce  ;  mix  ;  dose,  half  a  dram  to  a  dram,  three  times  a 

(lay. 

For  sick  and  nervous  headache,  dependent  on  an  acid  stomach,  the 
following  is  useful :  fluid  extract  ladies'  slipper,  half  an  ounce ;  fluid 
extract  catnip,  half  an  ounce;  fluid  extract  scuUcap,  half  an  ounce; 
water,  one  pint ;  mix  ;  dose,  one  and  a  half  to  three  drams. 

Lead  {Plumbum).  —  Lead  acts  u|X)n  the  system  as  a  sedative  and 
astringent.  Internally,  it  is  used  for  the  purpose  of  reducing  the  force 
of  the  circulation,  and  for  restraining  improper  bleeding,  and  other 
excessive  discharge -j.  Externally,  it  is  employed  to  subtiue  inflamrna- 
tion.  It  should  not  be  excessively  used  ;  for,  if  taken  internally  for  a 
long  time,  it  injures  the  nervous  system,  and  brings  on  apoplexy, 
palsy,  and  particularly  lead  colic.  Nature  generally  gives  notice  when 
H  is  doing  mischief,  by  drawing  a  blue  line  around  the  edge  of  the  gum. 
The  preparation  of  lead  chiefly  used  in  medicine  is  the  following: 

Acetate  of  Lead  (Plumbi  Acetas).  —  This  is  known  by  the  name 
of  sugar  of  lead,  and  is  a  white  salt,  crystallized  in  brilliant  needles. 
It  has  first  a  sweetish,  and  then  an  astringent  taste.  In  medicinal 
doses,  it  is  a  powerful  sedative  and  astringent ;  in  large  ones,  an  irri- 
tant poison.  It  is  principally  used,  internally,  for  bleeding  from  the 
hings,  bowels,  and  womb.  The  dose  is  generally  two  grains,  united 
to  half  a  grain  to  a  grain  of  opium,  in  the  form  of  pill.  Externally, 
ft  is  employed  in  form  of  solution,  and  applied  to  inflamed  surfaces 
mih  cloths.  Four  grains  of  sugar  of  lead,  and  four  of  pulverized 
opium  to  the  pint  of  water,  makes  a  good  lotion  for  various  purposes. 

Lemon  {Citrus  Limonum).  —  This  is  a  well-known  tropical  fruit, 
the  juice  of  which  has  a  grateful  acid  taste,  which  is  much  used  in 
fevers  and  inflammatory  complaints,  to  form  the  agreeable  drink 
called  lemonade.  The  oil  of  lemon,  obtained  from  the  fresh  rind 
of  the  fruit,  is  chiefly  used  in  perfumery,  and  to  render  the  taste  of 
medicines  more  agreeable. 

Lettuce  (Lactu^a  Sativa).  —  The  medicinal  properties  of  this  gar- 
den plant  are  contained  in  the  milk.  It  is  given  when  opium  disa- 
grees with  the  patient,  to  allay  cough  and  irritability. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  two  drams ; 
BoKd  extract,  dose,  two  to  five  grains.  The  following  is  a  usi:ful  com- 
pound syrup :  fluid  extract  lettuce,  two  ounces ;  fluid  extract  poppy, 
four  ounces ;  simple  syrup,  ten  ounces ;  mix  ;  dose,  half  a  dram  to  a 
dram. 

Life  Root  ( Senecio  Aureus).  —  This  is  a  perennial  plant,  growing 
on  the  banks  of  marshy  creeks,  in  the  Northern  and  Western  States, 
and  sometimes  called  Ragwort.  Both  the  root  and  herb  are  diuretic, 
pectoral,  diaphoretic,  and  tonic,  considerably  valued  as  a  remedy  in 
gravel,  and  other  urinary  affections,  particularly  strangury.  It  is  use* 
ml  for  promoting  menstrual  discharges. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram ;  infa- 
■ioi\  dose,  one  to  four  ounces ;  senecin,  the  active  principle,  dose, 


Kr 


628 


MEDICINES  AND  THEIR  PRBPABATIONS. 


three  to  five  grains.  For  chlorosis,  accompanied  by  absence  of  the 
menses,  the  following  is  a  useful  preparation  :  senecin,  aletrin,  and 
sulphate  of  iron,  four  grains  each.  Mix,  «..:d  divide  into  two  grain 
powders.  Six  grains  each  of  senecin  and  geraniin,  inixed,  and  taken 
in  doses  of  two  to  four  grains,  has  a  good  effect  in  restraining  an 
immoderate  flow  of  the  menses.  In  painful  menstruation  the  follow* 
ing  is  a  good  pill :  senecin,  two  grains ;  quinino,  six  grains ;  solid 
extract  belladonna,  three  grains ;  make  into  ten  pills,  and  take  one 
every  three  hours,  till  the  pain  is  subdued. 

Lime  (Calx).  —  This  is  one  of  the  alkaline  earths,  and  is  an  abnn< 
dant  natural  production.  It  is  used  in  several  forms  in  medicine,  of 
which  the  following  are  the  chief. 

Chloride  of  Lime  ( Calx  Chlorinata).  —  This  is  a  moidt,  grayish* 
white  substance,  having  the  odor  of  chlorine,  and  possessing  powerful 
bleaching  properties.  Externally  used,  it  is  disinfectant,  and,  dis* 
solved  in  water,  is  applied  with  advantage  to  ill-conditioned  ulcers, 
burns,  chilblains,  and  eruptions  of  the  skin,  also  as  a  gargle  in  putrid 
sore  throat,  and  as  a  wash  for  ulcerated  gums,  and  to  purify  the 
breath.  It  has  been  used  with  advantage  in  dysentery,  both  by  month 
and  injection,  to  correct  the  fetor  of  the  stools. 

Lime  Water  (Aqua  Calcis).  —  This  is  made  by  dissolving  four 
ounces  of  lime  in  a  gallon  of  water,  and  letting  the  solution  stand 
in  a  covered  vessel,  and  pouring  off  the  clear  liquor  when  it  is  w^anted 
for  use.  It  is  antacid,  antilithic,  tonic,  and  astringent,  valuable  in  all 
complaints  attended  with  acidity  of  the  stomach.  United  with  milk, 
and  used  as  the  sole  diet,  it  is  sometimes  the  only  remedy  for  chronic 
diarrhoea  of  long  standing.  Dose  ,of  lime  water,  half  an  ounce  to 
two  ounces. 

Liquorice  (Glycyrrhiza  Glabra).  —  This  grows  in  the  south  of 
Europe  and  Asia.  The  root  is  the  part  used.  It  is  demulcent  and 
expectorant,  and  is  useful  in  cough,  chronic  bronchitis,  and  irritations 
of  the  mucous  surfaces  generally.  The  pulverized  root,  united  with 
an  equal  amount  of  sulphur,  and  a  little  molasses,  is  a  valuable  pre- 
paration  for  coughs.  The  black  extract  may  be  used  for  the  same 
purposes  as  the  root. 

Liverwort  {Hepatica  Americana). —  An  indigenous  plant,  growing 
in  woods,  upon  the  sides  of  hills  and  mountains.  The  leaves  with- 
stand the  cold  of  winter,  and  the  flowers  appear  early  in  the  spring. 
The  whole  plant  is  medicinal.  It  is  a  mild  demulcent  tonic  and  as- 
tringent, and  has  been  ui«ed  in  fevers,  liver  complaints,  bleeding  from 
the  lungs,  and  coughs. 

Preparations.  —  Fluid  extract,  dose,  two  to  three  drams;  infusion, 
four  ounces  to  the  pint  of  water,  to  be  taken  freely. 

Lobelia  {Lobelia  Inflata). —  This  weed  grows  throughout  the  United 
States ;  both  its  seeds  and  leaves  are  used  in  medicine.  The  plant  is 
emetic,  expectorant,  sedative,  and  antispasmodic.  As  an  emetic,  it  is 
generally  used  in  combination  with  other  articles  for  that  purpose. 


MEDICINES  AMD  THEIR  PREPARATIONS. 


629' 


I  of  the 
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It  is  of  great  advantage  in  spasmodic  asthma,  as  well  as  in  bronchitis, 
cronp,  hooping-cough,  and  other  throat  and  chest  aflections.  When> 
ever  relaxation  is  required  to  subdue  spasm,  or  for  other  purposes, 
lobelia  will  be  found  useful. 

Preparations.  —  Fluid  extract,  dose,  as  an  expectorant,  ten  to  sixty 
drops ;  as  an  emetic,  one  fourth  of  a  dram  to  a  dram ;  tincture,  two 
ounces  to  a  pint  of  diluted  alcohol,  dose,  as  an  expectorant,  one  to 
three  drams,  as  an  emetic,  half  an  ounce  ;  infusion,  dose,  an  ounce 
every  half  hour  till  vomiting  ensues ;  lobelin,  the  active  principle,  dose, 
half  a  grain  to  a  grain  and  a  half.  The  following  mixture  will  be 
found  excellent,  as  an  expectorant  and  sudorific,  in  spasmodic  croup, 
hooping-cough,  and  asthma,  and  for  subduing  mucous  inflammation 
about  the  throat  and  air  passages  :  tincture  of  lobelia,  half  an  ounce; 
tincture  of  bloodroot,  two  ounces ;  oil  of  spearmint,  half  a  dram  ; 
empyreumatic  syrup,  five  ounces ;  dose,  half  a  dram  every  two  hours. 
A  poultice  made  of  lobelia,  elm  bark,  and  weak  lye,  relieves  sprains, 
bruises,  rheumatic  pains,  erysipelatous  inflammations,  and  poison 
from  ivy  or  dogwood. 


FiQ.  aoo. 


Kio.  210. 


LADIES'  BLIPFBB. 


LOBSUA. 


Lo^ood  {Haniatoxylon  Campechianum).  —  This  tree  is  a  native  of 
tropical  America.  The  wood  is  used  in  medicine.  It  is  tonic  and 
astringent,  and  is  used  with  advantage  in  diarrhoea,  dysentery,  and  in 
the  relaxed  state  of  the  bowels  after  cholera  infantum.  Used  freely 
with  other  treatment,  it  also  benefits  constitutions  broken  down  by 
disease  or  dissipation. 

Preparations.  ^ —  Fluid  extract,  dose,,  half  a  dram  to  a  dram  ;  solid 
extract,  dose,  five  to  thirty  grains ;  infusion,  half  an  ounce  to  a  pint 
of  water,  dose,  four  drams  every  three  or  four  hours,  in  diarrhoea. 

Magnesia  {Magnesia  Usta).  —  Calcined  magnesia  is  obtained  from 
carbonate  of  magnesia,  by  exposure  to  a  strong  h<eat.  It  is  a  white, 
inodorous,  light  powder,  of  a  feeble  alkaline  taste.  It  is  antacid  and 
laxative,  and  is  much  used  in  dyspepsia,  sick  headache,  gout,  and  in 
other  complaints  attended  with  sour  stomach  and  costiveness ;  like- 
wise a  favorite  remedy  in  complaints  of  children.    Dose,  as  a  laxative, 


i 


'  SEP 


630 


MEDICINES  AND  THEIR  PREPARATIONS, 


from  thirty  to  sixty  grains ;  as  an  antacid,  or  antilithic,  ten  to  thirty 
grainH,  once  or  twice  a  day. 

farboiiute  of  Mairn^^ia  {Magnesia;  Carbonas).  —  This  is  prepared 
from  sulphate  of  magnesia,  by  carbonate  of  soda.  It  is  antacid,  and 
when  it  meets  with  acid  in  the  stomach  and  bowels,  it  is  laxative. 

Sulpliiife  of  lllii|(iie8iu  {Mag'tiesuc  Sulphas).  —  Obtained  from  sea- 
water.  This  is  the  well-known  Epsom  salts  and  is  purgative  and 
diuretic.  Us(?d  in  all  cases  which  requin;  purgatives.  It  generally 
operates  without  griping,  and,  when  united  with  an  acidulated  infu- 
sion of  roses,  will  renr.iin  on  the  stomach  when  all  other  things  are 
rejected.  The  less  it  is  diluted,  the  better  and  more  easily  it  operat«\s, 
provided  a  draught  of  warm  water  be  taken  an  hour  afterwards.  It 
may  be  made  to  act  as  a  diuretic,  by  keeping  the  skin  cool,  and  walk- 
ing about  after  it  has  been  taken. 

Mule  Vemf{Aspidiuvi  Filix  Mas).  —  This  perennial  |)lant  is  found  in 
both  Europe  and  America,  also  in  Asia  and  northern  Africa.  The 
root,  which  is  th(!  medicinal  part,  should  be  gathered  during  summer, 
as  the  active  principle  is  more  abundant  at  that  season  than  any 
other.  It  is  also  said  to  deteriorate  by  age,  and  become  nearly  worth- 
less in  two  years.  It  is  slightly  tonic  and  astringent,  but  its  chief 
value  consists  in  its;  power  to  destroy  and  expel  the  .tapeworm. 

Pr eparatians. —  Solid  extract,  dose,  nine  to  fifteen  grains.  The  fol- 
lowing compound  pills  are  adapted  to  the  destruction  of  the  tape- 
worm :  solid  extract  male  fern,  two  scruples ;  gamboge,  fourtetin 
grains ;  calomel,  fourteen  grains ;  scammony,  eighteen  grains.  Mix, 
and  divide  into  twenty  pills.     Dose,  two  to  four  pills. 

Handrake  {Podaphyllum  Peltatum).  —  This  is  exclusively  an  Ameri- 
can plant.  The  root  is  the  medicinal  part.  It  is  cathartic,  alterative, 
anthelmintic,  hydragogue,  sialagogue,  and,  in  large  doses,  emetic.  It 
stimulates  and  quickens  the  action  of  the  liver  and  kidneys,  promotes 
expectoration,  and  determines  the  blood  to  the  surface.  Combined 
with  cream  of  tartar,  it  produces  watery  stools,  and  is  useful  in  dropsy. 
It  is  used  in  jaundice,  dysentery,  diarrhoea,  bilious,  remittent,  and  in- 
termittent fevers,  puerperal  fever,  typhoid  fever,  and  all  glandular 
enlargements.  But  it  has  a  more  particular  action  upon  the  liver, 
and  is  especially  useful  in  derangements  of  that  organ. 

The  severity  of  its  action  seems  to  be  the  only  objection  to  its  very 
extensive  use.  Its  harshness,  however,  may  be  much  lessened  by.ite 
combination  with  castile  soap,  alkalies,  ginger,  or  caulophyllin. 

Preparations. —  Fluid  extract,  dose,  half  a  dram  to  a  dram;  com- 
pound fluid  extract,  dose,  one  to  two  drams ;  solid  extract,  dose,  three 
to  twelve  grains;  tincture,  three  and  a  half  ounces  to  one  pint  of 
alcohol,  dose,  one  to  four  drams;  podophyllin,  the  active  principle, 
dose,  as  an  alterative,  one  eighth  to  a  quarter  of  a  grain ;  as  a  cathar- 
tic, one  to  two  grains.  • 

Manna.  —  This  is  the  concrete  juice  of  the  tree  called  Omus 
Europa;a,  growing  in  Sicily,  Calabria,  and  Apulia,  as  well  as  of  several 
other  species  of  tree.     Manna  is  a  gentle  laxative,  operating  mildly, 


itt= 


ml 


MEDICINES  ANii  THEIR  PREPAHATIONS. 


6in 


though  sometimes  producing  wind  and  pain.  It  is  considerably  used 
as  a  gentle  physic  for  children,  and  women  in  the  family  way.  The 
usual  way  of  prescribing  it  is  in  connection  with  senna,  rhubarb,  mag- 
nesia, or  the  neutral  salts.  Being  sweet,  it  conceals  the  taste  of  these 
remedies,  in  some  measure,  while  it  adds  to  their  purgative  effect 
Dose  of  mamia,  for  a  grown  person,  from  one  to  two  ounces ;  for  a 
child,  from  one  to  four  drams,  according  to  age.       . 

llltirHh  Rosi'iiiiiry  {Sta/icc  Caro/iniana).  —  This  plant  grows  on  the 
coast  from  Maine  to  (ieorgia.  The  root  of  it  is  the  medicinal  part. 
A  decoction  of  it  is  much  used  in  diarrho-a,  dysentery,  et(r.,  also  as  a 
gargle  in  ulcerated  sor(!  mouth,  and  the  throat  all'eirtion  of  searlel, 
fever,  and  as  an  inje(rtion  in  gleet,  whites,  and  falling  of  tlic^  womb, 
and  bowel.  Dose  of  the  decoction,  one  or  two  tablespoonfuls,  every 
hour  or  two.  . 


FiQ.  211. 


Fiu.  212. 


MANDUAKK. 


MARSHMALLOW. 


Harshmallow  {Althcca  Officinalis).  —  A  perennial  plant,  growing  in 
salt  marshes,  and  other  moist  places,  in  Europe.  The  root  is  the 
medicinal  part,  and  its  properties  are  those  of  a  demulcent  A  decoc- 
tion of  it  is  used  in  irritations  and  inflammations  of  mucous  mem- 
branes, as  in  inflammation  of  the  lungs,  stomach,  bowels,  and  bladder, 
and  some  affections  of  the  kidneys.  The  powdered  root,  and  also  the 
leaves  and  flowers,  are  sometimes  employed  in  the  form  of  poultice. 

Mastic'li.  —  This  is  the  hardened  gum  or  resin  which  flows  from 
incisions  in  the  snjall  tree  or  shrub  pislacia  fenHsc»s,  growing  upon 
the  borders  of  the  Mediterranean.  It  is  not  much  used  in  medicine, 
but  is  chiefly  employed  in  manufacturing  a  brilliant  varnish.  I  intro- 
duce it  here  principally  for  the  purpose  of  '•ecommending  the  follow- 
ing use  of  it  in  carious  teeth,  —  particularly  ii.  those  new  parts  of  the 
country  where  dentistry  is  not  much  known.  Dissolve,  in  a  well- 
stopped  bottle,  four  parts  of  mastich  in  one  part  of  sulphuric  ether. 
Saturate  with  this  solution  a  small  piece  of  cotton  of  the  size  of  the 
cavity  in  the  tooth,  and  then,  having  cleansed  and  dried  the  cavity, 
gently  press  the  cotton  into  it.  The  eilier  will  soon  evaporate,  and 
leave  the  gum  to  attach  itself  to  the  sides  of  the  tooth,  and  protect 
its  inner  surfaces  from  the  action  of  the  air  and  food. 


S:^     :,■  ■ 


M 


632 


MEDICINES  AMD  THEIR  PREPARATIONS. 


Matico  {Piper  Angustifolium). — The  leaves  of  this  plant  are  styptic, 
and  somewhat  stimulant  and  tonic.  The  leaves  brought  in  contact 
with  a  bleeding  wound,  have  considerable  power  to  arrest  the  fiow  of 
blood. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram  ;  tinc- 
ture, four  ounces  to  a  pint  of  diluted  alcohol,  dose,  two  drams  to  an 
ounce ;  infusion,  half  an  ounce  to  a  pint  of  water,  dose,  one  to  two 
ounces. 

Mendow  Saffron  ( Colchicum  Autumnale).  —  This  is  a  native  of  the 
temperate  parts  of  Europe,  where  it  grows  wild  in  moist  meadows. 
The  roots  and  seeds  are  used.  Colchicum  is  justly  regarded  as  a 
valuable  remedy  in  gout  and  rheumatism,  in  which  it  is  much  and 
chiefly  used.  It  is  thought,  also,  to  act  upon  the  nervous  system, 
allaying  pain,  and  producing  other  sedative  effects.  When  not  car- 
ried off  by  the  bowels,  it  produces  sweating,  and  is  occasionally 
diuretic  and  expectorant.  Dose  of  the  dried  root,  from  two  to  eight 
grains. 

Preparations.  —  Fluid  extract  of  root,  dose,  three  to  twelve  drops ; 
fluid  extract  of  seeds,  dose,  five  to  fifteen  drops  ;  tinctuie.  four  ounces 
to  twelve  ounces  diluted  alcohol,  dose,  ten  drops  to  half  a  dram; 
syrup,  two  ounces  to  fourteen  ounces  simple  syrup,  dose,  one  third  of 
a  dram  to  a  dram  ;  wine,  three  ounces  of  root  to  a  pint  of  sherry  - 
wine,  dose,  thirty  to  forty  drops. 

Monk's  Hood  {Aconite).  —  This  is  anodyne,  sedative,  and  diapho- 
retic The  leaves  ?•  '  root  are  generally  used  separately.  It  is  use- 
ful in  inflammatory  diseases,  neuralgia,  epilepsy,  paralysis,  gout,  and 
particularly  in  fevers. 

Preparations.  —  Fluid  extract,  dose,  two  to  six  drops  ;  solid  extract, 
dose,  one  quarter  of  a  grain  to  a  grain  ;  tincture,  eight  ounces  of  the 
root  to  a  pint  of  alcohol,  dose,  three  to  eight  drops. 

A  preparation  composed  of  one  dram  of  the  tincture  of  aconite 
root,  and  two  ounces  of  the  tincture  of  black  cohosh,  and  taken  in 
doses  of  one  teaspoonful  every  four  hours,  has  great  power  in  reliev- 
ing the  various  forms  of  neuralgia,  and  also  chronic  rheumatic  painx, 
particularly  among  old  people. 

For  nervous  headache,  irritability,  restlessness,  and  wakefulness,  the 
following  combination  of  aconite  is  useful : 

Solid  extract  of  aconite,  half  a  dram  ;  solid  extract  of  stramonium, 
four  grains ;  valerianate  of  quinia,  one  scruple.     Mix,  and  divide  into 
sixty  pills,  of  which  one  is  to  be  taken  every  two,  three,  or  four  hours, ' 
according  to  symptoms. 

Motherwort  {Leonurus  Cardiaca).  —  This  perennial  plant  is  sup- 
posed to  be  a  native  of  Tartary,  and  introduced  into  this  country. 
It  is  considerably  used  in  domestic  practice,  for  nervous  complaints^ 
and  many  chronic  disorders  attended  with  restlessness,  disturbed 
sleep,  pains  of  the  nerves,  and  affections  of  the  liver.  A  warm  infu- 
sion of  the  tops  and  leaves  is  useful  in  restoring  menstrual  suppres- 
aion  from  coldk 


MEDICINES  AND  THEIB  PREPARATIONS. 


63» 


Preparation.  —  Solid  extract,  dose,  three  to  six  grains.  Ck)mbfned 
with  blue  cohosh  and  skunk  cabbage,  the  solid  extract  is  a  nervine, 
antispasmodic,  and  emmenagogue. 


Fio.213. 


110.314. 


"^■^^'^ 


MEADOW  BAFFBOH. 


MOUIITAIII  LAnBRL. 


Moimtaiii  Lnurel  {Kalmia  LatifoHa).  —  The  laurel  is  found  in  most 
parts  of  the  United  States,  on  hills  and  mountains,  flowering  in  June 
and  July,  and  is  very  ornamental.  It  is  sometimes  called  big  ivp,  or 
calico  bush.  The  narrow-leaf  laurel,  or  sheep  laurel,  kalmia  ang^sti- 
folia,  is  also  common,  and  similarly  medicinal.  The  leaves  of  these 
plants  are  used  in  medicine,  and  produce,  when  taken  in  large  doses, 
vertigo,  dimness  of  sight,  etc.  In  medicinal  doses,  they  are  sedative  and 
astringent.  The  saturated  tincture  is  the  best  form  of  administration, 
which  may  be  taken  in  ten  to  twenty-drop  doses,  every  two  or  three 
hours,  in  syphilis,  active  hemorrhages,  hypertrophy  of  the  heart,  and 
jaundice. 

Hullein  ( Verbascum  Thapsus). — The  leaves  and  flowers  of  this  bien- 
nial plant  are  antispasmodic,  diuretic,  and  demulcent.  The  infusion 
is  frequently  used  in  domestic  practice,  and  is  useful  in  colds,  coughs, 
bronchitis,  etc. ;  and  may  be  drank  freely.  The  leaves  are  sometimes 
boiled  in  milk,  sweetened,  and  taken  for  bowel  complaints.  The 
leaves,  dipped  in  hot  vinegar  and  water,  are  very  useful,  applied  as  a 
fomentation  in  mumps,  acute  inflammation  of  the  tonsils,  and  malig- 
nant sore  throat ;  a  handful  of  them  may  also  be  placed  in  an  old  tea- 
pot, with  hot  water,  and  the  steam  be  inhaled  through  the  spout,  ia 
the  same  complaints. 

Hustdrd.  —  The  seeds  of  the  white  mustard,  sinapis  alba,  were,  a 
few  years  ago,  much  recommended  as  a  cure  for  constipation  cf  the 
boweK  ;  and,  swallowed  \vrhole,  in  teaspoonful,  or  even,  in  someobsti- 
nate  cases,  in  tabiespoonful  doses,  they  iflbrd  a  wholesome  stimulus 
to  the  bowels,  and  accomplish  some  good.  The  ground-mustard  is  a 
valuable  condiment  to  eat  in  small  quantities,  at  dinner,  in  dyspeptic 
caees.  It  iinds  its  most  important  uses,  however,  as  a  prompt  and 
almost  instantaneous  emetic  in  cases  of  poisoning,  and  also  as  a  val- 
uable counter-irritant,  when  applied  externally.  The  volatile  oil  of 
mustard^  one  part,  and  ten  parts  of  sweet  oil,  may  be  applied  to  the 
■kin,  instead  of  the  mustard  poultice,  and  with  similar  results. 


l:f- 


Myrrh.  —  The  tree  baliamodendron  mprrha,  growing  in  Arabia,  etc^ 
yields  a  juice  which  hardens  into  a  gum-resin,  called  myrrh.  This 
pleasant,  aromatic  gum,  is  stimulant,  tonic,  antiseptic,  emmenagogue, 
and  expectorant.  It  is  employed  in  chronic  bronchitis,  consumption, 
ohlorosis,  absence  of  the  menses,  etc.  It  is  generally  combined  with 
iron  and  other  tonics,  and  in  amenorrhcea,  is  frequently  combined 
with  aloes.  Locally,  it  is  considerably  used  as  a  wash  to  improve 
spongy  gums,  ulcers  of  the  mouth,  etc.  The  dose  is  from  ten  to  thirty 
grains,  to  be  given  in  pill,  or  in  powder  suspended  in  water.  The 
tincture  of  myrrh  is  a  useful  external  application. 

Naptha.  —  This  belongs  to  the  class  of  native  inflammable  sub- 
stances, called  bitumens.  It  is  a  transparent,  yellowish  white,  very 
light  and  inflammable  liquid,  and  is  found  abundantly  in  Persia.  Said 
to  have  been  used  with  advantage  in  Asiatic  cholera.  It  is  composed 
exclusively  of  carbon  and  hydrogen.  Dose,  from  'ten  to  twenty  drops, 
given  in  half  a  glass  of  wine,  or  mint  water.  During  the  formation 
of  coal  gas,  an  artificial  napthia.  is  obtained,  which,  when  purified, 
has  the  property  of  disso.'viiig  India  rubber. 

Medicinally,  it  is  chiefly  used  for  purposes  of  inhalation,  in  affec- 
tions of  the  chest. 

Naphthaline.  —  This  is  obtained  from  a  distillation  of  coal  tar.  It 
18  soluble  in  ether,  alcohol,  naphtha,  and  oils,  but  not  in  water.  It  ia 
an  excellent  expectorant,  particularly  in  cases  of  impending  suffoca- 
tion of  old  persons,  from  chronic  bronchitis ;  also  in  asthma  and  other 
pectoral  affections.  Being  stimulating,  it  is  improper  in  acute  bron- 
chitis, and  pulmonary  inflammation.  The  dose  is  from  ten  to  thirty 
Sains,  given  in  emulsion,  or  syrup,  every  fifteen  minutes,  until  abun- 
^nt  expectoration  takes  place.  A  scruple  of  napthaline,  mixed  with 
five  drams  of  lard,  makes  a  good  ointment  for  psoriasis,  dry  tetter, 
and  leprosy. 

Nitrate  of  Silver  {Argenti  Nitras). —  Nitrate  of  silver  is  a  solution 
of  silver  in  nitric  acid,  and  commonly  passes  under  the  name  of  lunar 
caustic.  It  is  both  in  the  form  of  small  cylindrical  rods,  and  of  crys- 
tals, the  latt«r  being  more  pure  than  the  former. 

As  an  internal  remedy,  nitrate  of  silver  is  tonic  and  antispasmodic, 
and  is  given  chiefly  in  nervous  diseases,  as  epilepsy,  StVitus's  dance, 
and  neuralgia  of  the  heart;  also  in  some  forms  of  dyspepsia,  attended 
with  pain  in  the  stomach,  and  vomiting.  The  dose  is  from  one  fourth 
to  half  a  grain,  in  the  form  of  pill.  It  should  never  he  taken  regu« 
larly  as  an  internal  remedy,  more  than  three  months,  as  it  is  apt,  after 
long  use,  to  change  the  skin  to  an  indelible  slate  blue. 

But  nitrate  of  silver  is  most  used  as  an  external  remedy,  in  pharyn- 
gitis, laryngitis,  tracheitis,  and  other  chronic  and  acute  inflammations 
of  mucous  membranes.  For  reducing  these  inflammations,  it  is  very 
nearly  a  specific ;  certainly,  it  is  altogether  the  best  remedy  we  h»v*' 
It  fails  in  some  few  cases ;  but  when  skilfully  used  it  itever  does  hann. 
The  solutions  to  be  applied  to  the  throat,  require  to  have  a  strength 
of  from  fifteen  to  a  hundred  and  twenty  grains  to  the  ounce  of  soft 


MEDICINES  AND  THEIR  PREPARATIONS. 


63S 


water.    A  solution  containing  one  to  four  or  more  grains  to  the  ounce 
of  water  is  often  used  in  inflammations  of  the  eye,  gonorrhoea,  etc. 

Xltre  {Potassee  Nitras).  —  Nitre,  which  also  passes  under  the  name 
of  nitrate  of  potassa,  and  saltpetre,  is  both  a  natural  and  artificial 
production.  As  a  medicine,  it  is  refrigerant,  diuretic,  and  diaphoretic, 
and  is  much  used  in  inflammatory  diseases.  It  increases  the  secre- 
tion of  urine  and  sweat,  and  lessens  the  heat  of  the  body,  and  the  fre- 
quency of  the  pulse.  United  with  tartar  emetic  and  calomel,  it  forms 
the  well-known  nitrous  powders,  which  promote  most  of  the  secre- 
tions, particularly  those  of  the  liver  and  skin.  One  of  these  powders, 
constituting  a  dose,  to  be  given  every  two  or  three  hours,  is  composed 
of  eight  grains  of  nitre,  one  fourth  of  a  grain  of  calomel,  and  one 
eighth  of  a  grain  of  tartai*  emetic. 

Sweet  Spirit  of  Xitre  (Spiritus  JEtheris  Nitrici).  —  Sweet  spirit  of 
nitre  is  diuretic,  diaphoretic,  and  antispasmodic.  It  is  deservedly 
much  esteemed  as  a  medicine,  and  is  extensively  employed  in  febrile 
diseases,  either  alone,  or  in  union  with  tartar  emetic,  or  with  spirit  of 
mindercrus.  It  is  often  u  grateful  stimulus  to  the  stomach,  relieving 
naisea  and  vomiting,  and  promoting  sleep.  It  acts  especially  upon 
the  kidneys,  augmenting  the  secretion  of  urine,  and  is  often  given  in 
conjum^tion  with  squills,  digitalis,  and  acetate  of  potassa.  The  dose 
is  a  teaspoonful,  given  in  wafer  every  two  or  three  hours. 

NutDieji;  {Myrhtica  Moschata).  —  The  nutmeg  is  from  a  tree  grow- 
ing in  the  Molucca  Islands.  It  is  stimulant  and  carminative,  and 
somewhat  used  to  remove  flatulency,  as  well  as  to  render  other  medi- 
cines palatable ;  it  is  most  employed,  however,  to  flavor  drinks,  and 
articles  of  diet.  In  large  doses,  it  is  poisonous,  producing  stupor  and 
delirium. 

Kui  Vomic^a  (Stri/chnos  Niix  Vomica).  —  The  tree  which  produces 
nux  vomica,  grows  in  Bengal,  Malabar,  and  the  coast  oi  Cororaandel, 
and  in  other  regions.  The  seeds  are  the  me- 
dicinal-part. 

Nux  vomica  is  an  emphatic  excitant  of  the 
brain  and  spinal  cord,  and,  in  large  doses,  is 
an  active  poison  ;  frequently  repeated  in  small 
doses,  it  is  tonic,  diuretic,  and  slightly  laxative. 

Given  in  full  doses,  it  is  apt  to  produce  miis- 
calar  contraction,  as  in  lock-jaw,  together  with 
frequent  starts  and  twitches,  as  if  from  electric 
shocks.  It  is  much  employed  in  treatment  of 
paralysis,  and  is  more  beneficial  in  general  than 
in  partial  palsy. 

Preparations. —  Fluid  extract,  dose,  two  to 
ten  drops ;  solid  extract,  dose,  half  a  grain  to  two  grains ;  tincture, 
four  ounces  to  the  pint  of  alcohol,  dose,  five  to  fifteen  drops ;  strych- 
nia, commonly  called  strychnine,  the  active  principle,  dose,  one  six- 
teenth to  one  eighth  of  a  grain. 

Oil  of  Ci^eput  ( Oleum  CdJuptUi).  —  This  oil  is  obtained  from  the 


FlO.  21&. 


strx  YomoA. 


I 


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l\ 


'■V 

c      'it  I 


636 


UEDICINES  Ain>  THEIR  PREPARATIONS. 


leaves  of  tlie  East  Indian  tree  cajuputi.  It  is  diaphoretic  and  anti< 
spasmodic,  and  a  powerful  diffusive  stimulant  Given  in  cramps  d' 
the  stomach  and  bowels,  colic,  flatulency,  hysterics,  and  chronic  rheu* 
matism.  It  is  considerably  used  as  an  ingredient  in  liniments,  to  be 
applied  externally  in  rheumatism,  and  neuralgia.  Dose,  from  one  to 
five  drops,  on  sugar. 

OH  of  Turpentine  ( Oleum  TerebirUhina).  —  This  is  generally  called 
spirits  of  turpentine,  and  is  obtained  by  distilling  turpentine.  As  f>. 
medicine,  it  is  stimulant,  cathartic,  diuretic,  anthelmintic,  and  astrin> 
gent.  In  large  doses,  it  causes  strangury,  and  other  unpleasant  symp' 
toms.  The  dose  is  from  five  to  thirty  drops,  repeated  every  two  oi 
three  hours.  Fifteen  drops,  taken  every  fifteen  minutes  or  half  houi 
powerfully  restrains  bleeding  from  the  lungs,  and  is,  perhaps,  the  bes^ 
remedy  we  have  for  this  frightful  accident. 

It  is  also  very  efficacious  in  checking  other  hemorrhages.  Exter- 
nally, it  is  used  considerably  as  an  ingredient  in  liniments  and  rube" 
facients,  in  rheumatism,  paralysis,  etc.  Combined  with  linseed  oil,  it 
is  much  used  for  burns  and  scalds. 

Olive  on  ( Oleum  Oliva).  —  This  oil,  often  called  sweet  oil,  is  ex- 
pressed from  the  fruit  of  the  olive  tree,  Olea  Europece.  It  is  nutrient 
and  emollient,  and  in  doses  of  one  to  two  fluid  ounces,  laxative.  It 
is  much  employed  as  a  constituent  of  cerates,  liniments,  and  plasters. 

Onion  (Allium  Cepa).  —  The  medicinal  properties  of  the  onion  are 
much  like  those  of  garlic.  The  juice,  mixed  with  sugar,  is  used  to 
some  extent  as  -x  remedy  for  the  coughs  and  colds  of  infants.  Roasted 
onions,  applied  as  a  poultice,  hasten  the  suppuration  of  boils,  tumors, 
etc.     They  are  also  useful,  in  some  cases,  applied  as  drafts  to  the  feet 

Opinni.  —  This  is  the  hardened  juice  of  the  unripe  seed  of  the  poppy, 
Papaver  Somniferum.  It  is  a  stimulant  narcotic  A  moderate  dose 
increases  the  fulness  and  frequency  of  the  pulse,  augments  the  warmth 
of  the  skin,  invigorates  the  mu  ;ular  system,  quickens  the  senses,  ani- 
mates the  spirits,  and  gives  energy  to  the  mental  faculties.  Its  opera- 
tion is  directed  with  special  force  to  the  brain,  which  it  sometimes 
excites  to  intoxication  and  delirium,  which  excitement  subsides  in  a 
short  time,  and  is  followed  by  a  delightful  calmness,  and  placidity  of 
mind,  all  care  and  anxiety  being  banished,  and  the  thoughts  yielded 
to  the  control  of  pleasing  fancies.  At  the  end  of  an  hour  or  more, 
this  reverie  is  succeeded  by  sleep,  which,  at  the  end  of  eight  or  ten 
hours,  passes  ofl*,  and  is  followed  by  headache,  nauseia,  tremors,  and 
other  nervous  disturbances.  Large  doses  are  followed  by  shorter 
periods  of  exhilaration  and  excitement,  and  by  more  protracted  sleep^ 

Opium  is  used  in  medicine  to  produce  gentle  perspiration,  relieve 
pain,  and  lessen  nervous  excitability  in  all  febrile  and  inflammatory 
diseases ;  also  as  an  antispasmodic  in  hysterics,  colic,  convulsions, 
coughs,  etc.  It  should  not  be  used  in  cases  of  constipation  of  the 
bowels.  A  solution,  composed  of  two  grains  of  opium  to  one  ounce 
of  water,  is  sometimes  a  valuable  injection  in  gonorrhoea  and  spas- 
modic stricture.    Dose,  as  a  stimulant,  one  quarter  U>  one  half  a  grain.' 


and  anti- 
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mt  syrnp' 
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lalf  houi 
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Exter 
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eed  oil,  it 

oil,  is  ex- 

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plasters. 

onion  are 
s  used  to 
Roasted 
8,  tumors, 
0  the  feet 

he  poppy, 
rate  dose 
e  warmth 
tnses,  ani- 
Its  opera- 
ometimes 
sides  in  a 
acidity  of 
a  yielded 
or  more, 
ht  or  ten 
mors,  and 
y  shorter 
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»n,  relieve 
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MEDICINES  AND  THEIR  PREPABATIONS.  - 


687  , 


as  a  narcotic,  one  to  two  grains ;  in  some  spasmodic  affections,  it  ii 
given  in  very  large  doses. 

■orphia,  generally  called  morphine,  is  one  of  the  alkaloid  principles 
of  opium.  It  is  used  under  the  various  forms  of  sulphate,  murtate, 
acetate,  and  valerianate  of  morphia, — all  having  the  general  properties 
of  opium,  and  are  given  for  similar  purposes,  in  doses  of  one  eighth 
to  one  quarter  of  a  grain.  One  sixth  of  a  grain  is  equal  to  one  grain 
of  opium. 

Strong  coffee  is  an  excellent  antidote  to  the  poisonous  eff'ecvs,  both 
of  opium  and  morphia.  A  solution  of  morphia  may  be  made  by 
adding  ten  grains  of  the  salt  to  one  fluid  ounce  and  a  half  of  distilled 
water,  and  half  an  ounce  of  diluted  alcohol,  and  then  adding  two 
drops  of  sulphuric  acid,  if  it  be  the  sulphate  of  morphia,  or  two  drops 
of  acetic  acid,  if  it  be  the  acetate  of  morphia,  or  two  drops  of  muri« 
atic  acid,  if  it  be  the  muriate  of  morphia.  The  eflects  of  morphia 
may  be  obtained  by  sprinkling  some  of  it  on  a  blistered  surface. 

Orang^e  Peel  (Aurantii  Cortex).  —  The  orange  is  the  fruit  of  a  tree 
belonging  to  the  tropical  climates.  Orange  juice  is  a  pleasant  refrig- 
erant, useful  in  fevers,  and  particularly  in  scurvy.  Sick  persons  suck- 
ing the  juiee  of  the  orange,  should  be  careful  not  to  swallow  any  of 
jthe  skinny  portion,  or  the  peel.  The  peel  of  the  orange  is  chiefly 
employed  to  give  a  pleasant  flavor  to  other  medicines,  and  to  prevent 
their  nauseating  properties.  It  is  a  mild  tonic,  carminative,  and  stom- 
achic, and  improves  the  bitter  infusions  and  decoctions  of  gentian, 
quai«sia,  columbo,  and  peruvian  bark.  Orange  peel  should  never  be 
given  in  substance. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  two  drams ; 
tincture,  one  ounce  and  three  quarters  to  a  pint  of  diluted  alcohol, 
chiefly  used  as  an  addition  to  infusions,  etc. ;  syrup,  two  ounces  fluid 
extract  or  tincture  to  a  pint  of  simple  syrup,  used  with  water  as  an 
agreeable  drink. 

Ori^num  ( Origanum  Vulgare).  —  A  perennial  herb  growing  in 
Europe  and  this  country.  The  warm  infusion  of  it  causes  perspira- 
tion, and  promotes  the  menstrual  discharge,  when  interrupted  by  a 
cold.  The  oil  of  origanum  is  a  very  useful  ingredient,  in  several 
stimulant  and  rubefacient  liniments. 

Parsley  {Petroselinum  Sativum).  —  The  root  of  this  biennial  plant 
is  aperient  and  diuretic,  and  is  used  in  dropsy,  scarlet  fever,  and  dis- 
eases of  the  kidneys ;  also  in  retention  of  the  urine,  gonorrhoea,  and 
strangury.  The  dose  of  the  infusion  is  from  two  to  four  fluid  ounces, 
two  or  three  times  a  day. 

The  bruised  leaves  are  applied  with  advantage  to  contusions, 
swelled  breasts,  and  enlarged  glands. 

Partridg^e  Berry  {Mitchella  Repens).  —  This  perennial,  evergreen, 
creeping  herb,  grows  in  dry  woods  and  swampy  places  throughout 
the  United  St-ates,  and  has  white,  fragrant  flowers  in  June  and  July. 
It  is  parturient,  diuretic,  and  astringent,  and  is  used  in  dropsy,  sup« 


!i    '       ' 


i     "■■ 


'M 


-:j?f^;|  ■!_  AiiM 


638 


MEDICINES  AND  THEIR  PREPARATIONS. 


pression  of  urine,  and  diarrhoea.  It  acts  as  a  tonic  npon  the  repro- 
ductive organs,  giving  tone  and  vigor  to  the  womb,  and  making  labor 
less  tedious.  Dose  of  the  decoction,  from  two  to  four  fluid  ounces, 
two  or  three  times  a  day. 

Peach  (Amygdalus  Persica).  —  The  leaves  of  the  peach  are  sedative 
and  slightly  laxative,  and  are  used  in  inflammations  of  the  stomach 
and  bowels  ;  likewise  in  irritable  bladder,  hooping-cough,  sickness  at 
the  stomach,  and  dysentery.  They  are  used  in  the  form  of  cold  infu- 
sion, a  tablespoonful  being  a  dose,  to  be  taken  every  hour  or  two.  A 
good  tonic  is  made  by  adding  four  ounces  of  the  bruised  kernels  to  a 
quart  of  honey. 

Pennyroyal  (Hedeoma  Pulegioides).  —  Pennyroyal  is  a  gently  stim- 
ulant aromatic ;  it  relieves  wind  colic  and  sick  stomach,  and  qualifies 
the  action  of  other  medicines.  Like  most  aromatic  herbs,  it  has  the 
property,  when  given  as  a  warm  infusion,  of  promoting  perspiration, 
and  of  exciting  the  menses,  when  the  system  is  already  disposed  to 
the  effort.  In  cases  of  recent  suppression,  it  may  be  given  at  bed- 
time as  a  warm  tea,  aft«r  bathing  the  feet  in  warm  water.  The  oil 
of  pennyroyal  has  the  properties  of  the  herb. 


Fio.  216. 


Fi8.  217. 


rBXRTBOTAL. 


PKBnvIAN  BABK. 


Peppennint  (Mentha  Piperita) — The  peppermint  is  a  native  of 
England,  where  it  is  largely  cultivated,  as  it  is  to  some  extent  in  this 
country,  for  the  sake  of  its  essential  oil.  It  is  a  valuable  herb,  having 
a  strong  aromatic  smell,  and  a  pungent,  warming  taste.  It  may  be 
used  in  the  form  of  tea,  which,  when  largely  drank,  imparts  warmth 
to  the  system.  It  is  valuable  in  colds,  flatulent  colic,  hysterics,  spasms, 
cramps  in  the  stomach,  nausea,  and  vomiting,  and  to  disguise  unpleas- 
ant medicines. 

The  peppermint  furnishes  an  essential  oil,  which,  dissolved  in  alco- 
hol, forms  the  essence  of  peppermint  The  dose  of  this  is  fifteen  to 
thirty  drops,  on  a  lump  of  sugar,  or  in  sweetened  water,  warm  or  cold. 


^^w? 


Persimmoil  (Diospyros  Virginiana).  —  This  is  a  tree  growing  in 
the  Southern  and  Middle  States.  The  bark  and  unripe  fruit,  are 
used  in  medicine, — being  astringent  and  tonic.  Persimmon  has  been 
found  useful  in  chronic  diarrhoea,  chronic  dysentery,  hemorrhage  from 
the  womb,  and  fever  and  ague.  It  is  used  in  the  form  of  infusion 
and  2.yrup,  in  doses  of  a  tablespoonful,  every  two  or  three  hours.  The 
infusion  is  also  used  as  a  wash  and  gargle  in  sore  mouth  and  throat, 
and  as  an  injection  in  whites. 

Peruvian  Bark  ( Cinchona).  —  This  valuable  bark  is  derived  from 
several  species  of  the  cinchona  tree,  on  the  western  coast  qf  South 
America.  The  remedy  is  said  to  have  been  first  introduced  into 
Europe  in  1640,  by  the  Countess  of  Cinchon,  wife  of  the  Viceroy 
of  Peru,  on  her  return  to  Spain. 

There  are  three  varieties  of  this  bark :  the  pale,  the  red,  and  the 
yellow.  The  pale  bark  is  least  liable  to  offend  the  stomach,  and  is 
perhaps  the  best  as  a  general  tonic ;  but  for  the  treatment  of  fever 
and  ague,  the  red  and  the  yellow  are  both  preferable  to  the  pale,  and 
the  red  is  considered  better  than  the  yellow. 

Cinchona  is  tonic  and  antiperiodic,  and  is  much  used,  and  with 
(  great  8ucc^s8,  in  all  periodical  diseases,  as  fever  and  ague,  remittent 
fever,  neuralgia,  and  epidemic  diseases ;  also  in  chronic  diseases  at- 
tended with  debility,  as  scrofula,  dropsy,  and  affections  of  the  skin. 
Dose  of  the  powdered  bark,  as  a  tonic,  from  ten  to  sixty  grains ;  as 
an  antiperiodic,  from  twenty  to  a  hundred  grains. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram ;  com- 
pound fluid  extract,  dose,  half  a  dram  to  a  dram ;  tincture,  four  ounces 
to  one  pint  diluted  alcohol,  dose,  one  to  four  drams  ;  infusion,  dose, 
one  to  two  ounces.  A  good  compound  infusion  of  cinchona  is  made 
by  combining  one  ounce  fluid  extract  with  half  an  ounce  of  fluid 
extract  of  snake-root,  two  drams  of  fluid  extract  of  orange  peel,  one 
dram  of  fluid  extract  of  cloves,  one  dram  of  carbonate  of  potassa,  and 
one  pint  of  water.  Dose,  one  to  one  and  a  half  ounces.  The  follow- 
ing is  a  good  nervine  and  tonic  for  persons  of  nervous  temperaments : 
fluid  extract  of  cinchona,  one  ounce ;  fluid  extract  of  valerian,  one 
ounce ;  essence  of  cardamom,  two  drams ;  dose,  one  dram  every  three 
hours. 

Cinchonia  is  a  white  crystalline  substance  obtained  from  the  pern- 
vian  bark.  It  is  sometimes  used  as  a  substitute  for  quinia,  in  doses 
of  from  one  to  four  grains,  three  times  a  day. 

Sulphate  of  Quinia  is  snow  white,  and  in  satin-like  crystals,  having 
an  exceedingly  bitter  taste.  It  is  completely  soluble  in  water,  or  alco- 
hol, by  adding  a  few  drops  of  sulphuric  acid.  It  is  the  chief  active 
principle  of  cinchona,  and  has  similar  properties,  namely,  febrifuge, 
tonic,  and  antiperiodic ;  it  is,  however,  less  apt  to  nauseate  and  op- 
press the  stomach.  In  the  treatment  of  intermittent  fevers,  it  has 
almost  entirely  superseded  the  use  of  the  bark. 

Valerianate  of  Quinia*  —  This  is  a  combination  of  quinia  and  vale- 
rianic acid.     It  is  tonic  febrifuge  and  sedative.     It  is  used  for  head- 


pR'Iflil,  T'* 


?i-'-:^'l 


ache  of  a  periodic  character,  and  for  nervous  irritability,  wakefulness, 
restlessness,  etc.     Dose,  from  half  a  grain  to  two  grains. 

Petrolium.  —  This  is  a  blackish  liquid  bitumen,  flowing  spontane- 
ously from  the  earth  in  Italy,  France,  West  India  Islands,  etc.  As  a 
medicine,  it  is  stimulating,  antispasmodic,  and  sudorific.  It  is  occa- 
sionally administered  in  affections  of  the  chest,  when  not  attended 
with  inflammation.  Externally,  it  is  employed  in  chilblaini),  chronic 
rheumatism,  paralysis,  diseases  of  the  joints,  and  affections  of  ths 
skin.  It  is  an  ingredient  in  the  well-known  remedy  called  Britiah 
oil.  The  petrolium  found  in  the  State  of  New  York,  and  called 
Seneca  oil,  is  extensively  used  in  domestic  practice.  The  dose  of 
petrolium  is  from  thirty  drops  to  a  dram. 

Phosphorus.  —  This  is  a  semi-transparent  solid,  and  is  flexible,  and 
has  a  waxy  lustre.  It  is  extracted  from  bones  by  sulphuric  acid.  As 
a  medicine  in  small  doses,  it  acts  as  a  powerful  general  stimulant ;  in 
large  doses,  as  a  violent,  irritant  poison.  When  taken  in  substance 
it  causes  irritation  of  the  stomach,  and  should,  therefore,  always  be 
administered  in  solution  ;  and  even  in  this  form  it  is  objectionable;  it  ok 
is  better  to  resort  to  the  phosphates,  and  the  hypophosphites.  Phos-  W 
phorus,  being  an  element  in  the  composition  of  the  brain,  has  been 
given,  and  with  advantage,  in  the  various  forms  of  nervous  debility, 
as  consumption,  typhus  fever,  amaurosis,  paralysis,  and  the  general 
breakdown  of  the  vital  powers.  Phosphorus  burns  when  exposed  to 
the  air,  and  should  therefore  be  kept  covered  with  water. 


Fia.  218. 


Fio.  319. 


FIKK  SOOT. 


PIPBI88KWA. 


Pink  Root  (Spig-efia  Marilandica).  —  This  perennial  herb  grows  in 
rich  soils  in  the  Middle  and  Southern  States.  The  root  is  the  roadici- 
nal  part.  It  is  a  powerful  anthelmintic,  and  is  but  little  used,  except 
for  expelling  worms. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram  and  a 
half ;  compound  fluid  extract,  dose,  half  a  dram  to  two  drams ;  fluid 


^^ 


MEDICINES  AND  THEIR  PREPARATIONS. 


641 


extract  of  pink  root  and  i^enna,  dose,  half  a  dram  to  a  dram ;  infusion, 
half  an  ounce  to  a  pint  of  water,  dose,  two  to  six.  ounces. 

Pipsissewa  (Chimaphila  Umhellata).  — This  is  a  small  evergreen 
plant,  growing  in  the  United  States,  and  in  Northern  Europe  and 
Asia.  It  is  known  by  the  name  oi princes'  pine.  The  whole  plant  is 
tonic,  diuretic,  and  astringent,  and  has  proved  itself  useful  in  dropsy, 
general  debility,  rheumatism,  chronic  disorders  of  the  kidneys,  blad- 
der, urethra,  etc. 

Preparations.  — Fluid  extract,  dose,  one  dram  ;  solid  extract,  dose, 
ten  to  twenty  grains  \  infusion,  dose,  two  ounces. 

Plantain  {Plantago  Major).  — This  perennial  herb  grows  both  in 
Europe  and  America.  A  strong  decoction  of  the  tops  and  the  roots 
is  highly  spoken  of  for  syphilis  and  scrofula ;  the  dose  being  from 
two  to  four  fluid  ounces,  two  or  three  times  a  day.  But  the  bruised 
leaves  are  most  useful,  when  applied  to  wounds,  ulcers,  bites  of 
poisonous  insects,  erysipelas,  etc. 

Plenrisy  Boot  (-4sc?^ea«  Tubero&a.) — This  perennial  plant  is 
abundant  in  the  Southern  States.  The  root,  which  is  the  part  used, 
is  oarniinative,  tonic,  and  diuretic ;  used  in  pleurisy,  bronchitis, 
inflannnation  of  the  lungs,  acute  rheumatism,  and  dysentery.  The 
warm  infusion  promotes  diaphoresis,  without  raising  the  temperature 
of  the  body.  United  with  the  warm  infusion  of  wild  yam  root,  it  is 
excellent  for  flatulency  and  wind  colic. 

Preparations.  —  Fluid  extract,  dose,  half  a  <lram  to  two  drams; 
tincture,  four  ounces  to  a  pint  of  diluted  alcohol,  dose,  three  to  five 
drams ;  infusion,  dose,  one  to  four  ounces  ;  asclepidin,  dose,  one  to  five 
grains.  Asclepidin  and  dios(forein,  united  in  equal  parts,  make  a  valua- 
ble preparation  for  flatulent  and  bilious  colic  ;  dose,  two  to  four  grains. 


Fio.  220. 


Fio.  221. 


PLEURISY  BOOT. 


POISON  HEMLOCK. 


Poison  Hemlock  (Conium  Maculatum). — This  biennial  plant  is  a 
native  of  Europe  and  Asia,  and  is  naturalized  in  this  country.  The 
leaves  and  the  seeds  are  used  in  medicine.  Conium  is  narcotic,  ano- 
dyne, antispasmodic,  and  deobstruent;  used  in  neuralgia,  asthma, 
syphilid,  chronic  rheumatism,  and  various  other  affections. 

81 


ill 


i 


I 


•I 


642 


.lEDICINES  A.  D  THEIR  PREPARATIONS. 


Preparations.  —  Fluid  extract,  dose,  five  to  twenty  drops;  .solid 
extract,  dose,  half  a  grain  to  two  grains  ;  tincture,  three  ounces  to  a 
pint  of  diluted  alcohol,  dose,  thirty  drops  to  a  drum ;  infusion,  hulf 
an  ounce  to  a  pint  of  water,  mainly  used  a.s  a  Avash  for  malignuut 
ulcers,  etc. 


FlO.  222. 


Poison  Oak  {Rhus  Toxicodendron) .  —  The  leaves  arc  the  medicinal 
part  of  this  creeping  shrub,  which  is  common  in  this  country.  Tbo 
tbi-m  of  using  this  medicine  is  that  of  a  saturated  tincture,  made  from 
the  fresh  leaves,  and  to  be  kept  in  well-corked  vials.  It  has  been 
found  useful  in  paralysis  of  the  bladder  and  rectum,  in  diseases  of  the 
eyes  and  skin,  and  in  chronic  rheumatism.  Dose  of  the  tincture,  from 
live  to  ten  drops,  three  times  a  day.     Large  doses  should  be  avoided. 

Poke  (Phytolacca  Decandra). — A  perennial  plant,  growing  in 
nearly  all  parts  of  the  country,  and  called  garget,  pigeon-berry,  and 
scoke.  The  root  is  the  part  used.  It  is  emetic, 
cathartic,  alterative,  and  slightly  narcotic.  It 
excites  the  whole  glandular  system,  and  is  used 
in  syphilis,  scrofula,  rheumatism,  and  affections 
of  the  skin.  The  root,  buried  in  hot  ashes  until 
soft,  and  then  mashed,  and  applied  as  a  poul- 
tice, is  said,  in  King's  Dispensatory,  to  be  un- 
rivalled in  felons  and  various  tumors.  Dose 
of  the  powdered  root,  as  an  emetic,  twelve 
grains  to  half  a  dram ;  as  an  alterative,  from 
two  to  six  grains. 

Preparations. — Fluid  extract,  dose,  ten  to 
thirty  drops ;  solid  extract,  dose,  dne  to  four 
gi'ains ;  tincture,  four  ounces  to  a  pint  of  di- 
luted alcohol,  dose,  half  a  dram  to  a  dram ; 
syrup,  two  ounces  to  fourteen  ounces  of  simple  syrup,  dose,  one  to 
two  drams ;  phytolaccin,  the  active  principle,  dose,  one  quarter  to 
one  grain.  For  mercurial  and  syphilitic  pains  in  the  bones,  the  fol- 
lowing pill  is  useful :  solid  extract  of  poke,  two  drams ;  solid  extract 
of  stillingia,  one  dram ;  solid  extract  of  stramonium,  eight  grains. 
Mix,  and  divide  into  sixty  pills,  of  which  one  pill  i.s  to  be  takeu 
every  one,  two,  or  three  hours. 

Potassa.  —  This  is  used  in  medicine  under  the  name  of  caustic 
potassa.  It  is  made  by  boiling  a  solution  of  potassa  in  a  clean  iron 
vessel  until  ebullition  ceases,  and  the  potassa  melts,  and  then  pouring 
it  into  cylindrical  moulds  ;  when  cold  it  is  to  be  kept  in  well-stopped 
bottles.  It  is  a  very  powerful  escharotic,  quickly  destroying  the  flesh 
which  it  touches,  and  extending  its  action  deep  under  the  surface.  It 
differs  in  this  respect  from  nitrite  of  silv^ir,  which  only  acts  upon  the 
surface,  and  is  not,  properly  speaking,  a  caustic 

Caustic  potassa  is  used  for  forming  issues.  The  method  of  using 
it  for  this  purpose  is  to  cut  in  a  piece  of  adhesive  plaster  a  hole  as 
large  as  the  desired  issue,  and  then,  having  stuck  this  upon  the  skin, 


70KE. 


I'll   "liSi'lW 

■'  "'t 


MEDICINES  AND  THEIU  PREPARATIONS. 


643 


to  apply  tho  end  of  the  taustio,  jji-cvioiisly  moistened,  to  the  openin<r. 
This  application  in  to  bo  continued  till  the  lite  of  the  part  i.s  destroyed, 
when  the  caustic  must  be  neutralized  by  vinegar,  or  carefully  washed 
ott'  with  a  wet  sponge. 
The  following  preparations  of  potassa  arc  used  in  medicine  : 

Acetate  of  Potassa  {Potaasm  Acetas).  — This  is  made  by  tho  union 
of  acetic  acid  and  carbonate  of  potassa,  and  in  consc(iuence  of  its 
extreme  deliquescence  when  exposed  to  the  air,  it  is  kept  in  closely- 
.stopped  bottles.  It  is  diuretic,  deobstruent,  and  mildly  cathartic. 
It  is  used  in  febrile  diseases,  several  skin  diseases,  such  as  psoriasis, 
eczenia,  and  lepra,  and  particularly  in  dropsical  aft'cctions.  Dose,  as 
ft  diuretic,  from  twenty  to  thirty  grains  ;  as  an  aperient  from  two  to 
three  drams. 

Bicarbonate  of  Potassa  (Potassce  Bicarbonas).  —  This  is  a  solution 
of  carbonate  of  potassa,  saturated  with  carbonic  acid.  This  acid  is 
diuretic,  antacid,  and  deobstruent ;  used  in  dropsy,  acidity  of  the 
stomach,  and  glandular  ol)structions.  Dose,  ten  to  thirty  grains. 
Twenty  grains  dissolved  in  eight  fluid  ounces  of  water,  and  mixed 
with  four  fluid  drams  of  lemon  juice,  forms  a  good  efl'ervescing 
draught. 

Bitartrate  of  Potassa  (Potassce  Bitartras). — This  salt  is  better 
known  as  cream  of  tartar,  and  super  tartrate  of  potassa.  It  is  formed 
from  the  matter  deposited  on  the  bottom  and  sides  of  casks,  during 
the  fermentation  of  sour  wines.  As  a  medicine  it  is  diuretic,  cathar- 
tic, and  refrigerant.  In  small  doses,  it  acts  as  a  cooling  aperient, 
gently  opening  the  bowels  ;  in  large  ones,  as  a  hydragogue  cathartic, 
causing  free,  Avatery  stools.  This  property,  as  well  as  its  power  of 
acting  upon  the  kidneys,  causes  it  to  bo  much  used  in  dropsical  com- 
plaints. Dissolved  in  boiling  water,  allowed  to  cool,  and  then  sweet- 
ened with  loaf  sugar,  it  forms  a  cooling,  pleasant,  acid  drink.  This 
kind  of  solution,  with  a  little  fresh  lemon  peel  added  to  it,  forms  the 
drink  called  imperial.  Combined  with  sulphur,  it  .  j  often  used  in 
skin  diseases.  Dose,  as  an  aperient,  a  dram  or  two  ;  as  a  hydragogue 
cathartic,  half  an  ounce  to  an  ounce  ;  as  a  diuretic  in  dropsical  com- 
plaints, a  dram  and  a  half  to  two  drams,  several  times  a  day.  Cream 
of  tailar,  powdered  rhatany,  and  myrrh,  mir«ed  in  equal  proportions, 
form  a  good  preparation  for  cleansing  the  teeth. 

Carbonate  of  Potassa  {Potassce  Carbonas).  —  Carbonate  of  potassa 
is  purified  jtearlash ,  and  is  frequently  called  salt  of  tartar.  The  com- 
mon saleratus  is  a  composition  between  the  carbonate  and  bicarbo- 
nate. Carbonate  of  potassa  has  the  same  medicinal  properties  with 
the  bicarl)onate,  and  is  used  for  similar  purposes. 

Chlorate  of  Potassa.  —  This  is  prepared  by  passing  an  excess  of 
chlorine  through  carbonate  of  potassa.  It  is  refrigerant  and  diuretic, 
and  is  given  in  scurvy,  scarlet  fever,  etc. ,  and  as  a  wash  in  canker 
in  the  mouth,  and  various  unhealthy  ulcers,  and  as  an  injection  iu 
leucorrhoea  and  gleet.  . 


1-1 V 


5;. 


1      ! 


H44 


MEDICINES  AND  THEIR  PREPARATIONS. 


Citrate  of  PotasM  (Potassce  Citraa).  — A  grateful,  cooling  diapho- 
retic, long  and  much  used  in  fevers,  chiefly  in  the  forms  of  the  neutral 
mixture i  and  eferveacing  draught. 

Solation  of  Citrate  of  Potassa  (Liquor  PotaascB  Citratis).  —  THIh 
is  prepared  by  taking  half  a  pint  of  lemon  juice,  and  adding  hicur- 
bonate  of  potassa  gradually  to  it,  until  it  is  saturated,  then  filtering. 
This  passes  under  the  nume  of  neutral  mixture,  saline  mixture,  and 
effervescing  draught.  It  is  a  valuable  refrigerant  diaphoretic,  well 
adapted  to  the  hot  stage  of  remittent  and  intermittent  fevers,  and 
indeed  to  almost  all  cases  of  fever,  with  a  dry,  hot  skin.  The  dose 
is  a  tablcspoonful,  or  half  a  fluid  ounce,  which  should  be  diluted 
when  taken,  and  be  repeated  every  one,  two,  or  three  hours,  accord- 
ing to  the  necessities  of  the  case. 

Solution  of  Potassa  {Liquor  Potassce).  —  This  is  a  transparent, 
caustic  fluid,  which  requires  to  be  kept  in  green  bottles,  tightly 
corked.  It  is  antacid,  antilithic,  and  diuretic.  It  is  used  in  some 
affections  of  the  skin,  and  scrofula,  but  more  particularly  for  scalding 
of  the  urethra,  in  gonorrhoea ;  in  this  case,  it  is  well  to  unite  a  few 
drops  of  laudanum  with  it.  The  dose  is  from  fifteen  to  forty  drops, 
two  or  three  times  a  day,  in  half  a  tumblerful  of  water.  In  dyspeptic 
cases,  attended  with  acidity  of  the  stomach,  it  may  be  associated 
with  some  simple  bitters. 

Sulphate  of  Potassa  (Potassce  Sulphas) .  —  This  is  a  mild  purgative, 
operating  without  irritation  or  pain.  As  an  aperient,  it  should  be 
given  in  doses  of  from  a  scruple  to  a  dram.  Ten  grains  of  rhubarb 
and  one  dram  of  carbonate  of  potassa,  united,  and  divided  into  six 
powders,  is  an  excellent  alterative  cathartic  for  children  having  defec- 
tive digestion  and  nutrition,  and  a  tumid  state  of  the  abdomen. 
One  powder  may  be  given  at  a  time,  as  often  as  may  be  necessary 
to  open  the  bowels  gently. 

Tartrate  of  Potassa  (Potassce  Tartras).  — This  often  passes  under 
the  name  of  soluble  tartar.  It  is  a  mild,  cooling  purgative,  operating, 
as  most  of  the  neutral  salts  do,  without  much  pain,  and  producing 


watery  stools.  It  is  useful  in  fevers.  Combining  it  with  senna, 
destroys  its  tendency  u  produce  griping  of  the  bowels.  The  dose 
varies  from  a  dram  vo  an  ounce,  according  to  the  effect  desired. 

Potassium.  —  This  is  a  soft,  bluish-white  metal.  Its  union  with 
oxygen,  in  the  propoilion  of  one  equivalent  of  each,  forms  potassa  or 
potash.     The  following  preparations  of  it  are  used  in  medicine  : 

Bromide  of  Potassium  (PotassU  Bromidum).  — This  is  a  perma- 
nent, colorless  salt,  having  a  pungent,  saline  taste,  a  little  more  acrid 
than  common  salt,  yet  similar  to  it.  As  a  medicine,  it  is  alterative 
and  resolvent,  and  is  used  occasionally  for  secondary  syphilis,  scrofula, 
and  enlarged  spleen.  Dose,  from  three  to  ten  grains,  three  times  a 
day,  in  pill  or  solution.  One  dram  of  the  bromide  of  potassium, 
rubbed  up  with  an  ounce  of  lard,  makes  an  ointment  which  has  been 
used  with  some  good  effect  in  goitre,  and  scrofulous  affections. 


MEDICINES  AND  THEIR  PREPARATIONS. 


645 


Cyannret  of  Potassium  {Potassii  Cyanuretum).  —  This  is  emi- 
nently poisonous,  acting  lioth  as  a  medicine  and  as  a  poison,  like  liy- 
drocyanic  acid.  It  has  therefore  been  recommended  as  a  .substitute 
for  that  acid.  The  dose  is  one  eighth  of  a  grain,  dissolved  in  half  a 
fluid  ounce  of  water. 

Sulphnret  of  Potassiam  (PotoAiV  Sulphuretum).  —  This  is  called 
liver  of  sulphur,  and  hepar,  being  composed  of  sulphur  and  potassium. 
It  has  been  used  in  chronic  bronchitis,  asthma,  hooping-cough,  and 
rheumatism.  Half  an  ounce  to  an  ounce  of  it,  dissolved  in  several 
pallons  of  warm  water,  makes  a  valuable  sulphur  bath  for  several  skin 
diseases,  as  itch,  prurigo,  etc. 

Prickly  Ash  {XantJioxylum  Fraxineum).  —  This  shrub  grows  in 

various  parts  of  the  United  States.     The  leaves  and  capsules  have 

a  pleasant,  aromatic  smell.     Its  medicinal  properties 

^°-  ^"- are  in  the  bark  and  berries.     The  bark  is  stimulant, 

tonic,  alterative,  and  sialagogue.     It  is  used  to  rouse 


^>     ^ 


Prickly  Abo. 


and  excite  the  system,  when  in  a  languid  state,  and 
for  derangements  of  the  liver,  rheumatism,  and  chronic 
syphilis.  It  stimulates  and  strengthens  mucous  mem- 
branes, and  is  a  valuable  tonic  in  low  typhoid  fever. 
Applied  externally,  it  im»  voves  indolent  and  malig- 
nant ulcers.  Dose  of  the  powdered  bark,  from  ten  to 
thirty  grains,  three  times  a  day. 

Preparations.  —  Fluid  extract,  dose,  fifteen  to  forty- 
five  drops  ;  tincture,  four  oimees  to  a  pint  of  diluted 
alcohol,  dose,  half  a  dram  to  a  dram  and  a  half;  infu- 
sion, half  an  ounce  to  a  pint  of  water,  dose,  half  an 
ounce  to  two  ounces ;  xanthoxylin,  the  active  princi- 
ple, dose,  two  to  six  grains. 
For   chronic  rheumatism,   the  following  is    a  good  preparation : 
xanthoxylin,  one  dram  ;  cimicifugin,  one  dram  ;  apocynin,  one  dram  ; 
diluted  alcohol,  one  pint ;  dose,  four  drams,  three  times  a  day. 

Prickly  Ash  Berries  are  carminative,  antispasmodic,  and  stinuilant, 
and  have  a  special  direction  to  mucous  membranes.  The  tincture  is 
excellent  in  nervous  diseases,  spasms  of  the  bowels,  flatulency,  and 
diarrhcea ;  and  combined  with  the  tincture  of  poke  berries,  is  very 
serviceable  in  chronic  rheumatism  and  syphilis.  It  is  said  to  have 
l)cen  used  with  great  success,  in  the  West,  in  Asiatic  cholera.  Dose 
of  the  tincture,  from  ten  drops  to  a  fluid  dmm,  in  sweetened  water. 
Dose  of  the  oil  of  prickly  asa  berries,  from  two  to  ten  drops,  on  sugar. 

Prickly  Elder  (Aralia  Spinosa). — ^This  is  a  tree  which  grows  in 
the  Southern  and  Western  States,  and  is  called  southern  prickly  ash, 
tvnA  toothache  tree.  The  bark  is  stimulant,  alterative,  and  diaphoretic. 
The  fresh  bark,  emc  Mc  and  cathartic.  The  tincture  is  serviceable  in 
skin  diseases,  syphi.  -,  and  chronic  rheumatism.  Dr.  John  King  re- 
ports, that  in  the  ch''  era  of  1849,  it  was  found  very  serviceable,  where 
cathartics  were  required,  in  the  following  combination :  compound 


I 


If 


powder  of  jalap,  one  dram;  powdered  prickly  elder  l)ark,  one  drum  ; 
compound  powder  of  rhubarb,  two  drams.  These  Avere  mixed,  and 
given  in  half-teaspoonful  doses,  every  half  hour,  or  hour,  until  they 
operated.  The  bark  is  sialagogue,  and,  in  small  doses,  powdered,  is 
said  to  relieve  the  dry  and  parched  condition  of  the  throat,  in  many 
diseases. 

Pumpkin  Seeds.  — The  infusion  of  pumpkin  seeds,  made  l)y  placing 
them  in  water  without  bruising  them,  are  mucilaginous  and  diuretic, 
and  are  used  in  inflammation  of  the  stomach  and  bowels,  scalding  of 
the  urine,  strangury,  etc.  But  this  infusion  is  more  pirticularly  valu- 
able for  its  power  of  expelling  the  tape-worm.  It  may  be  drank 
freely.  The  oil  of  pui.^iikin  seeds,  obtained  by  expression,  has  simi- 
lar properties,  and  may  be  taken  in  doses  of  six  to  twelve  drops, 
several  times  a  day. 

(Quassia  (Picroena  Excelsa).  — This  is  the  wood  of  a  tall  tree  grow- 
ing in  Surinam  and  some  of  the  West  India  Islands.  It  is  an  in- 
tensely ))itter  tonic,  feljrifuge,  and  anthelmintic,  possessing  in  the 
highest  degree  the  properties  of  the  simple  bitters.  It  invigorates 
the  digestive  organs,  without  produclnfif  much  excitement  of  the  cir- 
culation. It  is  Avell  adapted  to  dyspepsia  and  the  del)ility  of  the 
stomach  which  succeeds  acute  disease,  and  indeed  ail  complaints 
where  simple  bitter  is  required.  Its  generic  title  perpetuates  the  name 
of  the  negro  Quassi,  of  Surinam,  who  first  discovered  its  medicinal 
virtues,  about  the  middle  of  the  last  century,  and  who  became  famous 
for  treating  malignant  fevers  with  it,  as  a  secret  remedy. 

Preparations.  —  Fluid  extract,  dose,  hs'lf  a  dram  to  a  dram ;  solid 
extract,  dose,  three  to  five  grains  ;  tincture,  dose,  four  to  eight  drams ; 
infusion,  tv^o  drams  to  a  pint  of  water,  dose,  two  to  four  ounces. 

Queen  of  the  Meadow  {Eupatorium  Purpureum). — This  perennial 
herb  grows  in  low,  swampy  places,  in  many  parts  of  the  country.  It 
is  called  trumpet  weed,  and,  from  its  fine  medicinal  effects  in  com- 
plaints of  the  urinary  organs, ^mue?  root.  It  is  an  excellent  diuretic, 
tonic,  and  stimulant.  Used  in  gout,  rheumatism,  hematuria,  chronic 
diseases  of  the  urinary  organs,  strangury,  gravel,  and  dropsical  affec- 
tions. The  decoction  is  the  form  in  which  it  is  most  used ;  the  dose 
being  two  to  four  ounces,  two  or  three  times  a  day. 

A  preparation  called  etipuipurin  is  also  extracted  from  it,  which,  in 
three-grain  doses,  is  a  powerful  diuretic,  occasioning,  in  some  cases,  it 
is  said,  an  enormous  flow  of  urine. 

Queen's  Root  {StilUngia  Sylvatica).  —  This  pereunial  herb  grows 
in  sandy  soils  in  the  Southern  States.  The  root  is  medicinal,  being 
in  large  doses,  emetic  and  cathartic  ;  in  small  doses,  an  alterative  of 
considerable  value  in  skin  diseases,  rheumatism,  syphilis,  and  scrofula, 
and  in  such  other  complaints  as  require  alteratives. 

Preparations. —  Fluid  extract,  dose,  five  to  fifteen  drops  ;  compound 
fluid  extract,  dose,  half  a  dram  to  a  dram ;  tincture,  two  ounces  to  a 
pint  of  diluted  alcohol,  dose,  one  to  three  drams  ;  infusion,  dose,  one 
to  two  ounces.     In  chronic  bronchitis,  and  similar  complaints,  the 


following  syrup  is  well  recommended  :  fluid  extract  of  stillingia,  two 
ounces  -,  fluid  extract  of  bloodroot,  two  ounces  ;  fluid  extract  of  cherry 
l)ark,  two  ounces  ;  balsam  of  tolu,  one  ounce  and  a  half;  syrup,  two 
and  a  half  pints.     Dose,  one  to  two  drams. 

RedChickweed  (Anagallis  Arvensis) . — An  annual  plant,  common 
in  Europe  and  this  country.  It  has  small  scarlet  flowers  in  June 
and  July.  It  has  been  used  in  nervous  diseases,  as  mania,  delirium, 
epilepsy,  and  particularly  hydrophobia.  Old  and  ilUcouditioned 
ulcers  are  improved  by  its  use,  in  the  form  of  poultice. 

Red  Foot  (  Ceanolhus  Americanus) .  —  This  shrubby  plant  has  the 
names  of  Nieio  Jersey  tea  and  icild  snow-ball,  and  is  found  in  all 
parts  of  the  United  States.  The  bark  is  antispasmodic,  sedative, 
astringent,  and  expectorant,  and  tastes  and  smells  like  the  peach  leaf. 
A  decoction  is  useful  in  dysentery,  diarrhwa,  liooping-cough,  and 
chronic  Inonchitis,  in  doses  of  a  tablespoonful,  three  times  a  day. 
It  makes,  likewise,  a  very  good  injection  in  leucorrhcea  and  gleet, 
and  gargle  for  ulcerations  of  the  mouth  and  throat. 

Red  Clover  {Trifolium  Pratense). — The  blossoms  of  this  very 
common  biennial  plant  are  mr  licinal,  and  are  highly  recommended 
in  deep,  ragged,  and  cancerous  ulcers,  as  well  as  in  badly-condi- 
tioned burns.  They  are  soothing  and  detergent,  and  promote  heal^- 
ful  granulation. 

Preparation.  —  Solid  extract,  to  be  used  as  an  external  application, 
chiefly  in  the  form  of  ointment,  ma:^^  by  uniting  four  ounces  of  it 
with  half  a  pound  of  lard. 

Red  Rose  ( tlosa  Gallica) .  —  The  petals  of  the  rose  are  slightly 
tonic  and  astringent,  and  are  considerably  employed  in  chronic  inflam- 
mations of  the  eye.  Rose  water,  distilled  from  the  petals,  is  used 
for  similar  purposes. 

Red  8aunders  (Pterocaiyyus  Santalinus) .  —  This  is  a  large  tree 
growing  in  Ceylon,  the  wood  of  which  imparts  a  red  color  to  alco- 
hol, ether,  and  alkaline  solutions,  but  not  to  water.  It  is  almost 
solely  used  for  imparting  color  to  tinctures,  etc.,  having  little  or  no 
medicinal  i)roperties. 

Rosin.  —  This  is  the  solid  resinous  matter  which  remains  after  the 
distillation  of  turpentine.  It  is  much  used  as  an  ingredient  in  oint- 
ments and  ])lasters,  but  is  never  taken  internally.  The  vapor  which 
arises  from  heating  it  upon  some  hot  surface  is  sometimes  inhaled 
with  great  advantage  in  chronic  bronchitis,  and  other  chronic  aflec- 
tions  of  the  air  tubes. 

Rhatany  {Krameria  Triandra).  —  This  is  a  native  of  Peru,  grow- 
ing in  dry,  sandy  places.  It  is  a  powerful  astringent,  and  a  gentle 
tonic.  It  is  given  with  advantage  in  excessive  menstruation,  vomiting 
of  blood,  chronic  diarrhcea,  leucorrhcea,  and  inability  to  retain  the 
urine ;  likewise,  as  a  local  application  .in  falling  of  the  bowel.  It  is 
valuable  also  for  nose-bleed,  and  bleeding  gums.  Dose  of  the  powder, 
for  internal  use,  from  ten  to  thirtv  grains. 


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648 


MEDICINES  AND  THEIR  PREPARATIONS. 


Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram ;  solid 
extract,  dose,  five  to  twenty  groins  ;  tincture,  three  ounces  to  a  pint 
of  diluted  alcohol,  dose,  three  to  six  drams  ;  infusion,  two  ounces  to 
a  pint  of  water,  dose,  half  an  ounce  to  an  ounce. 

Bhabarb  {Rheum  Palmatum).  —  This  root  is  derived  from  several 
species  of  rheum,  and  passes  under  the  various  names  of  European, 
Russian^  Chinese,  East  India,  and  Turkey  rhubarb.  The  variety 
called  Russian,  or  Turkey  rhubarb  (for  they  are  the  same) ,  is  con- 
sidered the  best.  Rhubarb  is  cathartic,  astringent,  and  tonic.  It  is 
much  used  in  mild  cases  of  diarrhoea  and  cholera  infantum ;  likewise, 
as  a  stomachic  and  gentle  tonic  in  dyspepsia,  accompanied  with  a  de- 
bilitated state  of  the  digestive  organs.  It  is  a  valuable  remedy  in  the 
complaints  of  children,  and  is  deservedly  much  used  in  treating  them. 
It  acts  upon  the  muscular  coat  of  the  bowels,  producing  thick  rather 
than  watery  stools.  It  is  therefore  not  adapted  to  the  treatment  of 
d/opsical  complaints.  Its  astringency  may  be  increased  by  roasting 
it,  or  diminished,  by  combination  with  soap,  or  an  alkali. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram  ;  aro- 
matic fluid  extract,  dose,  half  a  dram  to  a  dram ;  fluid  extract  of  rhu- 
barb and  senna,  dose,  half  a  dram  to  a  dram ;  solid  extract,  dose,  two 
to  ten  grains  ;  tincture,  an  ounce  and  a  half  of  fluid  extract,  and  half 
an  ounce  of  essence  of  cardamom,  to  a  pint  of  diluted  alcohol,  dose, 
half  an  ounce  to  an  ounce  and  a  half;  infusion,  one  ounce  fluid  ex- 
tract and  vWO  ounces  spirit  of  cinnamon  to  a  pint  of  water,  dose,  one 
to  three  ouLces ;  syrup,  three  ounces  of  fluid  extract  to  fourteen  of 
syrup,  dose,  two  to  five  drams. 

Rosemary  {Rosmarinus  OJlcinali).  —  This  evergreen  shrub 
grows  on  thts  borders  of  the  Mediterranean,  and  is  cultivated  in  Europe 
and  this  country.  It  is  stimulant,  antispasmodic,  and  emmenagogue. 
It  is  not  used,  in  this  country,  however,  except  to  perfume  ointments, 
tinctures,  and  syrups. 

Round-Leaved  Pyrola  {Pyrola  RotundifoUa) . — This  perennial 
shrub  grows  in  various  parts  of  our  country,  and  bears  white  flowers 
in  June.  It  is  called  canker  lettuce,  pear-leaf  winter  green,  etc.  Its 
medicinal  properties  are  those  of  a  tonic,  astringent,  antispasmodic, 
und  diuretic.  Used  in  decoction  for  epilepsy  and  other  nervous  dis- 
orders ;  also  for  gravel,  and  other  diseases  of  the  bladder  and  kidneys. 
The  decoction  may  be  used,  too,  as  a  wash  for  ulcerations  of  the  mouth, 
indolent  ulcers,  and  chronic  ophthalmia.  The  decoction  may  likewise 
be  used  in  making  poultices  for  painful  swellings,  boils,  and  carbun- 
cles.    It  may  be  taken  in  doses  of  from  one  to  six  ounces. 

Rue  {Ruta  Oraveolena).  —  Rue  has  the  medicinal  virtues  of  the 
antispasmodics,  anthelmintics,  and  emmenagogues.  In  large  doses,  it 
is  poisonous.  It  is  useful  in  wind  colic,  worms,  hysterics,  epilepsy, 
etc.  Dose  of  the  leaves,  from  ten  to  twenty  grains  ;  of  the  infusion, 
from  one  to  four  ounces. 

Saflh)n  ( Crocus  Sativus) .  —  This  is  a  native  of  Greece  and  Asia 
Minor ;  it  is  also  cultivated  in  France,  England^  and  America,  as  well 


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as  in  other  countries.  It  has  been  thought  to  be  stimulant  and  anti- 
spiismodic,  in  small  doses,  relieving  pain,  and  producing  sleep ;  in  large 
tlases,  giving  rise  to  headache,  and  producing  stupor.  In  the  general 
judgment  of  the  profession,  it  is  now  considered,  however,  as  having 
very. little  activity.  It  is  accordingly  not  much  used,  except  in  do- 
mestic practice,  where  it  has  some  reputation  among  nui'ses  for  its 
jwwer  to  bring  out  measles,  and  other  eruptions.  It  is  also  thought 
to  be  beneficial  in  amenorrhoea,  dysmenorrhcea,  chlorosis,  and  hysteria. 
It  is  chiefly  used  at  present  to  impart  flavor  and  color  to  tinctures. 

Pr^arations.  —  Fluid  exti*act,  dose,  twenty  to  sixty  drops ;  tinc- 
ture, dose,  half  a  dram  to  a  dram ;  infusion,  one  dram  to  a  pint  of 
water,  dose,  two  to  three  ounces. 

Sage  (Salvia  Officinalis) .  —  The  tops  and  leaves  of  this  well-known 
garden  plant  are  aromatic,  astringent,  diaphoretic,  and  slightly  tonic. 
The  infusion  is  useful  in  debilitated  conditions  of  the  stomach,  at- 
tended with  flatulence  ;  it  frequently  relieves  nausea ;  the  cold  inf'-  • 
sion  cheeks  and  sometimes  entirely  removes  the  night-sweats  of 
hectic.  The  infusion  is  useful  as  a  gargle  in  inflammation  of  the 
throat,  particularly,  if  united  with  a  little  honey  and  alum.  Dose  of 
the  infusion,  from  one  to  three  fluid  ounces. 

Sarsaparilla  {Smilax  Officinalis).  —  Grows  in  swamps  and  hedges 
in  the  Middle  and  Southern  States,  The  root  has  long  been  held  in 
esteem  as  an  alterative,  diuretic,  and  demulcent,  beinjr  used  in  scrof- 
ula, chronic  rheumatism,  and  affections  of  the  skin ;  but  its  most 
extensive  and  useful  application  has  been  found  to  be  in  the  treat- 
ment of  secondary  and  tertiary  syphilis  ;  and  especially  in  the  broken 
condition  of  the  system  which  follows  the  use  of  mercury  in  these 
affections. 

Preparations. — Fluid  extract,  dose,  one  dram;  fluid  extract  of 
sarsaparilla  and  dandelion,  dose,  one  dram  ;  solid  extract,  dose,  five 
to  twenty  grains  ;  infusion,  dose,  two  to  four  ounces. 

Sassafras  (Laurus  Sassafras).  — This  tree  is  common  in  the  United 
States.  The  bark  of  the  root,  which  is  the  medicinal  part,  is  altera- 
tive, diuretic,  diaphoretic,  and  a  warm  aromatic  stimulant.  It  is 
mainly  used  to  improve  the  flavor  of  other  medicines,  and  also,  as  a 
constituent  of  those  compounds,  which  are  recommended  in  chronic 
rheumatism,  sjrphiloid  affections,  eruptions  of  the  skin,  and  scurvy. 

Preparations.  — Fluid  extract,  dose,  one  to  two  drams  ;  tincture, 
six  ounces  to  a  pint  of  alcohol,  dose,  half  an  ounce  to  an  ounce  ;  in- 
fusion, two  ounces  to  a  pint  of  water,  to  be  drank  as  desired. 

^Ay\n  (Juniperus  Sabina). — An  evergreen  shrub,  growing  in 
Europe  and  North  America.  The  tops  and  leaves  are  diuretic,  dia- 
phoretic, emmenagogue,  and  anthelmintic.  The  warm  infusion  pro- 
motes menstruation,  and  destroys  worms.  Cai'e  should  be  taken 
never  to  administer  this  medicine  during  pregnancy,  its  effects  being 
violent  and  dangerous. 

Preparations.  —  Fluid  extract,  dose,  ten  to  thirty  drops  ;  solid  ex- 
tract, dose,  one  to  five  gitiins :  tincture,  four  ounces  to  a  pint  of 


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650 


MEDICINES  AND  THEIR  PREPARATIONS. 


Fio.  224. 


diluted  alcohol,  dose,  half  a  dram  to  a  dram  and  a  half;  Infusion, 
haJ.f  an  ounce  to  a  pint  of  water,  dose,  half  an  ounce  to  an  ounce. 
The  following  mixture  is  useful  in  amenori'hoea :  fluid  extract  of 
savin,  half  a  dram;  fluid  extract  of  ginger,  one  dram;  sulphate  of 
potassa,  two  drams.  Mix.  Dose,  half  a  dram,  twice  a  day.  The 
oil  of  savin  has  properties  similar  to  those  of  the  leaves.  Dose, 
from  two  to  live  drops,  on  sugar. 

Scaminony  ( Convolvulus  Scammonia) .  —  This  plant  is  a  native  of 
Syria,  and  the  neighboring  countries.  The  medicinal  part  is  the 
hardened  juice  of  the  fresh  root.  It  is  an  energetic  cathartic,  pro- 
ducing griping,  and  sometimes  operating  with  decided  harshness,  on 
which  account  it  is  generally  combined  with  other  medicines  which 
lessen  the  severity  of  its  action.  The  dose  is  from  tivc  to  twenty 
grains. 

ScuUcap  {Scutellaria  Lateriflora). —  An  indigenous  plant,  flowering 
in  July  and  August.  Tiie  whole  herl)  is  used.  It  is  a  valuable  ner- 
vine, tonic,  and  antispasmodic ;  while  it  gives 
support  to  the  nerves,  therefore,  it  imparts  both 
quietness  and  strength  to  the  whole  system,  and 
does  not,  like  other  nervines,  leave  the  patient 
excited  and  Irritable.  It  finds  its  use  in  the  treat- 
ment of  neuralgia,  chorea,  convulsions,  lockjaw, 
and  most  other  diseases  of  the  nervous  system. 

Preparations.  —  Fluid  extract,  dose,  half  a 
dram  to  a  dram  ;  compound  fluid  extract,  dose, 
half  a  dram  to  a  dram ;  tincture,  four  ounces 
to  a  pint  of  diluted  alcohol,  dose,  one  to  two 
<lrams  ;  infusion,  dose,  a  wineglassful,  three  times 
a  day  ;  scutellarin,  the  active  principle,  dose,  two 
to  six  grains. 

Seneka  {Poly gala  Senega),  —  An  indigenous 
plant,  commonly  called  snake-root,  the  root  of 
which  is  used  in  medicine.  It  is  a  stimulating  diuretic  and  expecto- 
rant, and  in  large  doses,  an  emetic  and  carthartic.  It  excites  all  the 
secretions.  It  is  useful  in  chronic  bronchitis,  and  in  other  chronic 
aftections  of  i^he  breathing  tubes. 

Preparations.  —  Fluid  extract,  dose,  twenty  to  forty  drops  ;  infu- 
sion, dose,  one  ounce  to  an  ounce  and  a  half;  syrup,  four  ounces  of 
fluid  extract  to  twelve  ounces  simple  syrup,  dose,  half  a  dram  to  ii 
dram.  The  following  is  a  very  good  expectorant  cough  preparation : 
fluid  extract  of  seneka,  three  drams ;  fluid  extract  of  squill,  half  a 
dram  ;  syrup  of  tolu,  two  drams  ;  paregoric,  two  drams  ;  carbonate 
of  ammonia,  twenty  grains ;  water,  four  and  a  half  ounces.  Mix. 
Dose,  one  dram. 

Senna  (  Cassia  AcutifoUa) .  —  Grows  abundantly  in  Upper  Egypt. 
The  leaves  are  the  medicinal  part.  It  is  a  mild,  active,  and  certain 
carthartic,  and  is  much  used  in  combination  with  other  medicines, 


8CULLCAP. 


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edicines, 


MEDICINES  AND  THEIR  PREPARATIONS. 


651 


particularly  epsom  salts.  The  addition  of  cloves,  ginger,  cinnamon, 
and  other  aromatics,  removes  all  its  tendency  to  griping,  and  makes 
it  11  safe  and  gentle,  yet  active  purgative,  in  most  cases,  calling  for 
nn  evacuation  of  the  bowels. 

Preparations.  —  Fluid  extract,  dose,  one  to  two  drams  ;  fluid  ex- 
tinct of  senna  and  jalap,  dose,  half  a  dram  to  a  dram  ;  solid  extract, 
(lose,  three  to  eight  grains  ;  tincture,  three  ounces  to  thirteen  ounces 
of  diluted  alcohol,  dose,  half  an  ounce  to  an  ounce ;  infusion,  two 
ounces  to  a  pint  of  water,  dose,  half  an  ounce  to  an  ounr  o. 

Shrubby  Trefoil  (Ptelea  TrifoUata).  —  This  shrub,  which  grows  in 
the  West,  is  called  wafer-ash,  and  wingseed.  Its  bark  and  root  have 
tonic  properties,  and  are  used  in  intermittent  and  remittent  fevers,  and 
wherever  nature  needs  a  lift  in  getting  uj)  from  exhausting  complaints. 
The  medicine,  like  other  tonics,  improves  the  appetite  and  digestion. 
Dose  of  the  solid  extract,  from  three  to  five  grains,  three  or  four  times 
a  (lay ;  of  the  cold  infusion,  a  tablespoonful,  every  two  or  three  hours. 

The  oleo-resinous  principle  of  the  crude  bark  is  called  ptelein,  and 
is  a  powerful  tonic.  Dose  one  or  two  grains,  three  or  four  times  a 
day. 

Fig.  225.  .  Fia.  228. 


SKUNK    CABBAGE. 


SLIPPEHY    ELM. 


Sknnk  Cabbage  (  Symplocarpus  Foetidus ) . — A  perennial  plant,  grow- 
ini>'  in  moist  places  throughout  the  United  States  ;  sometimes  called 
mmdow  cabbage.  The  root  is  stimulant,  expectorant,  antispasmodic, 
iuul  slightly  narcotic.  It  is  given  for  pulmonary  and  In'onchial  affec- 
tions, epilepsy,  hysterics,  asthma,  hooping-cough,  and  irritable  nerves. 

Preparations.  —  Fluid  extract,  dose,  twenty  to  eighty  drops  ;  tinc- 
ture, three  ounces  to  a  pint  of  alcohol,  dose,  half  a  drain  to  a  dram  ; 
intiwion.  dose,  one  to  two  ounces  ;  syrup,  two  ounces  of  fluid  extract 
to  eight  ounces  of  simple  syrup,  dose,  two  to  three  drams.  For 
nsthnm  and  cough,  and  to  promote  expectoration,  and  remove  tight- 
ness across  the  chest,  the  followiug  is  a  very  good  compound  prepa- 


ration  :  one  ounce  each  of  the  fluid  extract  of  skunk  cabbage,  lolielia, 
bloodroot,  pleurisy  root,  and  ginger,  one  pint  of  water,  and  three 
pints  of  alcohol.     Dose,  two  to  four  drams. 

Slippery  Elm  (Ulmus  Fitlva). — The  inner  bark  of  this  well- 
known  tree  is  nutritive,  demulcent,  emollient,  and  slightly  expecto- 
rant and  diuretic.  It  is  valuable  as  a  demulcent  drink  in  inflamma- 
tions of  the  lungs,  stomach,  bowels,  bladder,  and  kidneys ;  also,  for 
coughs,  strangury,  dysentery,  and  the  -summer  complaint  of  infants. 
It  makes  a  valuable  poultice  for  vai'ious  purposes. 

Small  Spikenard  (Aralia  NudicauUs) . —  This  plant  gi-ows  througli- 
out  the  United  States,  from  Canada  to  the  Carolinas,  in  rocky  woods. 
It  is  called  false  aarsaparilla  and  wild  aaraaparilla.  The  root  is  a 
gentle  stimulant,  diaphoretic,  and  alterative.  It  is  used  in  domestic 
practice,  and  by  some  physicians,  in  rheumatism,  syphilis,  and  cuta- 
neous diseases.  The  American  spikenard,  aralia  racetnoaa,  resem- 
bles the  small  spikenard  in  medical  properties.  Either  of  these  roots 
is  valuable  in  chronic  affections  of  the  lungs  and  air  tubes. 

Soap  (»5a/)o). — Soap  is  laxative,  antacid,  and  antilithic,  and  is 
much  used  in  coml)ination  with  cathartics,  to  lessen  the  severity  of 
their  action.  In  mesenteric  fever,  advantage  is  derived  from  rub- 
bing the  tumid  belly  of  children  with  a  strong  lather  of  soap,  morn- 
ing and  evening;   and   few  things  are  moi*e  effectual  in 


removing 


hardened  feces  from  the  rectum  in  cases  of  obstinate  costiveness  than 
an  injection  of  soap-suds. 

Sodinm.  —  This  is  a  soft  white  metal.  United  with  oxygen  in  the 
proportion  of  one  equivalent  each,  it  forms  the  alkali,  soda.  The 
following  are  the  principal  preparations  of  soda  used  in  medicine  : 

Bicarbonate  of  Sodf^  (Sodce  Bicarbonas).  — This  is  a  white,  inodor- 
ous powder,  generally  called  super  carbonate  of  soda.  It  is  antacid, 
antilithic,  and  slightly  diuretic.  It  is  chiefly  used  in  preparing  what 
are  called  soda  powders,  and  in  various  preparations  of  medicine, 
when  an  antacid  is  required.  It  is  also  taken  simply  dissolved  in 
water,  for  acidity  of  the  stomach.  The  yeast  powders ^  now  so  much 
used,  are  said  to  be  composed  of  about  two  and  a  half  parts  of  cream 
of  tartar,  and  one  part  each  of  corn  starch  and  bicarbonate  of  soda. 
Housewives  may  as  well  make  the  combination  for  themselves. 

Borate  of  Soda  {Sodas  Boras).  — This  is  everywhere  known  by  the 
name  of  borax.  It  exists  naturally  formed  in  several  parts  of  the 
world,  and  is  likewise  manufactured.  It  is  a  mild  refrigerant  and 
diuretic ;  also  emmenagogue,  promoting  menstruation,  facilitating 
parturition,  and  favoring  the  expulsion  of  the  after-birth,  by  its  spe- 
cific influence  upon  the  womb.  It  has  considerable  reputation  in  the 
treatment  of  urinary  diseases,  particularly  those  connected  with  an 
excess  of  uric  acid.  The  dose  is  from  twenty  to  forty  grains  in  solu- 
tion. Combined  with  rose-water,  honey,  and  various  other  things, 
according  to  circumstances,  l)orax  makes  a  valuable  wash  for  inflam- 
matory affections  of  the  mouth  and  throat,  skin  diseases,  etc. 


3,  lol)elia, 
ind  three 

;his  well- 
expecto- 

intlamtna- 
also,  for 

>f  infants. 

s  through- 
ty  woods. 
B  root  is  a 
I  domestic 
and  cuta- 
la,  resem- 
hese  roots 

ic,  and  is 
everity  of 
from  rub- 
lap,  morn- 
removing 
eness  thai» 

'gen  in  tlie 
oda.  The 
idicine : 

ite,  inodor- 
is  antacid, 
aring  what 
medicine, 
issolved  in 
w  so  mucli 
ts  of  cream 
te  of  soda. 
Ives. 

lown  by  tlie 
arts  of  the 
igerant  and 
facilitating 
by  its  spe- 
ition  in  the 
ed  with  an 
ins  in  solu- 
her  things, 
for  intlara- 
etc. 


Chloride  of  Sodium  (Sodii  Chloridum) . — This  is  the  chemical 
name  of  muriate  of  soda,  or  common  salt.  In  small  doses,  it  is  tonic, 
alterative,  and  anthelmintic.  It  checks  bleeding  from  the  lungs, 
when  taken  in  teaspoonful  doses.  The  dose  as  an  alterative  is  from 
ten  to  sixty  giains.  As  moderately  used  in  food  by  most  civilized 
people,  it  promotes  digestion  and  improves  the  general  health. 

Sulphate  of  Soda  (Sodce  Sulphas).  —  This  has  a  very  pretty 
name,  but  it  will  not  sound  half  as  well  to  thousands  of  young  per- 
sons, when  they  are  told  that  it  is  the  well-known  glauber's  salts. 
From  half  an  ounce  to  an  ounce  of  it,  dissolved  in  half  a  tunil)lerful 
of  water,  acts  as  a  cathartic  ;  a  smaller  dose,  as  a  laxative  and  diu- 
retic. Its  nauseous  and  bitter  taste  may  be  somewhat  concealed  by  a 
little  cream  of  tai-tar,  or  lemon  juice,  or  a  few  drops  of  sulphuric  acid. 

Snlphite  of  Soda  (/Sodce  Sulphis).  —  This  preparation  is  in  the 
form  of  transparent  crystals,  and  is  very  soluble  in  water.  In  doses 
of  sixty  grains,  this  is  said  to  have  been  used  with  success  in  frothy 
vomitings ;  it  is  also  well  spoken  of  as  a  remedy  in  acute  rheuma- 
tism, and  as  a  wash  in  thrush,  and  some  diseases  of  the  skin. 

Tartrate  of  Potassa  and  Sc'  (Soda:  et  Potassce  Tartras).  —  Tliis 
is  one  of  the  mildest,  and  mosi  cooling  purgatives  among  the  salts. 
It  is  known  as  rochelle  salt,  and  generally  agrees  well  with  irrital)le 
and  delicate  stomachs.  Dose,  from  two  drams  to  an  ounce,  in  a  tuin- 
l)l(Mful  of  water.  The  gentle  physic  called  seidlitz  powders  is  com- 
posed of  two  drams  of  rochelle  salt  and  two  scruples  of  bicarbonate 
of  soda  in  a  blue  pajjcr,  and  thirty-live  grains  of  tartaric  acid  in  a 
while  paper.  The  contents  of  each  paper  is  dissolved  in  half  a  tum- 
bler of  water  by  itself;  one  solution  is  then  poured  into  the  other, 
and  the  whole  is  drank  during  the  effervescence. 

Solonion's  Seal  (  Convalaria  Multiflora) .  —  This  is  one  of  our  own 
perennial  plants,  and  is  found  in  various  parts  of  the  country.  The 
root  is  tonic,  mucilaginous,  and  astringent.  It  acts  especially  upon 
mucous  tissues,  and  has  therefore  found  its  use  in  chronic  dysentery, 
and  piles,  and  in  chronic  inflammation  of  the  stomach  and  bowels. 
Dose  of  the  decoction,  or  infusion,  from  one  to  four  fluid  ounces,  three 
or  four  times  a  day.  Large  doses  purge  and  vomit.  The  decoction, 
applied  locally,  relieves  the  inflammation  caused  by  the  poison  vine. 

Solution  of  Arsenite  of  Potassa  {Liquor  Potassce  Arsenitis). — 
This  is  known  under  the  names  of  arsenical  solution  and  Fowler's  so- 
lution. It  is  a  transparent  liquid,  having  the  color,  taste,  and  smell 
of  spirits  of  lavender.  It  has  the  general  action  upon  the  human 
body  of  the  arsenical  i)reparations.  It  is  the  preparation  generally 
resorted  to  where  arsenic  is  given  internally,  and  is  used  with  con- 
siderable success  in  intermittent  fever,  leprosy,  and  several  other  skin 
diseases,  St.  Vitus's  dance,  periodical  headache,  and  some  other  com- 
l)hiints.  The  dose  is  from  three  to  ten  drops,  three  times  a  day,  given 
in  water ;  generally,  it  is  better  not  to  go  beyond  five  dro'ps.  Some- 
times it  disturbs  the  stomach,  and  binds  the  bowels,  producing  head- 


'•w\ 


654 


MEDICINES  AND  lilEIR  PREPAllATIONS. 


ache,  dizziness,  and  confusion  of  mind.  When  such  effects  follow 
its  use,  it  must  be  hiid  aside,  and  a  purgative  given.  After  an  inter- 
val of  two  weeks,  it  may  l)e  resumed  in  smaller  doses.  It  often 
requires  to  be  used  for  several  months. 

Spanish  Flies  (Cantharis  Vesicatoria) . — These  insects  are  of  a 
beautiful,  shining,  golden-green  color.  They  attach  themselves  to 
such  trees,  in  France,  Spain,  and  Italy,  as  the  white  poplar,  cldiM', 
privet,  and  lilach,  upon  the  leaves  of  which  they  feed.  They  niiikc 
their  appearance  in  swarms  upon  these  trees,  in  May  and  June,  and 
ai*e  shaken  off  in  the  morning  while  torpid  with  the  cold.  Internally 
administered,  they  are  a  powerful  stimulant,  exercising  a  peculiar  in- 
fluence over  the  urinary  and  genital  organs.  In  large  doses,  thiy 
excite  violent  inflammation  of  the  alimentary  canal  and  urinary  or- 
gans, strangury,  irrittition  of  the  sexual  organs,  headache,  delirium, 
and  convulsions ;  also  painful  priapism,  vomiting,  bloody  stools,  sali- 
vation, fetid  breath,  hurried  breathing,  and  difficulty  of  swallowing. 
They  are  given  intei'nally  for  chronic  gonorrhoea,  leucorrhcea,  semi- 
nal weakness,  and  paralysis  of  the  bladder.  Dose  of  the  powder, 
from  half  a  grain  to  two  grains ;  of  the  tincture,  fiom  twenty  to 
sixty  drops.  Solution  of  potassa,  given  every  hour,  in  thirty-droj) 
doses,  is  a  remedy  for  strangury  produced  by  cantharides.  Spiinish 
flies  are  used  externally,  in  the  form  of  blistering  plaster ;  also  in  the 
form  of  tincture,  mixed  with  various  solutions,  to  produce  irritation 
and  redness  of  the  skin. 

Spearmint  (Mentha  Viridis).  —  This  has  carminative,  diuretic, 
and  antispasmodic  virtues.  The  Avarm  infusion  of  it  is  much 
employed  in  domestic  practice,  to  produce  perspiration,  after  taking 
cold,  and  while  suffering  from  feverish  symptoms,  from  various 
causes.  The  oil  of  spearmint  has  similar  properties  with  the  herh, 
and  may  be  taken  in  five  to  ten  drop  doses,  on  sugar.  One  ounce 
of  the  oil  of  spearmint,  dissolved  in  a  pint  of  alcohol,  constitutes 
the  essence  of  spearmint. 

Spermaceti  (Cetaceum). — This  is  a  white  crystalline  substance, 
obtained  from  the  head  of  the  spermaceti  whale.  In  household  j^rac- 
tice,  it  is  considerably  used  for  the  coughs  and  colds  of  children, 
being  generally  simmered  with  molasses  or  loaf  sugar.  It  forms  a 
p:.rt  of  several  cerates  and  ointments. 

Spider's  Web  (Tela  Aranece) .  — The  web  of  the  black  or  brown 
spider,  gathered  in  barns,  cellars,  etc.,  is  sometimes  given  in  five  or 
six  grain  doses,  in  pill  form,  and  it  is  said  with  good  effect,  in  peri- 
odical headache,  hysterics,  St.  Vitus's  dance,  asthma,  and  fever  and 
ague.     It  is  likewise  applied  externally  to  check  bleeding. 

Spirit  of  Nitric  Etlier  fSpiritmuEtherismtrici).  — The  gencvi\\ 
reader  will  know  this  article  better  under  the  name  of  sweet  spiritx 
of  nitre.  It  is  aiuretic,  diaphoretic,  antispasmodic,  and  stimulant,  and 
in  large  doses,  a  narcotic  poison.  It  is  much  used  in  diseases  of  the 
urinary  organs,  either  alone  or  combined  with  sedatives,  and  other 


vfm 


diuretics.     Dose,  from  twenty  drops  to  two  fluid  drains,  to  be  taken 
in  water,  three  or  four  times  a  day. 

Sponge  (Spongia).  — When  burned,  this  is  used  as  an  alterative  in 
stitttula,  scrofulous  tumors,  goitre,  and  obstinate  diseases  of  the  skin. 
It  is  much  employed  by  homoeopathic  physicians,  though  it  has  much 
less  remedial  power  than  iodine.  Dose,  one  to  three  drams,  mixed 
with  honey  or  syrup. 

Spurred  Bye  (Secale  Cornutum). — This  is  a  diseased  product  of 
rye,  known  by  the  name  of  ergot.  This  article  has  a  peculiar  eti'cct 
upon  the  womb,  causing  it  to  contract  with  great  energy,  Avhen  given 
in  full  doses.  It  should  never  l)e  given,  however,  continuously,  for  a 
great  length  of  time,  as  it  has  been  known,  when  so  used,  to  produce 
(hy  gangrene,  typhus  fever,  and  nervous  disorders  connected  with 
convulsions.  Such  were  its  ett'ects  in  certain  provinces  of  France,  in 
consequence  of  the  use  of  rye  bread  contaminated  with  it.  It  is  use- 
ful in  excessive  uterine  hemorrhage,  which  it  arrests  by  causing  the 
womb  to  contract,  and  thus  to  condense  its  tissue,  and  close  up  its 
bleeding  vessels.  It  has  also  been  successful  in  bleeding  from  the 
lungs. 

Preparations.  — Fluid  extract,  dose,  half  a  dram  to  a  dram  ;  tinc- 
ture, four  ounces  to  a  pint  of  diluted  alcohol,  dose,  two  and  a  half  to 
tive  drams  ;  infusion,  dose,  one  to  two  ounces  ;  wine,  five  ounces  of 
Huid  extract  to  a  pint  of  sherry  wine,  dose,  two  to  four  drams,  in  cases 
of  labor ;  for  other  purposes,  one  to  two  drams. 

Squill  {Scilla  Maritimd) .  — A  perennial  plant  gi'owing  in  countries 
on  the  Mediterranean.  In  large  doses,  it  is  emetic  and  purgative  ;  in 
small  doses,  expectorant  and  diuretic.  It  is  used  in  pulmonary  aft'ec- 
tions  to  increase  expectoration,  and  in  dropsical  complaints  to  aug- 
ment the  secretions  of  the  kidneys.  Dose  of  the  dried  root,  one  to 
five  grains,  generally  to  be  united  with  nitre  or  ipecac. 

Preparations.  —  Fluid  extract,  dose,  as  an  expectorant  and  diuretic, 
two  to  six  drops  ;  as  an  emetic,  twelve  to  twenty-four  drops  ;  com- 
pound fluid  extract,  dose,  ten  to  twenty  drops  ;  tincture,  two  ounces 
to  a  pint  of  diluted  alcohol,  dose,  twenty  to  forty  drops  ;  syrup,  dose, 
a  <]uarter  to  half  a  dram. 

Star  Grass  {AletrisFarinosa). — This  plant  is  found  in  dry  soils 
throughout  most  parts  of  the  United  States,  and  called  iinicoi'n  root, 
ague  root,  and  crow  corn.  The  root  is  an  intensely  bitter  tonic,  and 
is  used  to  improve  the  tone  of  the  stomach,  and  for  flatulent  colic  and 
hysterics.  It  is  said  also  to  give  tone  io  the  female  generative  organs, 
affording  a  protection  against  miscarriage.  The  Eclectics  call  it 
one  of  their  best  agents  in  chlorosis,  suppressed  menstruation,  engorge- 
ment and  falling  of  the  womb,  and  painful  menstruation.  Dose  of 
the  powdered  root,  from  five  to  ten  grains,  three  times  a  day. 

Preparations.  —  Fluid  extract,  dose,  ten  to  thirty  drops  ;  tincture, 
two  ounces  to  a  pint  of  diluted  alcohol,  dose,  half  a  dram  to  a  dram  ; 
infusion,  two  drams  to  a  pint  of  water,  dose,  one  or  two  ounces ; 


m 


}.\. 


i 


'» ii 


656 


MEDICINES  AND  THEIR  PREPARATIONS. 


syrup,  dose,  one  to  two  drams  ;  aletridin,  the  active  principle,  dose, 
one  to  three  grains. 

8t.  Ignatios's  Bean  (Faba  Sancti  Ignatii) .  — The  seeds  are  the  part 
used,  and  are  the  product  of  the  Ignatia  Amara,  —  a  tree  of  middle 
size,  growing  in  the  Philippine  Islands,  and  is  a  species  o{  the  atrich- 
no8.  These  seeds  possess  a  large  amount  of  strychnine,  and  conse- 
quently, in  medicinal  doses,  are  a  powerful  nervine  tonic,  and  are  used 
for  improving  the  digestive  functions,  and  for  rousing  and  strength- 
ening the  whole  system  when  prostrated  by  nervous  complaints. 

Preparations.  — Fluid  extract,  dose,  five  to  ten  drops  ;  solid  extract, 
dose,  half  a  grain  to  a  grain  and  a  half. 

Storax  (Stt/rax  Officinale).  —  This  is  the  hardened  juice  of  the 
storax,  a  native  of  the  countries  along  the  Mediterranean.  It  is  a 
stimulant  and  expectorant,  and  is  used  for  chronic  bronchitis,  laryn- 
gitis, and  cough.  The  liquid  storax  is  sometimes  employed  instead 
of  copaiva  in  gonorrhoea  and  gleet.  The  dose  is  from  ten  to  twenty 
grains.    Storax  is  a  constituent  in  the  compound  tincture  of  benzoin. 


Fig.  227. 


Flo.  228. 


STAR  ORASa. 


STRAMONIUM. 


Stramonium  {Datura  /Stramonium) .  —  This  annual  plant  is  most 
known  in  this  country  by  the  name  oi  Jamestown  %oeed;  in  England 
by  that  of  thornapple.  The  leaves  and  seeds  are  medicinal.  Stramo- 
nium is  a  powerful  narcotic  ;  it  is  also  antispasmodic,  anodyne,  and 
sedative.  It  is  used  in  various  nervous  affections,  as  chorea,  epilepsy, 
palsy,  tetanus,  and  mania.  It  is  much  used  for  relieving  acute  pains, 
etc.     Taken  in  large  doses,  it  is  a  powerful  poison. 

Preparations. — Fluid  extract,  dose,  five  to  twenty  drops  ;  solid 
extract,  dose,  half  a  grain  to  a  grain ;  tincture,  two  ounces  to  a  pint 
of  alcohol,  dose,  half  a  dram  to  a  dram  and  a  half,  and  to  be  gradu- 
ally increased. 

Sulphur.  —  This  is  considerably  used  in  medicine,  being  laxative, 
diaphoretic,  and  resolvent.  It  is  chiefly  used  for  piles,  chronic  iheu- 
matism,  gout,  asthma,  and  those  affections  of  the  breathing  organs 


'  ■':  'ill 


not  Attended  with  ucute  inflammation.  Externally  and  internally*  it 
is  much  employed  in  .skin  diseases,  particularly  the  itch,  for  which  it 
is  a  specific.  In  these  affections,  it  is  frequently  applied  in  the  form 
of  suljjhur  baths.  The  dose  of  sulphur  is  from  one  to  three  drams, 
mixed  with  syrup,  molasses,  or  milk.  When  sul>limcd,  this  article 
imMcdJfowei's  of  sulphur,  which  is  the  form  in  which  it  is  chiefly 
used  in  medicine. 

Sumach  {Rhus  Glabrum).  —  Found  in  almost  nil  parts  of  the  United 
Stiitcs,  in  old  neglected  fields,  and  by  the  side  of  fences.  The  bark 
aiul  berries  are  astringent,  tonic,  antiseptic,  and  diuretic,  and  are  used 
ill  (liarrli<ra,  dysentery,  gonoi'rhrea,  whites,  hectic  fever,  and  scrofula. 
Th(!  Itorries  make  a  valuable  gargle  in  quinsy,  and  ulcerations  of  the 
jiioiith  and  throat,  and  also  a  useful  wash  for  ringworm,  tetter,  and 
ulcers.  The  excrescences  which  grow  upon  the  loaves  have  nearly 
as  much  astriugency  as  galls,  and  when  pulverized  and  mixed  with 
liinl,  have  a  similarly  soothing  efl'ect  upon  piles. 

Preparations.  —  Fluid  extract,  dose,  one  to  two  drams  ;  tincture, 
four  ounces  to  thirteen  ounces  of  diluted  alcohol,  dose,  half  an  ounce 
to  iin  oimce. 

Sunflower  ( Hdianlhus  Annuns ) .  —  The  seeds  and  the  leaves  of  this 
plant  are  exi)ectorant  and  diuretic,  and  are  useful  in  several  pulmo- 
nary aflections.  The  seeds  yield  a  fixed  oil,  in  which  their  medicinal 
virtues  are  chiefly  found.  In  doses  of  ten  or  twenty  droi)8,  this  oil 
ads  favorably  upon  inflamed  mucous  surfaces,  ond  in  doses  three 
times  us  large,  it  greatly  augments  the  flow  of  urine. 

Swamp  Dogwood  ( Cornus  Sericea ) .  — This  is  found  in  damp  places, 
and  along  the  banks  of  rivers,  in  various  parts  of  our  country,  and  is 
known  as  red  ozier,  red  willow,  and  rose  Willow.  The  bark  is  tonic, 
stinmlant,  and  astringent,  and  has  been  used  for  similar  purposes  with 
dogwood  bark  ;  well  s[>oken  of,  also,  for  dyspepsia,  diarrhoea,  malig- 
nant fevers,  and  as  an  external  api>lication  to  foul  and  ill-conditioned 
ulcers.  Dose  of  the  [wwdered  bark,  from  twenty  to  sixty  grains  ;  of 
the  infusion,  from  two  to  four  fluid  ounces. 

Swamp  Milkweed  (Asclepias  Incamata) .  — This  is  a  native  of  the 
United  States,  and  l^ears  red  flowers  from  June  to  August.  It  has  the 
name  of  white  Indian  hemp.  The  root  is  emetic,  cathartic,  and  diuretic, 
and  is  useful  in  asthma,  bronchitis,  rheumatism,  syphilis,  and  worms. 

Preparations.  — Fluid  extract,  dose,  twenty  to  forty  drops ;  solid 
extract,  dose,  three  to  five  grains ;  tincture,  two  ounces  to  a  pint  of 
diluted  alcohol,  dose,  one  and  a  half  to  three  drams  ;  infusion,  dose, 
three  to  six  drams  ;  syrup,  four  ounces  fluid  extract  to  twelve  ounces 
simple  syrup,  dose,  half  a  dram  to  a  dram  and  a  half. 

Sweet  Fern  (Comptonia  Aspleni/olia) .  —This  shrub,  growing  in 
stony  pastures  in  New  England  and  Virginia,  is  tonic,  astringent, 
alterative,  and  aromatic,  and  is  used  in  diarrhoea,  dysentery,  cholera 
infantum,  rheumatism,  and  debility  after  fevers.  Dose  of  the  decoc- 
tion, from  one  to  four  fluid  ounces,  three  or  four  times  a  day. 

83 


,:i    '  ■  I 


658 


MEDICINES  AND  THEIR  PREPARATIONS. 


Sweet  Flag  {Acorun  Calamm).  — Found  in  damp  plaeos,  in  most 
parts  of  the  world.  The  root  is  Htimulant,  tonic,  and  aromatic:  us<'. 
ful  in  wind  colic,  weakened  conditions  of  tlie  stomach,  and  dysjiepsia. 
Dom  of  the  root,  from  twenty  to  sixty  grains  ;  of  the  infusion,  from 
two  to  four  rtuid  ounces. 

Sweet  Gum  {Liqnidamher  Styraciflna). — This  tree  grows  in  the 
Middle  and  Southern  States.  Being  wounded,  it  yields  a  yellowish- 
white,  honey-like  balsam,  which  hardens  into  a  gum.  This,  melted 
with  ecjual  parts  of  lard  or  tallow,  forms  an  ointment  which  is  used 
in  some  parts  of  the  country  for  piles,  ringworm  of  the  scalp,  fever 
isorcs,  and  other  complaints.  Used  internally,  it  has  very  nearly  the 
same  oflects  with  storax. 

Tag  Alder  {Alnus  Rubra). — This  shrub  grows  in  swamps  and 
other  damp  places,  in  northern  United  States.  The  bark  is  altera- 
tive, emetic,  and  astringent.  It  is  used  in  scrofula,  secondary 
syphilis,  herpes,  impetigo,  and  other  skin  diseases. 

Preparations.  —  Fluid  extract,  dose,  one  to  two  drams  ;  infusion, 
two  ounces  to  a  pint  of  water,  dose,  one  to  two  ounces  ;  ulnuin,  the 
active  principle,  dose,  one  to  three  grains. 

Tansy  ( Tanacetum  Vulgare) .  —  Tansy  is  a  perennial  herb,  having 
tonic,  emmenagogue,  and  diaphoretic  properties ;  the  cold  infusion 
l)eing  tonic,  and  useful  in  dyspepsia,  wind  in  the  stomach,  jaundice, 
and  worms ;  the  warm  infusion,  diaphoretic  and  emmenagogue. 
D6se  of  the  infusion,  from  one  to  four  fluid  ounces,  two  or  three 
times  a  day. 

Tar  {Fix  Liquida) . — The  medicinal  qualities  of  tar  are  like  those  of 
turpentine,  and  it  is  sometimes  used  in  old  chronic  coughs  and  bron- 
chitis. The  vapor  of  boiling  tar  was  once  thought  to  be  very  service- 
able in  bronchial  diseases,  when  inhaled.  Doubtless  it  is  useful  in 
some  cases,  but  its  virtues  have  been  extolled  aliove  their  merits. 
In  the  form  of  ointment,  it  has  real  efficacy  in  scald  head  and  tetter. 

Thimbleweed  (Rudbeckia  Laciniala).  —  The  whole  of  this  herb  is 
balsamic,  diuretic,  and  tonic,  and  in  the  form  of  decoction,  used 
freely,  is  said  to  ha^'e  Ijcen  found  useful  in  some  urinary  complaints, 
as  Bright's  disease,  strangury,  etc. 

Tobacco  {Nicotiana  Tabacttm).  — The  leaves  of  tobacco  are  acrid, 
narcotic,  and  poisonous,  and  are  chiefly  used  in  the  form  of  ointment, 
in  skin  diseases,  etc.  Its  poisonous  qualities,  however,  render  it 
dangerous  when  much  used,  even  externally. 

Trailing  Arbntns  {Epigma  Repena).  —  This  grows  in  sandy  woods 
and  rocky  soils,  its  flowers  appearing  in  early  spring,  and  exhaling  a 
spicy  fragrance.  The  leaves  are  diuretic  and  astringent,  and  are 
very  useful  in  gravel,  and  most  diseases  of  the  urinary  organs,  being 
regarded  in  some  cases  superior  to  Uva  ursi  and  buchu. 

Preparations.  —  Fluid  exti'oct,  dose,  one  to  two  drams  ;  infusion, 
dose,  two  to  four  ounces. 


■~"flSi 


MEDICINES  AND  THEIR  IMIEPARATIONS. 


6:)  9 


Tapioca  {Janipha  Manthot).  —  This  pliint  <rr()\vs  (n  Iho  West  IndioA 
andBnizil.  It  is  cultivated  thioHy  on  iiccoiint  of  \\\v  root,  which  is 
largely  used  aw  Jin  article  of  food,  parliculurly  for  \\w.  sick,  or  nithcr, 
for  those  recovoriii<i^  from  Hickin^ss.  Tho  starch  which  it  oontaJus  w 
separated  by  wa«hin«r,  scraping,  <^ratiii<;,  and  «rrindin<j;,  and  is  in  the 
form  of  hard,  white,  ronj^h  "grains.  It  is  prepared  for  use  by  hoilinjL' ; 
and,  in  debility  and  low  forms  of  <lisease,  may  have  the  addition  of 
wine,  nutmeg,  or  other  aroniatics. 

TnlipTree  (Liriodendron  Tulipifera) .  — This  is  a  large  and  elegant 
tree  growing  in  many  parts  of  the  country,  and  called /)o;)/r»r  and  white 
poplar.  The  hark  of  tho  root  is  aromatic,  stimulant,  and  tonic,  and 
in  warm  infusi<m,  diaphoretic.  It  is  used  in  fov<«r  and  ague,  chronic 
rheumatism,  and  chronic  diseases  of  the  stomach  and  bowels.  Dose 
of  the  powdered  bark,  from  a  scruple  to  two  drams  ;  of  the  infusion, 
from  one  to  two  fluid  ounces. 

Turkey  Corn  ( Coiydalis  Formosa).  — This  perennial  plant  is  called 
wild-turkey  pen,  and  ntagger-ioeed,  and  grows  in  rich  soils  in  the 
Southern  and  Western  States.  The  tuber,  which  is  the  medicinal 
part,  should  only  be  collected  while  the  plant  is  in  flower.  It  is  tonic, 
diuretic,  and  alterative.  It  is  much  valued  as  a  remedy  in  syphilis 
and  scrofula. 

Preparations.  —  Fluid  extract,  dose,  ten  to  forty  drops  ;  tincture, 
three  ounces  to  a  pint  of  diluted  alcohol,  dose,  half  a  dram  to  two 
drams;  corydalin,  the  active  principle,  dose,  half  a  grain  to  a  gratn. 
A  valuable  alterative  for  syphilis  is  made  by  uniting  eight  grains  of 
corydalin  with  ten  grains  of  hydrastin,  and  dividing  into  twelve  jww- 
ders.    Dose,  one  powder,  three  or  four  times  a  day. 

Turmeric  (  Curcuna  Longa) .  —  This  is  a  native  of  the  East  Indies 
and  Cochin  China.  The  root  is  a  stimulant  aromatic  and  tonic,  some- 
what like  ginger,  employed  in  debilitated  states  of  tho  stomach,  etc. 

Preparations.  —  Fluid  extract,  dose,  two  or  three  drams  ;  tincture, 
two  ounces  to  twelve  ounces  of  diluted  alcohol,  dose,  one  and  a  half 
to  two  ounces  ;  infusion,  dose,  two  to  four  ounces. 

Valerian  (  Valeriana  Officinalis).  —  This  is  a  European  plant,  flow- 
ering in  June  or  July.  The  root  is  tonic,  nervine,  and  antispasmodic, 
and  is  much  used  in  cases  of  irregular  nei-vous  action,  particularly 
morbid  nervous  vigilance,  or  hypochondria,  epilepsy,  lowness  of 
s[)irit8,  and  nervous  headache. 

Preparations.  —  Fluid  extract,  dose,  half  a  dram  to  a  dram  and  a 
half;  solid  extract,  dose  three  to  ten  grains  ;  tincture,  four  ounces  to 
a  pint  of  diluted  alcohol,  dose,  two  to  four  drams  ;  infusion,  half  an 
ounce  to  a  pint  of  water,  dose,  two  to  four  ounces  ;  syrup,  four  ounces 
of  Huid  extract  to  a  pint  of  simple  syrup,  dose,  two  to  four  drams. 

Vervain  (  Verbena  Hastata).  — A  perennial  plant,  common  in  the 
Ignited  States.  The  root  is  tonic,  emetic,  expectorant,  and  sudorific. 
It  is  used  in  intermittent  fevers,  colds,  and  obstructed  menstruation, 
in  the  form  of  warm  infusion.     The  cold  infusion  is  a  good  tonic  in 


660 


MEUICINES  AND  THEIR  PREPARATIONS. 


loss  of  appetite,  debility,  etc.  Dose  of  V.w.  powdered  root,  one  or  two 
scruples;  of  the  infusion,  from  two  to  four  ounces,  three  or  four 
times  a  day. 

Tinegar  (Acetum).  — This  is  refrigerant,  diuretic,  astringent,  and 
tonic  ;  used  in  fevers  and  inflammatory  complaints,  likewise  in  scurvy 
and  typhus,  as  an  antiseptic.  It  has  been  found  useful  In  dysentery 
and  scarlet  fever,  saturated  with  common  salt  Externally,  it  is  ap- 
[)lied  to  bruises,  inflammations,  sprains,  and  swellings.  It  sometimes 
has  a  good  effect  as  a  gargle  in  putrid  sore  throat,  etc.,  and  as  a  cool- 


ing wash  in  headack*^  during  fevers. 


Fig.  220. 


Pio.  230. 


'% 

^m 

'A 

^vT^nS^^^H 

^4 

ll^a 

'I 

^ 

r    .; 

•  '7^^m^  •  i 

TAPIOCA. 


TIBOINIA   «NAKB-BOOT. 


Fio.  231. 


Tirginia  Snake-root  (^Artstolochia  Serpentaria) .  —  This  is  a  peren- 
nial herb  of  the  Middle  and  Southern  States.  The  root  is  stimulant, 
tonic,  and  diaphoretic.  It  is  used  in  typhoid  fevers,  when  the  sy.«- 
tem  ne^  Is  support,  but  cannot  bear  active  stimulation. 
Combined  with  peruvian  barl:,  it  is  also  used  in  inter- 
miVl^nt  fevers.  The  <^old  infusion  is  employed  in  some 
forms  of  dyspepsia ;  likewise  as  a  gargle  in  malignant 
sore  throat. 

Preparations. — Fluid  extract,  dose,  one  quarter  to 
half  a  dram ;  tincture,  three  ounces  to  a  pint  of  diluted 
alcohol,  dose,  one  to  two  drams ;  infusion  half  an  ounce 
to  a  pint  of  water,  dose,  one  to  two  ounces,  in  low  forms 
of  fever.  The  following  is  a  good  compound  tincture ; 
half  an  ounce  each  of  fluid  extract  of  snake-root,  fluid 
extract  of  iiiecac,  fluid  extract  of  saffron,  fluid  extract 
of  ladies'  slipper,  together  with  half  an  ounce  of  cam- 
phor, and  one  and  a  half  pints  of  diluted  alcohol ;  dose, 
a  dram  to  a  dram  and  a  !mlf. 

Water  Horehouud. — This  article  has  been  desc^-'bed 
under  Bugle  fVeed,  but  the  cut  was  forgotten.      S\^e  Bugle   Weed 
(Lycopua  Virginicus), 


■fpppip 


MEDICINES  AND   THEIU  PREPARATIONS. 


661 


Water  Pepper  {Polygonum  Punctatum). — This  annual  plant  is 
called  .smart-weed,  and  jj^row.s  throughout  our  country,  in  low  grounds, 
and  along  ditches  and  brooks.  It  has  a  pungent,  bitinjr  taste,  and  is 
stimulant,  diuretic,  emmenagogue,  antiseptic,  and  vesicant.  It  is 
used  in  coughs,  colds,  gravel,  and  womb  complaints. 

Prepardtions.  —  Fluid  extract,  dose,  ten  to  sixty  drops;  solid 
extract,  dose,  two  t(^  three  grains  ;  tincture,  four  ounces  to  a  pint  oi' 
diluted  alcohol,  dos^e,  half  a  dram  to  two  drams  :  infusion,  half  an 
ounce  to  a  pint  of  v  ater,  dose,  half  an  ounce  to  an  ounce. 

WiiliOO  ( Euonymus  Atropurpiireus)  —  A  small  shrub  growing  in 
woods  in  many  jjurts  of  the  United  States.  The  bark  of  the  root  is 
•I  bitter  tonic,  laxative,  alterative,  diuretic,  and  expectorant,  and  is 
advantageously  used  in  jjulmonary  atl'ections,  dropsy,  constipation, 
torpidity  of  the  liver,  dyspepsia,  and  intermittent  fevers. 

Preparations.  —  Fluid  extract,  dose,  one  to  two  drams  ;  tincture, 
(our  ounces  to  twelve  ounces  of  diluted  alcohol,  dose,  half  an  ounce 
to  an  ounce. 

Wax.  —  The  yedow  and  white  wax  are  chiefly  used  as  ingredients 
of  i)lasters  and  ointments. 

White  Hellebore  (  Veratrum  AUncni).  —  This  is  an  European  pe- 
rouniul  jdant,  the  root  of  which  is  a  violent  emetic  and  })urgativc,  and 
in  large  doses  is  poisonous  ;  not  often  used,  except  externally,  in  the 
tbiin  of  oirtmenf  or  decoction,  for  the  cure  of  itch,  and  some  other 
^kiu  diseases. 

White  OaJ^  (  Quercfi.,^  Alba).  —  The  imier  bark  of  the  white  iak  is 
astringent,  tonic,  and  antiseptic,  and  has  been  used  \n  intermittent 
fever,  chi'onic  diarrluea,  chronic  mi  covis  discharges,  and  [)assive  hem- 
orrhages. As  awash  applied  externally,  it  s(mietinies  arrests  night- 
sweats,  and  as  an  astringent  gargle  and  injection,  its  use  's  c(»mmon 
for  relaxed  palate,  s|)ongy  gums,  leucorrhaa,  falling  of  the  l)()v/el,etc. 

Preparations.  — -  Fluid  extract,  dose,  half  a  dram  to  a  dram  ;  solid 
extract,  dose,  ten  to  twenty  grains  ;  tincture,  two  ounces  to  a  pint  of 
diluted  alcohol,  dose,  half  an  oun<;e  to  an  ounce. 

White  Pond  Lily  (Ni/mphcea  Odorata).  —  This  grows  in  ponds  and 
marshes  li.  many  parts  of  our  country.  The  root  is  de^nnlcent,  ano- 
dyne, astringent  and  alterative  ;  used  in  dysentery,  diarrluea,  gonor- 
rhoea, whites,  an'l  scrofula.  An  infusion  is  sometitnes  used  as  a 
gargle  in  ulce*^d  of  the  mouth  and  throat,  and  as  an  injection  in  leu- 


con'hoea.     Dose  of  the  infusion,  from  two  to  four  fluid  ounces. 

Wild  Cherry  ( PrwnMS  Viginiana),  —  This  tree  grows  extensively 
in  the  American  forests,  flourishing  where  the  soil  is  fertile  and  the 
climate  temperate.  The  inner  bark  is  tonic  and  stimulant  to  the  di- 
gestive organs,  and  sedative  to  the  nerves  and  the  circulation.  It  is 
much  used  in  consumption,  scr»jfula,  and  dyspepsia. 

Preparations.  —  Fluid  extract,  dose,  two  to  four  drams,  com|)ound 
fluid  extract,  dose,  half  a  dram  to  two  drams  ;  infusion,  half  an  ounce 


m 
Mil 


■ii 


662 


MEDICINES  ^iND  THEIR  PREPARATIONS. 


u)  a  pint  ot  water,  dose,  two  ounces ;  syrup,  three  ounces  of  fluid 
fextract  to  thirteen  ounces  of  simple  syrup,  dose,  two  drams  to  an 
ounce. 

Wild  Cucumber  {Momordica  Elaterium).  —  This,  sometimes  called 
squirting  cucumber,  is  a  native  of  the  south  of  Europe,  and  is  culti- 
vated" in  Great  Britain.  It  is  a  powerful  hydrago<]^ue  cathartic,  and 
in  lar<i;e  doses,  causes  nausea  and  vomitin*;.  On  account  of  the 
watery  stools  it  produces,  it  is  much  used  in  dropsical  complaints, 
though  the  severity  of  its  action  forbids  its  being  used  alone.  Dose, 
u  quarter  to  half  a  grain,  rei)eated  every  hour  till  it  operates ;  of 
elatorin,  from  a  sixteenth  to  a  twentieth  of  a  grain,  given  in  solution. 

"Wild  Ginger  {Asarum  Canadense) .  —  This  is  known  by  the  names 
of  coWs-foot  and  Canada  snake-root,  and  is  common  in  all  parts  oi' 
the  country.  The  root  is  tonic,  stimulant,  aromatic,  expectorant,  and 
diaphoretic.  It  is  used  in  pains  of  the  stomach,  colic,  etc.  Doso  of 
the  powder,  half  m  drain  :  of  the  tincture,  half  a  dram  to  two  drams. 


Fl<i.  232. 


Fro.  2P.''. 


1\   )^     ,. 


WILD  IMMOO. 


WITCU  UAKKL. 


Wild  Indigo  {Baptisia  Tinctoria).  —  This  perennial  shrub  is  foun'' 
in  most  parts  of  the  country.  The  bark  of  the  root  is  purgati^  ej 
emetic,  stimulant,  astringent,  and  antiseptic.  It  is  chiefly  usod  »v 
its  antiseptic  properties.  For  external  use  it  is  valuable  as  a  wash 
or  gargle  for  various  ulcers,  mercurial  sore  mouth,  and  scrofulous 
and  syphilitic  ophthalmia. 

Preparations.  —  Fluid  extract,  dose,  a  quarter  to  half  a  dram ; 
tincture,  two  ounces  to  a  pint  of  diluted  alcohol,  dose,  two  to  four 
drams  ;  infusion,  dose,  half  an  ounce  ;  baptisin,  the  active  principle, 
a  quarter  to  half  a  grain ;  gargle,  four  ounces  of  fluid  extmct  to 
twelve  ounces  of  water,  to  be  used  as  occasion  requires. 

Wild  Yam  {Dioscorea  Villosa).  —  A  perennial  vine,  found  moJ>  y 
at  the  South.     The  root  is  antispasmodic,  and  is  successfully  Uct' ;    ; 
bilous  colic.     It  is  said  to  bring  relief  in  the  mo.st  violent  ^^asey 
this  complaint.     It  allays  nausea  and  spasms  during  pregnancy.     It  i.s 
given  in  the  form  of  decoction,  two  or  three  t5ii'^  ounces  every  th.rty 


^1 


MEDICINES  AND  THEIR  PREPARATIONS, 


663 


or  forty  minutes.     Dose  of  die  tincture,  from  a  quarter  of  a  dram  to 
a  dram  ;  of  dioscorein,  the  active  principle,  o..e  to  four  grains. 

Willow  (Silex  Alba). — The  willow  is  common  in  Euroi)e  and 
America.  Its  bark  is  tonic  and  astringent ;  and  is  used,  occasionally, 
as  a  substitute  for  peruvinn  bark,  in  intermittent  fever.  It  is  also 
employed  in  the  treatment  of  chronic  diarrha?a  and  dysentery.  Dose 
of  the  powdered  bark,  one  dram;  of  the  decoction,  one  to  two  fluid 
ounces.  Siilicin,  the  active  principle,  is  given,  sometimes,  in  place 
of  quinine  ;  dose,  from  two  to  ten  grains. 

Wint*;rgreeii  (  Gaultheria  Procumbens) .  —  This  evergreen  grows  in 
mounbiinous,  barren  regions,  throughout  our  country.  The  leaves  are 
an  agreeable  stimulant,  aromatic,  and  astringent.  Used  for  chrop.ic 
diarrhoea,  and  as  an  emmenagogue.  The  oil  and  essence  are  useful 
in  flatulent  colic  ;  dose  of  the  oil,  from  Ave  lo  ten  drops,  on  sugar; 
of  the  essence,  thirty  to  forty  Jrops.  Much  used  to  flavor  other 
medicines. 

Witch  Hazel  (Ilamamelis  Virginica).  —  This  derives  its  name  from 
its  having  fruit  and  flowers  together  on  the  same  tiee.  It  is  found  in 
most  parts  of  our  country.  The  bark  and  leaves  are  toni(!,  astringent, 
and  sedative.  It  is  used  in  bleeding  from  the  lungs  and  stomach,  and 
in  diarriia'a,  dysentery,  and  excessive  nmcous  discharges.  It  is  also 
used  in  incipient  consumption,  and  for  sore  mouth,  etc. 

Preporalions.  —  Fluid  extract,  dose,  one  to  two  drams;  infusion, 
dose,  four  drams  ;  syru[),  four  ounces  of  fluid  extract  to  twelve  ounces 
of  simple  syrup,  dose,  one  to  two  drams. 


Fig.  234. 


Fia.  235. 


WOLFBBAKiC. 


WOBIIWOOD. 


Wolfebane  {Aconitum  Napellua) .  — This  has  already  l>een  described, 
under  its  other  common  name,  which  is  Monkshood;  but  as  the  ctit 
we  h>«:l  prepared  to  accompany  it  was  omitted,  we  give  it  a  place 
here,  referring  the  reader  to  monkshood  for  its  description. 


,i   ll- 


Wi 

,..rl^:l 

'  ':*'::vi"a 

:,:!.;;;|_ 
'lii*?i*il 


664 


MEDICINES   AND  THEIR   PREPARATIONS. 


Wormseed  (Chenopodhim  Anthelminticum) . — This  perennial  is 
called  Jerusalem  oak,  and  is  found  in  waste  places  all  over  the  United 
States.  An  oil  is  extracted  from  the  seeds,  which,  in  doses  of  fiom 
four  to  eight  di-ops,  niorning  and  evening,  for  a  child,  destroys  worms. 
A  stiong  infusion  of  tin;  tops  has  a  similar  ctfect.  Tl.e  romody  should 
be  used  four  or  tive  days,  and  he  followed  hy  a  purge. 

Wormwood  (Artemisio  Ahf<-int/tinm) .  — The  tops  and  hiavosof  Ihis 
perennial  are  tonic  and  anthelmintic  ;  used  in  intermittent  fever,  jaun- 
dice, and  worms.  It  restores  the  appetite  in  a  wtiakeniid  state  of  tho 
digestive  organs,  and  is  also  useful  in  amenorrhtt'a.  It  is  excelleiil 
applied  as  a  tincture,  or  in  the  form  of  fomentation,  to  bruises,  sprains, 
and  local  inllanunations. 

Prejxiritfions. — Fluid  extract,  dose,  one  third  to  two  thirds  of  a 
dram  ;  solid  extract,  dose,  three  to  five  grains  ;  tincture,  two  ounces 
to  fou'icen  ounces  of  diluted  alcohol,  dose,  two  to  *bur  drams  ;  syrup, 
two  oi.  '!   id  extract  to  six  ounces  of  simple  s>yri>p,  dose,  one  to 

two  dran 

Yarrow  ^^Lchillea  Millefolium).  — A  perennial  herb,  common  to 
the  Old  AVorld  and  New,  and  growing  in  old  fields  and  along  fences. 
It  is  tonic,  astringent,  and  alterative,  and  has  been  used  in  inter- 
mittent fever,  bleeding  from  the  lungs,  excessive  menstruation, 
wind  colic,  and  chronic  dysenteiy.  Dose  of  the  infusion,  a  wine- 
glassful,  three  or  four  times  a  day. 

Yeast  {Cercvlsla'.  Fermenlum).  — Yeast  \s  slightly  tonic  and  stim- 
ulating, and  has  been  used  with  advantage  in  ty|)hoid  fever  ;  also  in 
scarlet  fever,  and  in  all  diseases  where  there  is  a  disposition  to  jjutrid- 
ity.  The  dose  is  from  one  to  two  fiuid  ounces,  every  two  or  three 
hours.  It  makes  an  excellent  antiseptic  poultice,  for  unhealthy  and 
fetid  ulcers,  especially  if  combined  with  powdered  slii)pery  elm  bark, 
and  charcoal. 

Yellow  Dock  {Rumex   Crispus).  —  The  root  of  this       ^"'-  ^'^■ 
perenniel  i)lant  is  alterative,  tonic,  diuretic,  and  deter- 
gent, and  is  regarded  as  very  valuable  in  the  treatment 
of  scrofula    syphilis,  leprowy,  scurvy,  and  other   skin 
diseases. 

Preparations.  —  Fluid  extract,  dose,  one  to  two 
dnuns  ;  solid  extract,  dose,  four  to  eight  grains  ;  syrup, 
four  ounces  of  fluid  extract  to  twelve  ounces  of  simplfe 
syrup,  dose,  half  an  ounce  to  an  ounce ;  rumin,  the 
active  principle,  dose,  two  to  four  grains. 

Yellow  Jessamine  ( Geheminum  Sempervirens) .  — 
'.his  abounds  in  the  Southern  States,  where  it  is  culti- 
vated as  an  ornamental  vine.  The  root  is  a  powerful 
febrifuge,  narcotic,  and  relaxant,  controlling  and  8ul>- 
duing  ifever,  quieting  nervous  irritability  and  excitement,  equalizing 
the  circulation,  promoting  pei-spirution,  and  rectifying  the  secretions. 
It  is  much  used  by  the  Eclectics  of  the  Western  States,  but  the  general 


TBIXOW  DOCK. 


It-.    '  ;     ^ 


i^'l 

■■i 


DOCE. 


MEDICINES  AND  THEIR  PREPARATIONS. 


665 


judgment  of  the  i)rofession  is,  that  it  is  too  |)owerful  a  remedy  to  be 
siife.  My  own  opinion  is,  that  the  American  hellebore  is  equally 
trt'cc'tive  with  the  yellow  jessamine,  and  that  its  general  use  involves 
far  loss  danger. 

Preparations.  —  Fluid  extract,  dose,  two  to  twenty  drops  ;  tincture, 
four  ounces  to  a  pint  of  alcohol,  dose,  fifteen  to  sixty  drops,  and  in- 
crease ;  gelserainin,  the  active  princii)le,  dose,  half  a  grain  to  a  grain 
iiiul  a  half. 

Yellow  Ladies'  Slipper  (CypripediumPubescens). — This  perennial 
l)laut  is  called  American  valerian,  nerve  root,  etc.  The  HI)rous  roots 
iiie  tonic,  nervine,  antispasmodic.  Mid  diai)horetic,  and  are  used  in 
ncivous  headache,  nervous  excitability,  hysterics,  neuralgia,  and  St. 
Vitus's  dance.     Dose  of  the  powder,  ironi  ten  to  thirty  grains. 

Preparations  -Fluid  extract,  dose,  half  a  dram  to  a  dram  ;  solid 
extract,  dose,  five  to  fifteen  grains  ;  tincture,  two  ounces  to  a  pint  of 
diluted  alcohol,  dose,  half  an  ounce  to  an  ounce  ;  syrup,  four  ounces 
of  iluid  extract  to  fourteen  ounces  of  simple  syrup,  dose,  two  to  four 
drams;  cypripcdin,  the  active  principle,  dose,  two  to  four  grains. 

Yellow  Parilla  {Meninpermum  Ganadense).  —  This  is  a  perennial 
jiiant,  growing  in  woods,  and  near  stream^s,  througluMit  the  country. 
The  root  has  the  properties  of  a  tonic,  laxative,  alterative,  and  diu- 
retic. It  is  valued  in  the  treatment  of  scrofula,  syphilis,  skin  diseases, 
•font,  rheumatism,  dyspei)sia,  general  del)ility,  and  chronic  iniianuna- 
rion  of  the  stonmch  and  bowels.  Dose  of  the  decoction,  from  two  to 
four  fluid  ouiicv  s,  three  times  a  day  ;  of  the  solid  extract,  from  two  to 
four  grains. 

Zinc.  —  Several  preparations  of  this  metal  are  used  in  medicine,  as 

follows:  . 

Acetate  of  Zino.  — This  is  used  as  an  external  remedy  only,  gener- 
ally as  an  astringent  Avash  for  inflammations  of  the  eye,  and  as  an 
nijection  in  gonorrhoea,  but  only  after  the  acute  stage  of  these  diseases 
has  past.  The  strength  of  these  solutions  generally  should  be  one  or 
two  grains  to  a  fluid  ounce  of  soft  water. 

Chloride  of  Zinc  (Zmct  Chloridum), —  This  is  a  powerful  escharo- 
tic,  and  is  employed  as  an  external  application  to  cancers  and  obsti- 
nate ulcers.  A  weak  solution  of  it  is  occasionally  em[)loyed  in  old 
chronic  gleet,  also  in  whites,  and  puruleat  discharge  from  the  neck 
of  the  womb. 

Iodide  of  Zinc  (  Zinci  lodidum) .  —  This  is  in  the  form  of  white 
needles,  and  is  tonic  and  astringent.  It  is  not  much  used,  except 
externally,  being  applied  in  a  solution  of  twenty  grains  to  a  fluid 
ounce  of  water,  to  enlarged  tonsils,  by  means,  of  a  camel's-hair  pencil, 
or  a  piece  of  s]ionge  tied  to  the  end  of  a  stick. 

Oxide  of  Zinc  (Zinci  Oxidum).  —  Thi£<  is  an  inodorous,  white  pow- 
der, insoluble  in  water  and  alcohol.  It  is  tonic  and  antispasmodic, 
and  is  given  in  chorea,  epilepsy,  hooping-cough,  and  other  similar 


1  Jll-il 


'  i 


tip 


C66 


MBDICINKS  AND  THEIR  PREPARATIONS. 


diseases ;  but  it  is  more  especially  employed  to  an-est  the  night- 
sweats  of  consumi)tion,  for  which  purpose,  we  have  at  present  no 
other  article  of  equal  efficacy.  It  is  sprinkled  externally  ujion  ex- 
coriated surfaces,  and  is  used  in  ointments.  Dose  from  two  to  eight 
grains,  in  the  form  of  pill.  • 

Precipitated  Carbonate  of  Zinc  ( Zinci  Carbonas  Prcecipitatas) .  — 
This  is  emi)loyed  for  the  same  purpose  as  prepared  calamine,  being 
adapted  only  to  external  use. 

Prepared  Calamine  (Culamina  Proeparata).  —This  is  in  theforiu 
of  a  pinkish  or  flesh-colored  powder,  of  an  earth}'  appearance.  It  is 
employed  only  as  an  external  application,  being  dusted  on  excoria- 
tions and  Hupei-ficial  ulcerations,  as  a  mild  astringent.  It  should  be  a 
very  fine  powder. 

Snlpliate  of  Zinc  {Zinci  Sulphas).  —  This  is  a  colorless,  transpar- 
ent salt,  crystallizing  usually  in  small,  four-sided  prisms.  It  is  tonic 
and  astringent,  and  in  large  doses,  a  prompt  emetic.  Used  "s  atonic 
incases  of  debility  attended  with  irritation.  In  obstinate  intermit- 
tents,  it  is  sometimes  conjoined  with  sulj/hate  of  quinia ;  it  is  chiefly 
employed,  however,  in  such  spasmodic  diseases  as  ei)ilepsy,  chorea, 
and  hooping-cough.  As  an  astringent,  it  is  used  externally,  being 
applied  in  solution  to  bleeding  surfaces,  as  a  wash  In  ophthalmia,  and 
as  an  injection  in  whites  and  chronic  gonorrhoea. 

Valerianate  of  Zinc  ( Zinci  Valerianas).  —  This  is  in  v/hite,  pearly 
scales,  with  a  faint  odor  of  valerianic  acid.  It  is  tonic  and  antispas- 
modic, and  is  used  in  the  various  nervous  affections  which  accompany 
chlorosis.  Dose,  one  or  two  grains,  several  times  a  day,  in  the  form 
of  pill. 

Preparations.    Pharmacy. 

The  preparation  of  medicines  for  use,  constitutes  the  art  of  phar- 
macy. It  is  the  peculiar  business  of  the  apothecary.  It  will  not  he 
necessary  in  these  psiges  to  describe  his  art,  in  all  particulars,  but 
merely  as  many  of  the  preparations  which  it  is  his  duty  to  prepare  as 
are  really  needed  in  the  treatment  of  disease.  In  doing  this,  I  shall 
classify  the  preparations  alphabetically,  and  begin  with 

Cerates. 

These  substances  have  a  degree  of  hardness  midway  between  oint- 
ments and  plasters.  They  may  be  spread  upon  leather  or  linen,  with- 
out the  use  of  heat,  and  they  do  not  melt  and  run  when  applied  to  the 
skin.  They  are  made  of  wax,  or  spermaceti,  combined  with  lard  or 
oil.  The  articles  are  melted  together  by  a  very  gentle  heat,  and  dur- 
ing  the  process  of  cooling,  the  whole  should  be  Avell  stirred. 

Calamine  Cerate.  —  Prepared  calamine  and  yellow  wax,  each  three 
ounces  ;  lard,  one  pound.  Melt  the  lard  and  wax  together.  When 
the  mixture  begins  to  thicken,  on  cooling,  gradually  stir  in  the  cala- 
mine. 


Il        'IIIIW'^I'I' 


MEDICINES  AND  THEIR  PREPARATIONS. 


667 


This  is  called  Turner's  cerate,  and  is  useful  for  burns,  excoria- 
tions, superficial  ulcers,  and  sores. 

Goulard's  Cerate. — Take  of  solution  of  subacetate  of  lead,  two 
Huid  ounces  and  a  half;  white  wax,  four  ounces  ;  olive  oil,  nine  fluid 
ounces  ;  cauiiihor,  half  a  dram.  Mix  the  wax,  ju'eviously  melted j 
with  eight  fluid  ounces  of  tiic  oi! ;  remove  from  the  fire,  and  when  the 
mixture  Ix5gins  to  thicken,  gradually  pour  in  the  solution  of  subacetate 
of  lead,  stirring  constantly,  with  si  wooden  spatula,  till  it  becomes 
cool.     Then  add  the  camphor,  dissolved  in  the  remainder  of  the  oil. 

This  is  the  cerate  of  subacetate  of  lead,  and  is  used  for  excoriations, 
inrtamed  burns,  scidds,  and  chilblains,  and  for  eru^jtions  of  the  skin. 
Excellent  for  blistered  surfaces,  indisposed  to  heal. 

Half  an  ounce  of  this  preparation  united  vrA\\  half  an  ounce  of 
fiiini)lo  cerate,  atid  one  dram  each  of  calomel  and  powdered  opium, 
makes  a  very  valuable  I'emedy  for  various  eruptions  of  the  skm,  of  a 
local  nature.  .  ''   ,•' 

Resin  Cerate.  —  Take  of  resin,  five  ounces  ;  lard,"  eight  ounces  ; 
yellow  wax,  two  ounces.  Melt  together  with  a  gentle  heat,  and  stir 
till  cool. 

This  IS  known  as  basilicon  ointment,  and  is  used  as  a  gentle  stimu- 
lant to  blistered  surfaces,  indolent  ulcers,  burns,  scalds,  and  chilblains. 

Compouiid  Resin  Cerate  — Take  of  resin,  suet,  and  yellow  wax, 
each  a  poujjd  ;  turpentine,  half  a  pound;  flax-seed  oil,  half  a  pint. 
Melt  togetlier,  strain  through  linen,  and  stir  till  cool. 

This,  under  the  name  of  Deshler's  salve,  is  i)opularly  used  for  sim- 
ilar t)urposes  with  the  resin  cerate. 

Sayine  Cerate. — Take  powdered  savine,  two  ounces;   resin  ce- 
rate, a  pound.     Mix  the  savine  with  the  cerate,  previously  softened. 
Used  as  a  dressing  for  perpetual  blisters. 

Simple  Cerate.  —  Lard,  eight  ounces ;  white  wax,  four  ounces. 
Melt  together,  and  stir  till  cool. 

Used  for  dressing  blisters,  wounds,  etc.,  where  it  is  desirable  sim- 
ply to  preserve  the  moisture  o£  the  part,  and  to  exclude  the  air. 

Spanish  Flies  Cerate,  known  as  blistering  plaster.  Take  finely 
powdered  Spanish  flies,  a  pound ;  yellow  wax  and  resin,  each  seven 
ounces ;  lard,  ten  ounces.  To  the  wax,  resin,  and  lard,  previously 
melted  together  and  strained,  add  the  Spanish  flies,  and,  by  means  of 
the  most  gentle  heat,  keep  the  mixture  in  a  fluid  state  for  half  an 
hour,  stiiTing  occasionally,  then  remove  the  heat,  and  stir  till  cool. 

This  can  be  easily  spread  without  the  aid  of  heat,  and  is  used  for 
the  pur^iose  of  drawing  blisters.  It  is  now,  however,  superceued  in  a 
great  degree  by  various  preparations,  composed  for  the  most  jMirt  of 
mntharidin,  either  dissolved  in  oil,  and  applied  to  the  skin  by  means 
of  a  piece  of  paper  saturated  with  it,  or  incorporated  with  wax,  and 
sj)read  in  a  very  thin  layer  upon  fine  waxed  cloth,  s;ilk,  or  paper,  con- 
»<tituting  the  blistering  cloth,  blistering  [laper,  etc. 


668 


MEDICINES  AND  THEIR  PREPARATIONS. 


'^i 


'—•H 


Confections,  Conserves,  and  Electuaries. 

These  arc  soft  solids,  in  which  medicinal  articles  are  incorporated 
with  sii<rar,  syrup,  honey,  or  some  other  saccharine  matter,  for  the  jmr- 
pose  both  of  preserving  the  mass,  and  of  rendering  the  medicine  inon- 
palatable  and  convenient  for  use. 

Aromatic  Confection.  — Take  of  aromatic  powder,  five  and  a  li.ilf 
ounces;  jjowdcred  saffron,  half  an  ounce  ;  syru])  of  orange  ])ccl,  .-i,\ 
ounces  ;  clarified  honey,  two  ounces.  Rub  the  aromatic  i)ow(lcr  wit'i 
the  saffron  ;  then  add  the  syrup  and  honey,  and  beat  the  whole  Ic- 
gether,  in  a  morUu',  till  they  are  thoroughly  mixed. 

Given  in  debilitated  states  of  the  stomach,  as  a  vehicle  for  other 
medicines.     Dose,  from  ten  grains  to  a  dram. 

Compound  Confection  of  Catechu.  — Take  of  compound  powder  of 
catechu,  live  ounces  ;  simple  syrup,  five  fluid  ounces.  Add  the  synip 
gradually  to  the  powder,  and  mix  them  Avell. 

To  be  given  in  diarrhoea  and  chronic  dysentery,  in  the  dose  of  half 
a  dram  to  a  dram. 

Confection  of  Senna,  otherwise  called  lenitive  electuary.  Take  of 
senna,  eight  ounces;  coriander  seeds,  four  ounces  ;  bruised  licjuorico 
root,  three  ounces  ;  tigs,  a  i)ound  ;  pulp  of  prunes,  pul})  of  tamarinds, 
pull)  of  purging  cassia,  each,  half  a  pound  ;  refined  sugar,  two  pounds 
and  a  half;  water,  four  pints,  liub  the  senna  and  coriander  togotlier 
and  separate  ten  ounces  of  the  ])owdcr  with  a  si(;ve.  Boil  the  resichu! 
with  the  liquorice  root  and  figs,  in  the  water,  to  one  half;  then  press 
out  the  liquor,  and  strain.  P^vaporate  tiie  strained  licjuor,  by  the  most 
gentle  heat,  to  a  pint  and  a  half;  then  add  the  sugar  and  form  a 
syrup.  Lastly,  rub  the  i)uli)s  with  the  syrup,  added  gradually,  and, 
having  thrown  in  the  sifted  powder,  beat  all  together  till  Avell  mixed. 

This  is  a  i)leasant  and  adnurable  laxative,  being  well  adapted  to 

.the  habitual  costiveness  of  ])regnant  women,  and  those  affected  with 

piles  ;  for  this  latter  puri)()'Te,  it  is  still  better  combined  with  cream  of 

tartar  and  sulphur,  as  described  in  No.  6  of  the  prescriptions,  at  the 

end  of  the  book. 

Decoctions. 

These  are  solutions  of  vegetable  medicines,  obtained  by  boiling 
them  in  wa^er.  They  differ  from  infusions,  in  being  subjected  to 
a  greater  degree  of  heat,  the  water  during  their  preparation  being 
kept  up  to  the  boiling  point.  The  process  should  be  conducted  in  a 
covered  vessel,  and  the  boiling  must  not  be  continued  for  a  very  long 
time.  Medicines,  whose  active  principle  is  volatile,  are  not  proper  for 
decoctions,  the  active  principle  being  driven  off  by  heat  and  lost. 

The  usual  proportion  of  vegetable  substances  used  in  making  de- 
coctions is  one  ounce  to  a  pint  of  water,  and  the  dose  of  the  decoc- 
tion, from  one  to  four  ounces. 


I 


sse  of  liiilf  ( 


MEDICINES  AND  THEIR  PREPARATIONS. 


669 


EsBenoes. 

These  are  generally  prepared  by  dissolving  one  ounce  of  the  essen- 
tial oils  of  plants  in  one  pint  of  alcohol.  The  oils  of  lemon,  pepper- 
mint, sassafras,  etc.,  are  made  in  this  way,  and  their  properties,  of 
course,  are  similar  to  the  oils  from  which  they  are  prepared.  They 
are  gcncndly  taken  in  a  little  sweetened  water,  in  doses  of  ten  drops 
to  a  teaspoonful. 

Extracts. 

These  ate  soft  solids,  obtained  by  evaporating  the  tinctures,  or 
solutions,  of  vegetjible  substances.  The  active  principles  of  dried 
vegetables  can  only  be  extracted  by  some  liquid ;  this,  for  preparing 
extracts,  is  either  water,  or  alcohol,  or  a  mixture  of  the  two.  Those 
obtained  by  the  use  of  water  are  called  aqueouft,  or  xcatery  exlractft; 
those  by  means  of  alcohol,  alcoholic  extracts ;  and  those  by  both  alco- 
hol and  water,  hydro-alcoholic  extracts. 

Extracts  are  generally  prepared  on  a  large  scale,  by  persons  who 
i;<ake  a  business  of  it.  Like  other  articles,  many  of  these  prepara- 
tions get  into  the  market  which  are  inferior  in  quality,  and  even 
worthless.  Without  disparaging  the  i)reparations  of  other  manufac- 
turers, 1  would  mention  those  prepared  by  the  large  manufacturing 
house  of  Tilden  &  Co.,  at  New  Lebanon,  New  York,  as  w«rthy  of 
|)ul)lic  confidence.  Most  of  their  solid  extracts,  with  the  proper  doses. 
Hie  mentioned  in  previous  pages,  under  the  several  articles  from  which 
they  are  made. 

Fluid  Extracts. 

These  are  concentrations,  into  a  small  bulk,  in  liquid  form,  of  the 
active  principles  of  medicinal  substances.  They  are  a  valuable  class 
of  remedies,  l)eing  in  some  cases  preferable  to  tinctures,  having  less 
alcohol ;  and  l>etter  than  extracts  or  decoctions,  because  not  so  often 
injured  by  heat  in  their  pi*eparation,  and  not  requiring  to  be  taken  in 
large  doses.  Great  skill  is  required  in  their  preparation,  and  they 
should  alwaj's  be  obtained  from  those  who  have  the  reputation  of 
making  reliable  articles.  None  that  I  am  acquainted  with,  better 
deserve  confidence  than  those  of  Tilden  &  Co. 

Fomentations. 

Fomentation  is  a  sort  of  partial  or  local  hot  bath,  and  consists 
either  in  the  application  of  cloths  dipped  in  hot  water,  or  some  hot 
medicated  decoction,  and  applied  to  the  affected  part,  or,  of  bitter  or 
anodyne  herbs  steeped  in  vinegar  or  water,  and  then,  while  hot,  en- 
closed in  a  muslin  bag,  and  laid  upon  the  diseased  place.  In  either 
case,  whether  the  cloths  wet  in  a  decoction  of  the  herbs,  or  the  herbs 
themselves,  slightly  steeped,  be  applied  in  a  bag,  the  application  should 


if!:!"" 


■| 


•■>.,| 


in 


'li 


4? 


,11 


670 


MEDICINES  AND  THEIR  PKEPAUATI©N8. 


1m}  as  hot  as  can  be  home,  and  not  so  moist  as  to  wet  the  bed  or 
(;lothes  of  the  patient. 

Fomentations  act  by  their  warmth  and  moisture  chiefly ;  and 
slightly,  in  some  cases,  by  their  medicinal  virtues.  Their  object  is 
to  lessen  pain  and  inflammation,  l)y  relaxing  the  parts,  and  relieving 
tension  and  spasm.  They  may  be  prepared  from  equal  parts  of  hops 
tansy,  and  wormwood,  or  from  equal  parts  of  hops,  lobelia,  and  stra- 
monium, etc.,  etc. 

Infusions. 

For  a  description  of  simple  infusions,  see  page  588.  Those  made 
of  one  article  only  are  sufficiently  referred  to  in  previous  pages.  It 
will  only  be  necessary  here  to  insert  such  compound  infusions  as  are 
deemed  important. 

Componnd  Inflision  of  Catecha.  —  Take  of  powdered  catechu,  half 
an  ounce  ,  bruised  cinnamon,  a  dram ;  boiling  water,  a  pint ;  macer- 
ate for  an  hour  in  a  covered  vessel,  and  strain.  An  elegant  mode  of 
administering  catechu.  Dose,  from  one  to  three  fluid  ounces,  three  or 
four  times  a  day.  . 

Compound  Infusion  of  Gentian.  — Take  of  bruised  gentian,  half  an 
ounce  ;  dried  orange  peel  and  coriander  seeds,  bruised,  each  a  dram ; 
diluted  alcohol,  four  fluid  ounces ;  cold  water,  twelve  fluid  ounces. 
First,  pour  on  the  diluted  alcohol,  then,  three  hours  afterward,  the 
water.  Let  the  whole  stand  twelve  hours,  and  strain.  An  excellent 
form  for  using  gentian.  Dose,  one  fluid  ounce,  three  or  four  times  u 
day. 

Compound  Inftision  of  Geranium.- —  Take  of  geranium  root,  sweet 
bugle  loaves,  golden  seal  root,  witch-hazel  bark,  each,  in  coarse  powder, 
one  ounce ;  boiling  water,  four  pints.  Mix,  and  allow  all  to  stand  in 
a  covered  vessel,  two  hours,  applying  a  gentle  heat ;  then  strain.  Two 
drams  of  alum  may  or  may  not  be  added. 

Used  in  chronic  diarrhoea  and  dysentery,  in  one  or  two  tablespoon- 
ful  doses,  every  two  or  three  hours ;  also  as  an  injection  in  gleet, 
whites,  falling  of  the  bowel,  etc. ;  and  as  a  gargle  in  ulcerations  of 
the  mouth  and  throat. 

Componnd  Inftision  of  Parsley.  —  Take  of  parsley  roots  and  seeds, 
and  subcarbonate  of  iron,  each,  two  ounces ;  horseradish  root,  one 
ounce  ;  squill,  juniper  berries,  white  mustard  seed,  mandrake  root, 
and  queen  of  the  meadow  root,  each,  half  an  ounce  ;  coarsely  bruise 
these  articles,  and  place  them  in  boiling  cider,  and  exjiose  them,  for 
twenty-four  hours,  to  a  very  gentle  heat,  in  a  covered  earthen  vessel. 
The  cider  should  be  sparkling  and  tart.  Let  the  articles  stand  in  the 
cider. 

Useful  in  dropsy.  Dose,  one  or  two  fluid  ounces,  three  or  four 
times  a  dUy. 

Compound  Inftision  of  Senna.  —  Take  of  senna  and  manna,  each, 
one  ounce ;  jalap,  cream  of  tartar,  and  caraway  seeds,  bruised,  each, 


^W|"P! 


two  drums  ;  boiling  water,  one  pint.  Add  all  the  ingredients  to  the 
water,  in  a  covered  vesHcl,  and  let  them  stand  twelve  hours.  Then 
udd  four  ounces  of  elixir  sulutis. 

This  is  a  vahuible,  and  not  disagreeable,  gentle  i)hysic  for  various 
j)uri)()ses.     Dose,  from  one  to  four  ounces. 

Compoond  Inftasion  of  Trailing  Arbutus.  —  Take  of  queen  of  the 
laoadow  root,  dwarf  elder  bark,  marshniallow  root,  and  trailing  arbu- 
tus, each,  coarsely  bruised,  half  an  ounce  ;  add  to  them,  one  {)int 
of  boiling  wat6r,  and  one  i)int  of  Holland  gin,  and  steep  by  the  tire 
four  hours,  in  a  closely  covered  vessel.  Strain,  and  sweeten  with 
honey. 

Excellent  for  gravel,  suppression  of  urine,  scalding  of  urine,  and 
various  other  disorders  of  the  urinary  organs.  Dose,  from  an  ounce 
to  a  wineglassful,  with  more  or  less  frequency,  according  to  the  ur- 
gency of  the  case. 


Injeotions.  —  Clysters. 

These  are  preparations  to  be  introduced  into  the  lower  bowel  by 
means  of  a  syringe.  A  sufficient  number  of  them  are  given  among 
the  recipes  at  the  end  of  the  book.  It  is  not  necessary  to  repeat 
them  here. 

Liniments. 

These  are  liquid  preparations,  generally  a  little  thicker  than  water, 
and  thinner  than  oils,  intended  only  to  be  applied  to  inflamed,  pain- 
ful, or  swelled  parts.  They  are  designed  to  soothe,  or  quiet,  or  stim- 
ulate, or  make  red  the  part  to  which  they  are  applied  ;  and  are  rubbed 
on  with  the  hand,  or  a  piece  of  flannel  or  cotton,  and  frequently  in 
connection  with  heat,  by  sitting  or  standing  before  a  fire. 

A  large  number  of  liniments  are  given  under  the  head  of  recipes 
at  the  end  of  the  book.     To  those,  I  add  a  fe  v  valuable  ones  here. 

Camphor  Liniment.  — Take  six  drp.ms  of  camphor,  and  dissolve  it 
in  one  fluid  ounce  of  chloroform,  and  add  to  this  one  fluid  ounce  of 
olive  oil. 

For  sprains,  neuralgia,  rheumatism,  etc. 

Compound  Camplior  Liniment. — Take  two  ounc  ^  nad  a  half  of 
camphor,  a  fluid  dram  of  oil  of  lavender,  seventeen  iiuid  ounces  of 
alcohol,  and  three  fluid  ounces  of  strong  solution  of  ammonia.  Dis- 
solve the  camphor  and  the  oil  in  the  alcohol ;  then  add  the  ammonia, 
and  shake  till  they  are  mixed. 

To  be  used  as  a  rubefacient  and  anodyne  for  local  pains,  particu- 
larly rheumatism. 

Compound  Liniment  of  Ammonia.  —  Take  five  fluid  ounces  of 
strong  water  of  ammonia,  two  fluid  ounces  of  tincture  of  camphor, 
and  one  fluid  ounce  of  spirit  of  rosemary.     Mix  them  well  together. 


JfM  l67.,„^: 


This  is  Hitnilar  to  Dr.  Granville*  a  counter-irritant  lotion;  and  is  used 
ns  II  |)r(>ini)t  nnd  powerful  rubefacient,  or  even  vesicatory,  in  neural- 
gin,  rheiimatiKni,  gout,  .spasms,  and  inflammations. 

Croton  Oil  Liniment. — Take  one  fluid  ounce  of  croton  oil,  and 
seven  fluid  ounces  of  oil  of  turpentine.  Mix,  and  shake  them  well 
together. 

A  good  rubefacient  and  pustulating  preparation  to  apply  to  the 
chest  and  other  parts. 

Liniment  of  Opium.  —  Take  six  ounces  of  castilc  soap,  an  ounce 
and  a  half  of  opium,  three  ounces  of  camphor,  six  fluid  drams  of  oil 
of  rosemary,  and  two  pints  of  alcohol.  Macerate  the  soap  and  o|)iuiu 
in  the  spirit  for  three  days  ;  then  filter,  and  add  the  oil  and  cam|)hor, 
and  shake  briskly. 

This  is  a  useful  anodyne  and  rubefacient  liniment  for  bruises, 
sprains  and  i)ains  of  a  rheumatic  and  gouty  nature. 

Liniment  of  Spanish  Flies.  — Take  an  ounce  of  powdered  Spanish 
flies,  and  half  a  pint  of  oil  of  turpentine.  Mix,  and  apply  gentle  heat 
to  them,  in  a  covered  vessel,  for  three  hours.     Then  strain. 

Employed  with  advantage,  externally,  in  the  sinking  stage  of  ty- 
phoid fevers.  If  so  powerful  as  to  be  in  danger  of  causing  blistering, 
it  may  be  weakened  by  adding  flax-seed  or  olive  oil. 

Liniment  of  Turpentine.  — Take  half  a  pint  of  oil  of  'nrpentine, 
and,  a  pound  of  resin  cerate.  Melt  the  cerate,  and  adi'  oil  to  it, 
mixing  them  well. 

This  is  a  valuable  remedy  for  scalds  and  burns,  and  should  be 
applied  soon  after  the  accident,  and  be  discontinued  when  the  inflam- 
mation excited  by  the  fire  is  removed.  The  burned  or  scalded  surface 
should  be  covered  with  lint  wet  with  the  liniment. 

Opodeldoc. —  Take  three  ounces  of  white  bar  soap,  sliced,  an  ounce 
of  camphor,  a  fluid  dram  each  of  oil  of  rosemary  and  oil  of  origa- 
num, and  a  pint  of  alcohol.  Digest  the  soap  in  the  alcohol  by  means 
of  a  gentle  heat,  until  it  is  dissolved ;  then  add  the  camphor  and  oils, 
and  when  they  are  dissolved,  pour  the  whole  into  broad-mouthed 
vials. 

This  is  the  camphorated  soap  liniment^  and  is  used  as  an  anodyne 
application  to  sprains,  bruises,  and  painful  tumors,  etc. 

Medicated  Waters. 

Those  preparations  consisting  of  water  impregnated  with  some 
medicinal  substance  are  called  medicated  waters.  They  are  prepared 
from  volatile  oils  by  triturating  in  a  mortar  a  dram  of  the  oil,  more 
or  less,  with  a  small  quantity  of  carbonate  of  magnesia,  and  then  very 
gradually  pouring  on  one  quart  of  water,  while  the  trituration  is  con- 
tinued. At  last,  the  pre^iaration  is  filtered  through  paper.  The  quan- 
tity of  oil,  magnesia,  and  water,  used  for  each  preparation,  is  as  fol- 
lows : 


MEDICINES  AND  THEIR  PREPARATIONS. 


673 


Oil  of  bitter  almonds,  sixteen  minims;  carbonate  of  magnesia,  a 
drani ;  wuter,  one  quarts 

Oil  of  cinnamon,  half  a  fluid  dram ;  carbonate  of  magnesia,  a  dram; 
water,  one  quart. 

Twenty  minims  of  oil  of  roses,  a  dram  of  carbonate  of  magnesia, 
bnd  one  quart  of  water. 

Oil  of  fennel,  half  a  fluid  dram ;  carbonate  of  magnesia,  a  dram; 
water,  a  quart. 

Peppermint  Water,  Spearmint  Water,  and  Pennyroyal  Water,  are 
all  prtipared  from  the  same  quantities  of  their  several  oils,  as  Cinna* 
moil  Water. 

The  dose  of  these  waters  is  half  a  fluid  ounce  to  two  fluid  ounces, 
except  the  bitter  almond  water,  which  is  one  or  two  fluid  drams. 

Caiiiplior  Water,  —  Take  two  drams  of  camphor,  forty  minims  of 
alcohol,  four  drums  of  carbonate  of  magnesia,  and  one  quart  of  water. 
Rub  the  camphor  first  with  the  alcohol,  afterwards  with  the  carbonate 
of  magnesia,  and  lastly,  with  the  water,  gradually  added.  Then  filter 
through  paper. 

Medicated  Wines. 

Wines  are  used  in  making  certain  preparations,  because  the  alco- 
hol they  contain  will  extract  from  plants,  etc.,  some  medicinal  proper- 
ties which  water  will  not,  and  at  the  same  time  is  less  stimulating 
thuii  the  tincture^*,  etc.,  made  from  alcoholic  spirits. 

C'oiiiponiid  Wine  of  Coiiifrey  {Restorative  Wine  Bitters).  —  Take 
one  ounce,  each,  bruised,  of  comfrey,  Solomon's  seal,  and  spikenard; 
and  half  an  ounce,  each,  bruised,  of  chamomile  flowers,  Colombo,  and 
gentian.  Cover  these  with  boiling  water,  and  let  them  stand  twenty- 
four  hours,  in  a  covered  vessel.  Then  add  two  quarts  of  sherry  wine. 
Macerate  fourteen  days,  express  and  strain. 

Valuable  in  leucorrhoea  and  other  female  complaints.  Dose,  from 
half  a  fluid  ounce  to  two  fluid  ounces,  three  or  four  times  a  day. 

Coinpound  Wine  of  Golden  Seal.  —  Take  one  dram,  each,  bruised, 
of  golden  seal  root,  tulip  tree  bark,  and  bitter  root,  half  a  dram  of 
pulverized  cayenne,  and  two  quarts  of  sherry  wine.  Macerate  for 
fourteen  days,  with  occasional  shaking ;  then  expre'^s  and  stmin. 

This  is  a  pleasant  bitter  tonic  in  dyspepsia,  etc.  Dose,  from  half  a 
fluid  ounce  to  two  fluid  ounces,  three  times  a  day.  , 

Wine  of  Ipecacuanha.  —  Take  two  ounces  of  bruised  ipecac,  and 
one  quart  of  sherry  wine.  Macerate  fourteen  days,  with  occasional 
shaking.     Then  express  and  filter  through  paper. 

This  is  a  valuable  emetic  preparation,  —  especially  for  children. 
Dose,  as  an  emetic,  for  an  adult,  one  fluid  ounce ;  as  an  expectorant, 
from  ten  to  thirty  minims ;  for  a  child  two  years  old,  as  an  emetic, 
one  fluid  dram,  repeated  every  fifteee  minutes  till  it  operates. 

85 


{ 

I 

ftif 


mil. 


Mixtures 

These  are  prcjjarations  in  which  medicinal  substances  which  can» 
not  be  dissolved  in  water  are  suspended  in  it  by  means  of  some  viscid 
matter,  like  sugar,  or  gum  arabic.  Their  object  is  to  conceal  the  taste, 
prevent  the  sickening  effect,  and  make  it  more  easy  to  take  disagreea- 
ble medicines.  To  make  a  perfect  mixture  requires  skill.  Ge»>*»rally, 
tlie  medicine  to  be  suspended  should  be  triturated  in  a  mortar  with 
the  sugar,  gum  ;  rabic,  etc.,  before  the  water  is  added. 

kiiiioud  Ml\tiir'e.  —  Take  half  an  ounce  of  sweet  almonds,  half  a 
chain  of  powdered  gum  arabic,  two  drams  of  sugar,  and  eight  fluid 
ounces  of  water.  Soak  the  almonds  in  the  water,  and  having  removed 
their  external  coat,  beat  them  with  the  gum  arabic  and  sugar  in  a 
mortar,  till  they  are  thoroughly  mixed ;  then  rub  tne  mixture,  gradu> 
ally  adding  the  water,  and  lastly,  strain. 

This  is  an  agreeable,  nutritive  demulcent,  in  bronchial,  dysenteric, 
and  urinary  affections.  It  must  be  used  freely,  the  dose  being  from 
two  to  eight  fluid  ounces. 

Chalk  Nixturet  —  Take  half  an  ounce  of  prepard  chalk,  two  drams 
each  of  refined  sugar  and  powdered  gum  arabic,  and  four  fluid  ounces 
each  of  cinnamon-water  and  water.  Rub  them  together  till  they  are 
thoroughly  mixed. 

This  is  much  used  in  looseness  of  the  bowels,  accompanied  with 
acidity,  particularly  among  children.  If  an  increase  of  its  astringency 
be  required,  add  laudanum,  or  kino,  or  catechu. 

Compo'<md  Mixture  of  Iron.  —  Take  a  dram  of  myrrh,  twsnty-five 
grains  of  carbonate  of  potassa,  one  scruple  of  powdered  sulphate  of 
iron,  half  a  iiuid  ounce  of  spirit  of  lavender,  one  dram  of  refined  sugar, 
and  seven  and  a  half  fluid  ounces  of  rose  water.  Ri:b  the  myrrh  in 
a  mortar,  gradually  adding  the  rohe  water,  then  mix  with  these  the 
spirit  of  lavender,  sugar,  and  carbonate  of  pptat^.x,  and  lastly,  the 
Sulphate  of  iron.  Pour  the  whole  into  a  glasb  bottle,  and  keep  it 
well  stopped. 

This  is  about  the  same  thing  as  GriffitlCs  myrrh  mixture^  and  is 
considerably  used  in  chlorosis,  and  other  affections  requiring  the  use 
of  iron. 

Brandy  Mixture. — Take  four  fluid  ounces  each  of  brandy  and  cin- 
namon water,  the  yolks  of  tv*ro  eggs,  half  an  ounce  of  refined  sugar, 
and  three  drops  of  oil  of  cinnamon.     Mix  them. 

A  useful  siimulant  and  nutritive  draught,  to  be  used  in  the  sinking 
stage  of  low  form^  of  fever. 

Extract  of  Riiubarb  and  Potassa  (Neutralizing  Extract).  —  Take 
two  pounds  of  the  best  rhubarb,  one  pound  each  of  cinnamon  and 
gulden  seal.  Grind  or  coarsely  bruise  the  articles,  and  mix  them; 
macerate  them  for  two  days  in  one  gallon  of  the  best  fourth  proof 
brandy.     Then  express  the  tincture  with  strong  pressure,  and  add  to 


wim 


M 


It  one  fluid  dram  of  oil  of  peppermint,  previously  dissolved  in  a  little 
alcohol.  Break  up  the  compressed  residue  from  the  press,  and  place 
it  in  a  perculator,  and  gradually  run  warm  water  through  it,  until  the 
strength  is  exhausted.  Evaporate  this  solution  to  four  pints,  and 
while  the  liquor  is  still  hot,  dissolve  in  it  two  pounds  of  bicarbonate 
of  potassa,  and  three  pounds  of  refined  sugar.  Continue  the  e>;apo- 
ration,  if  necessary,  until,  when  added  to  the  tincture  first  obtaint'd, 
it  will  make  a  gallon  and  a  half,  tWen  mix  the  two  solutions  together. 
This  is  a  useful  preparation  for  diarrhoea,  dysentery,  cholera  morbus, 
summer  complaints  of  children,  acidity  of  the  stomach,  heartburn,  etc 
Dose,  one  fluid  dram. 

Mettauer's  Aperient.  —  Take  one  ounce  and  a  half  of  pulverized 
aloes,  four  ounces  of  bicarbonate  of  soda,  two  fluid  ounces  of  com- 
pound spirits  of  lavender,  and  two  quarts  of  water.  Place  the  whole 
in  a  jar,  or  jug,  and  let  them  stand  fourteen  days,  shaking  well  once 
a  day.     Then  pour  off  from  the  flregs.     It  improves  by  age. 

This  preparation  was  made  by  Professor  Mettauer,  and  was  held 
in  so  high  ec  ceem  by  him,  that  when  he  sent  it  to  the  London  Lancet, 
he  requested  that  he  might  have  the  credit  of  compounding  it  Tc  is 
one  of  the  best  known  aperients  for  costiveness,  —  particulatly  'A'hen 
connected  with  bilious  dyspepsia.  For  that  class  of  bilious  persons 
who  overeat,  and  hav*^  acid  stomachs,  it  has  great  value.  In  bilious 
cases,  the  nitro-muriatic  acid,  taken  before  meals  (the  aperient  after 
meals)  may  be  usefully  associi'^^ed  with  it.  In  the  constipation  of 
hysteria  and  hypochondriariis,  the  fluid  extract  of  valerian  may  be 
added  to  it.     Dose,  from  two  drams  to  two  ounces. 

Saline  Mixture  ( White  Liquid  Physic).  —  Take  half  a  pound  of 
sulphate  of  soda,  and  one  and  a  half  pints  of  water.  Mix,  and  dis- 
solve the  soda ;  then  add  two  fluid  ounces  of  nitro-muriatic  acid,  and 
one  dram  and  eight  grains  of  powdered  alum. 

Used  to  allay  nausea  and  vomiting,  and  as  a  cooling  purgative; 
also  for  colic,  diseases  of  the  liver,  diarrhoea,  dysentery,  intermittent 
fevers,  etc. 

This  is  one  of  the  remedies  of  the  Eclectic  school  of  physicians, 
and  is  held  by  them  in  high  esteem.  Dose,  a  tablespoonful  in  a  gill 
of  water,  to  be  repeated  eveiy  hour  or  two,  until  it  causes  one  or  two 
•vacuations  from  the  bowels. 

Ointments. 

Ointments  are  composed  of  fatty  substances,  about  the  consistence 
01  butter,  impregnated  with  medicine.  All  gritty  matter  should  be 
excluded  from  them.  To  prevent  the  rancidity  to  which  they  are 
liable,  a  little  glycerin  is  now  frequently  added. 

Ointment  of  Acetate  of  Lead.  —  Take  two  ounces  of  white  wax, 
and  four  ounces  of  lard ;  melt  them  together,  and  add  two  and  a  half 
irams  of  finely  powdered  acetate  of  lead;  stir  constantly  till  cold. 
Thtd  is  useftil  for  burns  scalds,  ulcers,  and  excoriations. 


ii    't 


^.    V 


676 


MEDICINES  AND  THEIR  PREPARATIONS. 


Ointment  of  Bayberry.  —  Take  half  a  pound  each  of  tallow,  white 
turpentine,  and  bayberry,  and  four  ounces  of  olive  oil ;  melt  together 
and  strain. 

Good  for  scrofulous  and  indolent  ulcers. 

Ointment  of  Belladonna.  —  Take  a  dram  of  extract  of  belladonna- 
and 'an  ounce  of  lard ;  mix  them. 

A  useful  anodyne  application  for  painful  tumors,  neuralgia,  etc. 

Ointment  of  Creosote.  —  Take  half  a  fluid  dram  of  creosote,  and  an 
ounce  of  lard  ;  mix  them. 

A  useful  application  for  syphilitic,  scrofulous,  and  cancerous  ulcers. 

Compound  Ointment  of  Galls. — Take  six  drams  of  finely  powdered 
galls,  six  ounces  of  lard,  and  a  dram  and  a  half  of  pu.'verized  opium; 
rub  them  together. 

A  valuable  preparation  in  irritable  piles. 

Ointment  of  Red  Iodide  of  Herciiry.  — Take  one  dran  of  red  iodide 
of  mercury,  and  seven  drams  of  ointment  of  white  wix:  incorporate 
them  thoroughly  together  by  trituration  in  a  mortar. 

Used  as  a  dressing  for  indolent  scrofulous  ulcers. 

Ointment  of  Nitrate  of  Mercury.  —  Take  one  ounce  of  mercury, 
eleven  fluid  ounces  of  nitric  acid,  nine  fluid  ounces  of  fresh  neats-foot 
oil,  three  ounces  of  lard.  Dissolve  the  mercury  in  the  acid,  then  heat 
the  oil  and  lard  together  in  an  earthen  vessel  to  200°  F. ;  then  add 
the  mercurial  solution,  and  stir  with  a  wooden  spatula,  constantly,  as 
long  as  efliervesccnce  continues,  and  afterward  occasionally  till  the 
ointment  stiffens. 

milder  Ointment  of  Nitrate  of  Mercury.  —  Take  an  ounce  of  oint- 
ment of  nitrate  of  mercury,  and  seven  ounces  of  lard ;  rub  them  to- 
gether. 

The  first  of  the  above  two  preparations  is  the  citrine  ointment,  and  is 
much  and  advantageously  employed  as  an  external  application  in 
porrigo,  impetigo,  psoriasis,  and  pityriasis.  It  is  nearly  a  specific  for 
mflammation  of  the  eyelids  connected  with  the  formation  of  scaly 
matter  about  the  lashes.  The  second  of  these  two  preparations  is 
merely  a  dilution  of  the  first. 

Ointment  of  Oxide  of  Zinc.  —  Take  half  an  ounce  of  oxide  of  zinc, 
and  three  ounces  of  lard ;  rub  them  together. 

This  is  a  mild  astringent  application  in  chronic  opthalmia,  erup- 
tions of  the  skin,  sore  nipples,  and  other  excoriations. 

Ointment  of  Poison  Hemlock. — Take  one  dram  of  extract  of  poison 
hemlock  (Tilden  &  Co.'s  preparation),  and  one  ounce  of  lard;  rub 
them  together. 

An  anodyne  application  for  painful  swellings,  ulcers,  and  piles. 

Ointment  of  Poke.  —  Take  a  dram  of  the  extract  of  poke,  and  one 
ounce  of  lard  ;  mix  them. 

For  malignant  ulcers,  scald  head,  itch.  etc. 


Ointment  of  Stinmoninm.  —  Take  one  dram  of  the  extract  of  stra- 
monium leaves,  and  one  ounce  of  lard ;  rub  the  extract  ^ith  a  little 
water  till  it  is  uniformly  soft,  and  then  with  the  lard. 

Used  as  an  external  application  in  irritable  ulcers,  painful  piles,  and 
skin  eruptions. 

Simple  Ointment  —  Take  a  pound  of  white  wax,  and  four  pounds 
of  lard ;  melt  them  together  with  a  gentle  heat,  and  stir  constantly 
till  cold. 

Ointment  of  Rose  Water. —  Take  a  fluid  ounce  of  rose  water,  two 
fluid  ounces  of  oil  of  almonds,  half  an  ounce  of  bpermaceti,  one  dram 
of  white  wax ;  melt  together,  by  means  of  a  w?ater-bath,  the  oil,  sper- 
maceti, and  wax ;  then  add  the  rose  water,  and  stir  the  mixtuie  con- 
stantly till  cold. 

This  is  the  well  known  preparation  called  cold  cream,  and  is  used 
with  much  ^^Hvantage  for  chapped  lips  and  hands,  excoriations,  etc. 

Spermaceti  Ointment  —  Take  five  ounces  of  spermaceti,  fourteen 
of  white  wax,  and  a  pint  of  olive  oil ;  melt  them  together  over  a  slow 
fire,  and  stir  constantly  till  cold. 

A  mild  dressing  for  blisters,  wounds,  and  excoriated  surfaces. 

Tiir  Ointment  —  Take  a  pound  each  of  tar  and  suet ;  melt  the 
Buet  with  a  gentle  heat,  and  add  the  tar  to  it ;  then  stir  constantly  till 
they  are  cold. 

A  useful  stimulating  application  to  various  scaly  and  scabby  erup- 
tions, particularly  leprosy  and  scald  head. 

Ointment  of  Wliite  llellel»ore.  —  Take  on*-  ounce  of  powdered  white 
hellebore  root,  four  ounces  of  lard,  and  twelve  drops  of  oil  of  lemons; 
rub  them  thoroughly  together. 

A  useful  ointment  for  the  cure  of 

Ointment  of  Wild  Indi<^. —  Take  o.ie  pound  of  powdered  wild 
indigo  root,  moisten  it  thoroughly  with  al(oh>  !,  and  let  it  starid 
twenty-four  hours;  then  put  it  in  a  percolator,  and  add  alcohol  as 
long  as  the  liquid  which  passes  contains  the  taste  oi  tlu-  root.  Distil 
the  alcohol  from  this  filtered  tincture  until  half  a  gallon  of  tinetur*-  is 
obtained.  Melt  one  pound  of  fresh  butter,  without  salt,  add  me 
above  tincture,  and  carefully  evaporate  the  rest  of  the  alroliol ,  stir 
constantly  till  cold,  after  the  alcohol  has  nearly  passed  t)fl. 

This  is  one  of  the  preparations  of  the  Eclectics,  and  is  a  cleansing, 
detergent,  antiseptic,  and  discutient  ointment^  useful  in  scrofi  'ous, 
erysipelatous,  and  malignant  ulcers,  eruptions  of  the  skin,  etc. 

Pile  Ointment.  —  Take  three  handfuls  each  of  witch  nu/ul  bark, 
white  oak  bark,  and  sweet  appletree  bark  ;  bruise  or  grind  them,  and 
add  to  them  three  pints  of  water;  boil  down  to  one  pint,  and  strain  ; 
add  to  this  liquid  half  a  pound  of  lard,  and  simmer  till  the  water  all 
disappears,  stirring  continually  both  before  and  after  removing  from 
the  fire  till  it  cools.  • 

This  forms  a  brick-colored  anodyne,  astringent  ointment,  admira* 
bly  adapted  to  the  cure  of  pile  tumors. 


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Compound  Lead  Ointment  —  Take  two  and  a  half  pounds  of  olive 
oil,  four  ounces  each  of  beeswax  and  unsalted  butter,  and  half  a 
pound  of  white  turpentine  ;  melt  them  together,  strain,  and  then  heat 
to  nearly  the  boiling  point ;  then  gradually  add  one  pound  of  red 
lead,  stirring  constantly  till  the  mixture  becomes  black  or  brown; 
then  remove  from  the  fire,  and  when  it  is  partly  cool,  add  to  it  a 
mixture  of  twelve  ounces  of  honey,  and  half  a  pound  of  powdered 
camphor. 

This  is  a  very  healing  ointment,  and  is  much  used  for  ulcers,  burns, 
wounds,  and  skin  diseases. 

Compoiind  Snlphur  Ointment.  —  Take  one  ounce  of  sulphur,  one 
dram  each  of  ariunoiiidted  mercury  and  benzoic  acid,  one  fluid  dram 
each  of  sulphuric  acid  and  oil  of  bergarnot,  two  drams  of  nitrate  of 
potassa,  and  half  a  pound  of  lard.  First,  melt  the  lard  with  a  gentle 
heat,  then  add  the  other  ingredients,  stirring  constantly  till  they  are 
cold. 

A  sovereign  remedy  for  itch. 

Pills. 

Pills  are  small  masses  of  medicinal  substances,  in  globular  shape, 
and  of  a  size  convenient  for  swallowing.  Each  pill  generally  weighs 
from  three  to  five  grains.  Those  medicines  which  cannot  be  dissolved 
in  water,  and  are  particularly  unpleasant  to  the  taste,  are  usually 
given  in  the  form  of  pill.  Sugar-toated,  as  now  very  extensively 
prepared  by  Tildcn  &  Co.,  from  every  important  medicine,  and  in  a 
great  variety  of  <ombination,  they  will  doubtless  become  a  very  pop- 
ular form  of  taking  medicine.  Physjcians  cannot  do  better  than  to 
use  the  pills  of  the  abovenamed  extensive  manufacturing  house. 

The  method  of  making  pills  is  as  follows :  If  the  substanc?  to  be 
worked  into  pills  be  a  solid  extract,  add  a  few  drops  of  water  to  it, 
and  rub  it  to  the  right  consistence ;  if  it  be  a  resin,  add  to  it  a  few 
drops  of  alcohol ;  if  it  be  a  soft  or  liquid  substance,  rub  up  with  it 
some  inert  substance,  or  crumb  of  bread,  or  wheat  flour,  or  starch,  or 
pulverized  gum  arable  ;  if  it  be  a  powder,  mix  it  with  some  soft 
substance,  as  confection,  soap,  or  syrup,  molasses,  honey,  or  mucilage 
of  gum  arable.  The  mat(  rials  must  be  well  mixed  and  rubbed  into 
a  uniform  mass,  which  shonld  be  rolled  with  a  spatula  or  case  knife, 
into  a  cylinder  of  just  the  same  size  throughout.  This  is  to  be  di- 
vided equally  into  the  number  of  pills  required,  each  of  which  is 
rolled  into  a  spherical  form  between  the  thumb  and  finger,  or  upon 
the  palm  of  one  hand  by  the  index  finger  of  the  other. 

So  many  valuable  pills  are  prescribed  among  the  "  Recipes,"  that  it 
is  not  necessary  here  to  add  to  their  number. 

Plasters. 

Plasters  are  composed  of  wax,  resins,  gums,  fats,  and  oils,  and 
sometimes  medicinal  substances,  and  are  spread  upon  linen,  muslin. 


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or  leather,  —  mostly  the  latter.  When  cold  they  are  hard  ;  but  when 
brought  to  the  warmth  of  the  human  body,  they  so  far  soften  as  to 
adhere  firmly  to  the  skin,  but  do  not  "  run  "  so  as  to  spread  outward, 
and  soil  the  under-clothes.  They  are  intended  generally  to  excite  and 
irritate  the  skin;  sometimes  as  mechanical  supporters;  and  sometimes 
to  affect  the  system  by  having  their  medicinal  matters  absorbed. 

Belladonna  Plaster.  —  Take  three  ounces  of  resin  plaster,  and  an 
ounce  and  a  half  of  extract  of  belladonna,  add  the  extract  to  the 
plastei  previously  melted  by  a  gentle  heat,  and  mix. 

A  useful  anodyne  application  in  neuralgia,  rheumatic  pains,  and 
dysmenorrhoea. 

Compound  Capsicum  Plaster. —  Melt  together  half  a  pound  of  resin, 
and  two  ounces  of  beeswax  ;  to  this  add  one  pint  of  spirit  in  which 
two  ounces  of  powdered  cayenne,  enclosed  loosely  in  a  linen  bag,  has 
been  digested  one  hour  by  a  gentle  heat ;  evaporate  the  spirit  by  a 
moderate  heat,  and  add  one  ounce  of  powdered  camphor,  and  one 
fluid  dram  and  a  half  of  oil  of  sassafras  ;  stir  constantly  till  cold. 

This  may  be  used  whenever  a  stimulating  plaster  is  required. 

Compound  Cr<tlbanum  Plaster.  —  Take  two  ounces  of  galbanum, 
three  ounces  of  burgundy  pitch,  half  an  ounce  of  resin,  half  an  ounce 
of  yellow  wax,  and  four  ounces  of  lead  plastar ;  melt  them  all  to- 
gether, over  a  gentle  fire. 

This  is  a  valuable  strengthening  plaster,  and  may  be  used  for  weak- 
ness of  various  parts,  as  well  as  for  scrofulous  enlargement  of  glands 
and  joints. 

Compound  Lead  Plaster.  —  Take  one  pound  of  lead  plaster ;  melt 
it  by  a  moderate  heat,  and  then  add  two  fluid  ounces  each  of  linseed 
oil  and  tincture  of  opium,  six  fluid  ounces  of  oil  of  turpentine,  and 
two  thirds  of  a  pound  of  oil  of  origanum ;  stir  together  till  cold. 

Used  for  burns,  scaldj,  chilblains,  etc. 

Compound  Resin  Plaster. — Take  three  pounds  of  resin,  four  ounces 
each  of  beeswax  and  hemlock  gum ;  melt  the  articles  together,  then 
remove  from  the  fire,  and,  when  nearly  cold,  add  gradv^ally  one  fluid 
ounce  each  of  oil  of  hemlock,  oil  of  sassafras,  and  olive  oil,  with  half 
an  ounce  of  camphor  dissolved  m  them,  and  half  a  fluid  ounce  of  oil 
of  turpentine.  Pour  the  whole  ito  cold  water,  and  work  in  the 
hands  till  cold,  forming  it  into  rolls. 

This  is  an  excellent  strengthening  plaster,  useful  for  rheumatism, 
enlarged  joints,  glands,  and  wherever  a  weakened  part  needs  gentla 
stimulation  and  support. 

Spiced  Plaster.  —  Take  one  ounce  each  of  powdered  ginger,  cloves, 
cinnamon,  and  black  pepper ;  one  dram  of  pulverized  cayenne  ;  half 
a  fluid  ounce  of  tincture  of  ginger ;  and  a  sumcient  quantity  of  honey. 
Mix  the  powders,  and  then  add  the  tincture  and  honey,  to  form  a  stiff 
poultice. 

This  is  applied  with  great  advantage  over  the  stomach  in  cases  of 
nausea  and  vomiting. 


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Compound  Tar  Plaster.  —  Boil  three  pounds  of  tar  half  an  hour, 
then  add  one  pound  and  a  half  of  burgundy  pitch,  one  pound  of  white 

fam  turpentine  (after  having  melted  them  together  and  strained), 
tir  together,  then  remove  from  the  fire,  and  add  ten  ounces  each  of 
finely  powdered  mandrake  root,  bloodroot,  poke  root,  and  Indian  tur* 
nip ;  mix  thoroughly  together. 

This  is  an  irritant,  rubefacient,  suppurative  plaster,  and  is  consider- 
ably  used  by  the  Eclectics,  to  produce  counter-irritation  and  revulsion 
in  neuralgia,  rheumatism,  and  other  painful  aifections,  as  well  as  in 
chronic  inflammation  of  internal  organs.  To  be  spread  thinly  on  soft 
leather,  n'-d  renewed  daily  on  the  same  leather.  Four  days  are  re- 
quired to  produce  suppuration.  If  it  produce  great  pain  or  inflam* 
mation,  remove  it,  and  apply  mutton  tallow,  or  elm  poultice. 

Lead  Plaster.  —  Take  one  pound  and  a  quarter  of  very  finely  pow- 
dered semivitrified  oxide  of  lead,  one  quart  of  olive  oil,  and  half  a 
pint  of  water.  Boil  together  over  a  gentle  fire,  stirring  constantly  till 
the  oil  and  litharge  unite  and  form  a  plaster.  If  the  water  nearly  all 
evaporates  before  the  process  is  completed,  add  a  little  boiling  water. 

A  useful  plaste-  for  ulcers,  burns,  excoriated  surfaces,  etc. 

Red  Oxide  of  Lead  Plaster.  —  Melt  together  one  quart  of  olive  oil, 
and  one  ounce  each  of  beeswax  and  resin  ;  heat  to  the  boiling  point, 
and  then  add  gradually  three  quarters  of  a  pound  of  powdered  red  lead. 
Stir  constantly,  and  when  the  oil  has  taken  up  the  lead,  the  mixture 
will  be  brown  or  shining  black ;  then  remove  from  the  tire,  and  when 
nearly  cold,  add  four  scruples  of  powdered  camphor,  and  stir  together. 
It  should  not  be  removed  from  the  fire  until  it  has  acquired  a  proper 
consistence  for  spreading,  which  may  be  easily  ascertained  by  allow- 
ing a  portion  of  it  to  cool  on  a  knife. 

This  is  a  valuable  plaster  for  scrofulous  and  syphilitic  ulcers,  also 
for  burns,  scalds,  and  several  skin  diseases. 

Poultices. — Cataplasms. 

Bread  and  Water  Poultice.  —  Put  the  needed  quantity  of  boiling 
water  in  a  basin ;  throw  in  crumbled  white  bread,  or  cracker,  and 
cover  with  a  plate.  When  the  bread  or  cracker  has  soaked  up  all  it 
will,  drain  off  the  remaining  water.  Spread  one  third  of  an  inch 
thick,  and  apply. 

Flaxseed  Poultices.  —  Put  boiling  wat^r  in  a  basin,  and  stir  in  fiax- 
seed  meal  to  make  a  thick  past«.     Spread  on  linen,  and  apply. 

Yeast  Poultice.  —  Mix  half  a  pint  of  yeast  with  one  pound  of  flax- 
seed meal.     Stir  carefully  while  heating. 

Carrot  Poultice.  —  Boil  the  proper  quantity  of  carrots  till  they  are 
quite  soft.  Strain  off  the  water,  mash  them  to  a  pulp,  and  add  a  little 
lard  or  sweet  oil  to  prevent  them  from  getting  hard,  then  spread.  A 
good  application  for  malignant  and  ofl'ensive  sores. 


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Oat  Heal  Ponltioe. — Place  hot  water  in  a  basin,  and  stir  in  oat  meal 
bIowIV)  while  it  boils,  till  the  poultice  is  of  the  right  thicknes'i ;  that 
is.  till  it  will  not  run  on  the  rag  on  which  it  is  spread. 

Indian  Me&l  Poultice.  —  Made  the  same  as  oat  meal  poultice. 

Arrow  Root  Poultice.  —  Mix  two  or  mure  tablespoonfuls  of  arrow* 
root  with  a  little  cold  water,  in  a  basin,  till  it  is  all  united  with  the 
water.  Then  add  boiling  water,  and  stir,  till  the  whole  becomes  a 
thick  paste. 

Slippery  Elm  Poultice.  —  Stir  ground  slippery  ^Im  bark  into  hot 
water,  and  let  it  swell.  This  is  a  very  soothing  p(»ultice  for  irritable 
sores. 

Onion  Poultice.  —  Made  in  the  same  way  as  the  carrot  poultice. 
This  is  quite  stimulating,  and  iLduces  indolent  sores  to  matarate 
more  freely.     It  is  excellent  for  slow  boils. 

Charcoal  Poultice. —  Take  either  the  bread  and  milk,  or  the  Indian 
meal  poultice,  and  stir  into  it  one  qufirter  its  bulk  of  finely  pulverized 
charcoal.     Excellent  for  thoroughly  clviansing  a  foul  sore  or  ulcer. 

Anodyne  Poultice.  —  Take  half  an  ounce  of  the  extract  either  of 
foxglove,  or  henbane,  or  stramonium,  or  conium,  or  belladonna,  and 
mix  with  it  half  a  pint  of  tepid  water.  Then  stir  in  as  much  flax- 
seed meal  as  will  make  a  poultice  of  th^  right  thickness.  Always  be 
careful  not  to  apply  this  poultice  wher^  thc-re  is  much  skin  off,  lest 
the  extract  used  be  so  much  absorbed  as  to  produce  poisonous  efiects. 
These  poultices  allay  the  pain  of  cancerous  and  other  sores. 

Lobelia  Poultice. — Powdered  lobelia  and  ground  slippery  elm  bark, 
each,  one  ounce.  Stir  these  into  hot  weak  lye,  to  n^ake  a  poultice. 
For  wounds,  fistula,  whitlow,  boils,  erysipelas,  and  stings  of  insects. 

Poke  Root  Poultice.  —  Roast  a  sufficient  quantity  of  fresh  poke 
root  in  hot  ashes.  When  it  is  quite  soft,  pound  it,  and  make  a  poul- 
tice. To  be  applied  to  tumor-,  to  scatter  them,  or  hasten  their  suppu- 
ration.    To  be  removed  every  four  hoars. 

Mustard  Poultice.  —  Stir  up  a  tablespoonful  of  ground  mustard 
trith  a  little  water,  to  ^he  consistence  of  paste.  Spread  upon  linen 
or  brown  paper,  and  cov^tr  with  thin  muslin,  that  the  mustard  may 
Qot  stick  to  the  sk.  n  when  the  poultice  is  removed. 


Powders. 

A  SINGLE  substance  used  as  a  powder  is  called  a  simple  powder  f 
two  or  more  united,  a  compound  powder.  Under  the  above  head,  I 
shall  describe  only  compound  powders.  In  preparing  compound 
powders,  the  substances,  if  of  difierent  degrees  of  hardness,  should 
generally  be  pulverized  separately.  Many  powders  require  to  be  ex- 
cluded from  the  light,  which  may  be  done  by  covering  the  bottles  in 
Arbich  they  are  kept  with  black  varnish. 


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MEDICINES  AND  THEIR  PREPARATIONS. 


Aromatic  Powder.  —  Take  two  ounces  each  of  cinnamon  and  gin- 
ger,  and  an  ounce  each  of  cardamom  deprived  of  the  capsules,  and 
grated  nutmeg.  Rub  them  together  int«)  a  very  fine  powder,  and 
keep  in  well-stopped  bottles. 

The  powder  is  stimulant  and  carminative,  and  in  cases  of  weak- 
ened digestion,  may  be  given  in  ten  to  thirty-grain  doses. 

Compound  Powder  of  Aloes  and  Canella.  —  Take  a  pound  of  aloes, 
and  three  ounces  of  canella.  Rub  them  separately  to  a  fine  powder, 
and  mix  them. 

This  is  the  preparation  known  as  hiera  piera,  or  simply  picra.  It 
may  be  used  for  amenorrhoea,  or  generally  as  a  bitter  to  correct  co8< 
tiveness,  and  improve  the  appetite. 

Compound  Powder  of  Catechu.  —  Take  two  ounces  each  of  catechu 
and  kino,  and  half  an  ounce  each  of  cinnamon  and  nutmeg.  Reduce 
all  to  a  fine  powder,  mix,  and  pass  them  through  a  tine  sieve. 

For  chronic  diarrhoea,  dysentery,  etc.  Dose,  from  fifteen  to  thirty 
grains. 

Compound  Powder  of  Chalk.  —  Take  half  a  pound  of  prepared 
chalk,  four  ounces  of  cinnamon,  three  ounces  each  of  tormentil  and 
gum  arable,  and  half  an  ounce  of  long  pepper.  Rub  them  separately 
into  a  very  fine  powder,  and  mix. 

This  powder  is  warm,  stimulant,  astringent,  and  antacid,  and  is 
well  fitted  for  diarrhoea,  not  connected  with  inflammation. 

Compound  Powder  of  Chalk  with  Opium. —  Take  six  ounces  and  a 
half  of  compound  powder  of  chalk,  and  four  scruples  of  powdered 
opium.     Mix  them. 

The  opium  in  this  preparation  increases  the  efficacy  of  the  com- 
pound powder  of  chalk  in  diarrhoea.  Dose  for  an  adult,  ten  to  twenty 
grains,  and  repeated  after  each  discharge. 

Compound  Powder  of  (iolden  Seal.  —  Take  two  drams  each  of 
powdered  golden  seal,  blue  cohosh,  and  helonias,  and  mix  them. 

Useful  in  dyspepsia,  and  chronic  inflammation  of  the  mucous  mem- 
brane of  the  stomach,  etc.  Dose,  half  a  teaspoonful  to  a  teaspoonful, 
three  or  four  times  a  day. 

Compound  Powder  of  Hydrastin.  —  Take  half  a  dram  each,  in 
powder,  of  hydrastin,  leptandrin,  rhubarb,  and  myricin.  Mix  tho- 
roughly, and  divide  into  thirty-two  powders. 

This  is  tonic  and  laxative,  and  is  useful  in  dyspepsia,  jaundice^ 
chronic  inflammation  of  the  bowels,  and  during  recovery  from  ex- 
hausting complaints.  One  powder  may  be  taken  often  enough  to 
produce  one  movement  of  the  bowels  a  day. 

Inhaliuf  Powder.  —  Take  one  dram  of  crystals  of  nitrate  of  silver, 
and  two  and  a  half  drams  of  lycopodium.  Work  the  lycopodium 
into  a  very  stiff"  paste,  with  a  little  warm  water,  in  which  the  nitrate 
18  dissolved.  Spread  this  thin  in  a  shallow  dish,  cover  it  so  as  to  shut 
out  the  light,  and  set  it  where  it  wili  dry;  when  thoroughly -dry,  pul- 
verize. 


==J 


^~™^^^p^ 


>^l:!^ 


I  have  used  this  powder  with  great  advantage  in  many  caues  of 
bronchitis,  by  directing  three  or  four  grains  of  it  to  be  inhaldd  once  a 
day,  in  an  instrument  I  had  constructed  for  that  purpose.  This  is  the 
only  really  valuable  catarrh  snvff  ever  used.  A  pinch  of  it  taken  once 
a  day  (never  oftener)  for  nasal  catarrh,  will  often  do  excellent  service. 

Compound  Powder  of  Ipecacnniilia.  —  Take  a  dratn  each  of  pow- 
dered ipecacuanha  and  opium,  and  one  ounce  of  sulphate  of  potassa. 
Rub  them  together  into  a  fine  powder. 

This  is  the  well  known  Dove/s  powder.  It  is  an  admiral^Ie  ano- 
dyne and  diaphoretic,  and  is  much  used  in  inflammatory  complaints, 
particularly  rheumatism  and  pneumonia,  complicated  with  low,  ty- 
phoid symptoms.     Dose,  from  five  to  fifteen  grains. 

Compound  Powder  of  Jaliip.  —  Take  half  an  ounce  of  pulverized 
jalap  and  senna,  one  ounce  bf  pulverized  bitartrate  of  potassa,  half  a 
dram  of  pulverized  ginger,  and  ten  grains  of  pulverized  cayenne. 
Mix  thoroughly. 

This  is  a  valuable  purgative  medicine,  and  may  be  used  in  most 
cases  where  a  simple  cathartic  is  required.  Dose,  half  a  teaspoonful 
to  a  tablespoon  fui. 

Com|Miund  Powder  of  Kino.  —  Take  fifteen  drams  of  kino,  half  an 
ounce  of  cinnamon,  and  a  dram  of  dried  opium.  Rub  them  sepa- 
rately  to  a  very  fine  powder,  and  mix  them. 

This  is  anodyne  and  astringent,  and  is  useful  in  diarrhoea,  etc. 

Compound  Powder  of  Rhubarb.  —  Take  four  ounces  of  powdered 
rhubarb,  one  pound  of  magnesia,  and  two  ounces  of  finely  powdered 
ginger.     Mix  thoroughly,  and  preserve  in  well-stopped  bottles. 

An  excellent  laxative  and  antacid,  and  well  adapted  to  the  bowel 
complaints  of  children. 

Compound  Powder  of  Rhubarb  and  Potassa  {Neutralizing  Pawder). 
~-Take  half  an  ounce  each  of  powdered  rhubarb,  bicarbonate  of 
potassa,  and  peppermint  leaves.     Mix  thoroughly. 

Valuable  in  diarrhoea,  cholera  morbus,  dysentery,  summer  com* 
plaint  of  children,  sour  stomach,  heartburn,  etc. 

Worm  Powder.  —  Take  one  ounce  each  of  powdered  white  Indian 
hemp  root  {asclepias  incamata),  mandrake,  pink  root,  and  bitter  root; 
two  ounces  of  powdered  balmony,  and  four  scruples  of  powdered 
aloes.     Mix  thoroughly. 

A  very  good  remedy  for  all  kiads  of  worms.  A  teaspoonful  of  the 
powder  may  be  mixed  with  a  gill  of  molasses,  and  a  teaspoonful  of 
this  given  to  a  child  every  hour  or  two  till  it  operates.  After  this, 
give  a  teaspoonful  three  times  a  day,  for  a  few  days. 

Syrnps. 

A  8TR0N0  solution  of  sugar  and  water  is  a  simple  syrup.  When 
the  water  is  first  charg«d  with  some  medicinal  substance,  and  sugar 


^l"v?*if  'Si.f! 


k 


684 


MEDICINES  AND  THEIR  PREPARATIONS. 


IB  added  to  this,  we  have  a  medicated  syrup.     Refined  sugar  should 
always  be  preferred,  in  preparing  medicated  syrups. 

Simple  Syrup.  —  Take  two  and  a  half  pounds  of  refined  sugar,  and 
a  pint  of  water ;  dissolve  the  sugar  in  the  water  by  heat,  remove  any 
Bcum  that  may  arise,  and  strain  while  hot. 

Syrnp  of  Almonds.  —  Take  a  pound  of  sweet  almonds,  four  ounces 
of  bitter  almonds,  three  pint«  of  water,  and  six  pounds  of  refined 
sugar.  Blanch  the  almonds,  then  rub  their,  in  a  mortar  to  very  fine 
paste,  and  add,  during  the  trituration,  three  fluid  ounces  of  the  water, 
and  one  pound  of  the  sugar.  Mix  the  paste  thoroughly  with  the 
remainder  of  the  water.  Strain  with  strong  expression,  add  the  re. 
mainder  of  the  sugar  to  the  strained  liquor,  and  dissolve  by  a  gentle 
heat.  Strain  through  fine  linen,  and  after  it  is  cool,  put  it  into  bottles, 
thoroughly  stopped,  and  keep  in  a  cool  place. 

This  is  demulcent,  nutritive,  and  sedative,  and  is  sometimes  added 
to  cough  mixtures,  etc. 

Synip  of  Citric  Acid. —  Take  two  drams  of  powdered  citric  acid, 
four  minims  of  oil  of  lemons,  and  two  pints  of  syrup.  With  one  fluid 
ounce  of  the  syrup,  rub  the  citric  acid  and  oil  of  lemons,  then  add 
the  remainder  of  the  syrup,  and  dissolve  by  a  gentle  heat. 

This  is  much  employed  as  an  agreeable  and  cooling  addition  to 
drinks,  especially  to  carbonic  acid  water.  Tartaric  acid,  being  cheaper 
than  citric  acid,  is  often  substituted  for  it,  and  the  preparation  thus 
made  is  much  sold  under  the  name  of  lemon  syrup. 

SyiUp  of  Giirlic.  —  Take  six  ounces  of  fresh  garlic,  sliced  and 
bruised,  one  pint  of  diluted  acetic  acid,  and  two  pounds  of  refined 
sugar.  Macerate  the  garlic  in  ten- fluid  ounces  of  the  diluted  acetic 
acid,  in  a  glass  vessel,  four  days,  and  express  the  liquor.  Then  mix 
the  rest  with  what  remains  of  the  acid,  and  again  express,  till  suffi- 
cient has  passed  to  make  the  whole  when  filtered  measure  a  pint 
Then  pour  the  filtered  liquor  on  the  sugar  in  a  bottle,  and  shake  till 
it  is  dissolved. 

Excellent  in  the  bronchial  affections  of  children.  Dose,  a  teaspoon* 
fnl,  for  a  child  a  year  old. 

Symp  of  fiiin^er.  —  Add  two  fluid  ounces  of  tincture  of  ginger  to 
a  quart  of  simple  syrup;  evaporate  the  alcohol  by  a  gentle  heat 

This  is  carminative  and  stimulant,  and  gives  tone  to  the  debilitated 
stomach,  removing  wind,  etc.  It  is  added  to  other  medicines  to  im- 
prove their  flavor. 

Compoand  Syrup  of  Hypopliospliites.  —  Take  256  grains  of  hypo- 
phosphite  of  lime,  192  grains  of  hypophosphite  of  soda  128  grains 
of  hypophosphite  of  potassa,  96  grains  of  recently  precipitated  hypo- 
phosphite  of  iron,  240  grains  of  hypophosphorous  acid  solution,  12 
ounces  of  white  sugar,  half  an  ounce  of  extract  of  vanilla,  and  a 
sufficient  quantity  of  water.  Dissolve  the  salts  of  lime,  soda,  and 
potassa,  in  six  ounces  of  water ;  put  the  iron  salt  into  a  mortar,  and 
gradually  add  solution  of  hypophosphorous  acid  till  it  is  dissolved; 


les  to  im« 


MEDICINES  AND  THEIR  PREPARATIONS. 


68ft 


to  thia  add  the  solution  of  the  other  nalts,  after  it  has  been  rendered 
ilightly  acidulous  with  the  same  acid,  and  then  water,  till  the  whole 
measures  nine  fluid  ounces.  Dissolve  this  in  sugar,  with  heat,  and 
flavor  with  the  vanilla.  Without  Havorins,  this  syrup  is  not  unpleas- 
ant, being  slightly  valine,  and  not  at  all  ferruginous.  Any  other 
flavoring  may  bo  used,  as  orange  peel,  orange  Howcr,  or  ginger.  It 
is  also  suggested  to  physicians  that  glycerine  may  be  used,  wholly  or 
partially,  in  place  of  sugar,  when  indicated,  six  ounces  and  a  half  of 
^{lycerine  being  substituted  for  twelve  ounces  of  sugar. 

This  syrup  has  been  much  used  of  late  as  a  new  remedy  for  con- 
<(umption,  on  the  authority  of  Dr.  Churchill.  It  is  elegantly  manu- 
factured by  Dr.  James  R.  Nichols  &  Co.,  of  this  city.  Dose,  a  tea- 
Bpoonful,  three  times  a  day  before  meals. 

Syrup  of  Ipecacuanha.  —  Take  one  ounce  of  ipecacuanha,  in  coarse 
powder,  one  pint  of  diluted  alcohol,  two  pounds  and  a  half  of  sugar, 
and  one  pint  of  water.  Macerate  the  ipecacuanha  in  the  alcohol 
fourteen  days,  and  filter;  evaporate  the  filtered  liquor  to  six  fluid 
ounces,  filter  again,  and  add  water  to  make  the  liquor  measure  a  pint ; 
then  add  the  sugar,  and  proceed  as  directed  for  syrup. 

This  is  chiefly  used  in  complaints  of  children.  Dose,  as  an  emetic, 
for  an  adult,  two  fluid  ounces ;  for  a  child  a  year  or  two  old,  one  or 
two  fluid  drams.  As  an  expectorant,  for  an  adult,  two  fluid  drams ; 
for  a  child,  five  to  twonty  minims. 

Syrup  of  Lemons.  —  Take  a  pint  of  strained  lemon  juice,  two 
pounds  and  a  half  of  refined  sugar,  and  two  and  a  half  fluid  ounces 
of  rectified  spirit;  boil  the  juice  ten  minutes,  and  strain;  then  add 
the  sugar,  and  dissolve.  After  the  syrup  has  cooled,  mix  the  spirit 
with  it, 

A  cooling  and  grateful  addition  to  drinks  in  fevers,  and  serves  to 
cover  the  taste  of  salts  and  other  purgatives. 

Aromatic  Syrup  of  Rhubarb.  —  Take  two  ounces  and  a  half  of 
bruised  rhubarb,  half  an  ounce  each  of  bruised  cloves  and  cinnamon, 
two  drams  of  bruised  nutmeg,  two  pints  of  diluted  alcohol,  and  six 
pints  of  syrup.  Macerate  the  rhubarb  and  aromatics  in  the  alcohol 
for  fourteen  days,  and  strain ;  then,  by  a  gentle  heat,  evaporate  the 
liquor  to  a  pint,  and,  while  hot,  mix  it  with  the  syrup  previously 
heated. 

This  is  a  warm  cordial  laxative,  admirably  fitted  for  the  bowel 
complaints  of  infants.  Dose,  a  fluid  dram,  repeated  every  two  hours 
till  it  operates. 

Syrnp  of  Seneka.  —  Take  four  ounces  of  fluid  extract  of  seneka,  and 
one  pint  of  wat.er ;  mix,  and  dissolve  in  the  liquid  one  pound  of  refined 
sugar,  and  proceed  as  directed  for  syrup. 

This  is  a  stimulating  expectorant,  used  in  colds,  coughs,  etc.,  after 
inflammatory  symptoms  have  subsided.  Dose,  for  an  adult,  one  or 
two  teaspoonfuls,  as  often  as  necessary. 

Syrup  of  Squill.  —  To  one  pint  of  vinegar  of  squiU,  add  two  pounds 
of  refined  sugar,  and  proceed  as  directed  for  syrup. 


6H6 


MEDICINES  AND  THEIR  PREPARATIONS. 


It  is  a  useful  expectorant  for  coughs  and  bronchial  affectiund  of 
infants  and  children.     Dose,  half  a  dram  to  a  drain. 

Syrup  of  Tolu.  —  Take  two  fluid  ounces  of  tincture  of  tolu,  and 
one  pint  of  simple  syrup;  mix,  and  gently  heat  the  mixture  to  evapo- 
rate  the  alcohol. 

This  is  chiefly  used  to  flavor  other  preparations. 

Syrup  of  Wlld-Clierry  Bark.  —  Place  two  pounds  and  a  half  of 
coarsely  powdered  wild-cherry  bark  in  a  percolator,  and  pass  through 
it  one  gallon  of  water.  Strain  this,  and  dissolve  in  it  by  heat  sixteen 
pounds  of  refined  sugar. 

This  makes  an  elegant  tonic  and  sedative  preparation,  and  is  mixed 
vath  various  other  articles  in  prescribing  for  dyspepsia,  consumption, 
etc. 

t'Omiiound  Syrup  of  Partridge  Berry. —  Take  half  a  pound  of  par- 
tridge-berry, and  two  ounces  each  of  helonias,  blue  cohosh,  and  hi^h 
cranberry  bark  ;  add  to  them  one  quart  of  brandy,  antl  macerate  luur 
days.  Press  out  the  brandy  ;  and  place  the  herbs  in  three  quarts  of 
boiling  water,  and  boil  down  to  .two  and  a  half  pints.  Strain,  add  one 
pound  of  sugar,  and  evaporate  to  two  and  a  half  pints.  Remove  from 
the  fire,  and  when  nearly  cold,  add  the  brandy  previously  pressed  out. 

This  is  considerably  used  by  the  Eclectic  physicians,  under  the 
name  of  motlier^s  cordial;  and  may  be  usefully  employed  by  all  pliy- 
sicians  in  suppression  of  the  menses,  painful  menstruation,  profuse 
menstruation,  and  habitual  abortions.  Dose  from  one  to  two  ounct"!. 
two  or  three  times  a  day. 

Compound  Syrup  of  Phosphates  (Chemical  Food). — Take  ten  drama 
of  protosulphate  of  iron,  twelve  drams  of  phosphate  of  soda,  twelve 
drams  of  phosphate  of  lime,  twenty  drams  of  phosphoric  acid  (glacial). 
two  scruples  of  carbonate  of  soda,  one  dram  of  carbonate  of  potustsa, 
sufficient  quantity  of  muriatic  acid,  sufficient  quantity  of  water  of 
ammonia,  two  drams  of  powdered  cochineal,  sufficient  water  to  make 
twenty  fluid  ounces,  three  pounds  of  sugar,  and  fifteen  drops  of  oil 
of  orange.  Dissolve  the  sulphate  of  iron  in  two  fluid  ounces  of  boil- 
ing water,  and  the  phosphate  of  soda  in  four  fluid  ounces  of  boiling 
water.  Mix  the  solutions,  and  wash  the  precipitated  phosphate  ol 
iron  till  the  washings  are  tasteless. 

Dissolve  the  phosphate  of  lime  in  four  fluid  ounces  of  boiling  water, 
with  sufficient  muriatic  acid  to  make  a  clear  solution,  precipitate  it 
with  water  of  ammonia,  and  wash  the  precipitate. 

To  the  freshly  precipitated  phosphates,  as  thus  prepared,  add  the 
phosphoric  acid,  previously  dissolved  in  the  water.  When  clear,  add 
the  carbonates  of  soda  and  potassa,  and  afterwards  sufficient  muriatic 
acid  to  dissolve  the  precipitate. 

Now  add  the  cochineal  mixed  with  the  sugar,  apply  heat,  and  when 
the  syrup  is  formed,  strain  and  flavor  it 

This  is  an  elegant  syrup,  agreeable  both  to  the  eye  and  taste,  and 
has  been  extensively  sold  and  used  as  a  nutritive  tonic,  in  chronic  de- 
bility, in  cases  of  broken  down  constitution,  wasting  of  the  flesh,  etc. 


o  ounce''. 


Compoond-Syrnp  of  Rhubarb  and  Potassa  {Neutralizinfi^  Cordial). — 
Take  half  a  pouivl  e&uh  of  powdered  rhubarb  and  bicurbonatc  po- 
tassa,  and  four  ounocs  each  of  cinnamon  and  golden  Heal ;  niueerute 
for  four  days  in  one  gallon  of  best  fourth  proof  brandy.  Express  ihe 
tincture  with  utrong  pre»«surc,  and  add  to  it  two  fluid  drains  of  oil  of 
peppermint,  previously  dissolved  in  a  little  alcohol.  Break  up  the 
cake  from  the  press,  place  it  in  a  percolator,  and  gradually  puss 
through  it  warm  water  till  the  strength  id  'Exhausted.  Evaporate  this 
tiolution  to  four  quarts,  and  w)iile  the  liquor  is  still  hot,  dissolve  in  it 
8ix  pounds  of  refined  sugar.  Continue  the  evaporation,  if  necessary, 
till  the  addition  of  the  tincture  first  obtained  will  make  three  gallons. 
Then  add  the  tincture. 

A  valuable  antacid  and  laxative  in  diarrhoea,  dysentery,  cholera 
morbus,  and  summer  complaint  of  children.  Dose,  for  an  adult,  a 
tablespoon ful,  to  be  taken  as  circumstances  require. 

Compound  Syrup  of  Sarsaparilla.  —  Take  a  pound  each  of  sarsa- 
parilla,  yellow  parilla,  and  pipsissewa ;  an  ounce  and  a  half  of  guaia- 
cum ;  one  ounce  each  of  red  roses,  senna,  and  liquorice  root ;  and 
three  minims  each  of  oil  of  sassafras,  anise,  and  partridge-berry ;  di- 
luted alcohol,  five  pints,  and  four  pounds  of  refined  sugar.  Grind 
and  mix  the  sarsaparilla,  yellow  parilla,  pipsissewa,  guaiacum,  roses, 
senna,  and  liquorice,  and  add  to  them  the  alcohol.  Let  the  whole 
stand  fourteen  days ;  then  express  and  filter.  Evaporate  by  a  water 
bath  to  one  quart,  and  add  the  sugar.  Lastly,  rub  the  oils  in  a  mor- 
tar with  a  little  of  the  syrup,  and  thoroughly  mix  with  the  remainder. 

This  is  a  valuable  alterative  syrup,  and  is  used  for  syphilis,  scrofula, 
diseases  of  the  skin,  etc.  It  is  much  improved  by  adding  half  an 
ounce  of  the  iodide  of  potassium  to  each  pint  of  the  syrup.  Dose,  a 
tablespoonfuL 

Compound  Aromatic  Syrup  of  Senna.  —  Take  four  ounces  of  senna, 
one  ounce  and  a  half  of  jalap  root,  half  an  ounce  of  rhubarb,  one 
dram  of  cinnamon,  one  dram  of  cloves,  and  half  a  dram  of  nutmeg^ 
Reduce  these  articles  to  a  coarse  powder ;  add  one  quart  of  diluted 
alcohol.  Let  the  whole  stand  two  days,  and  percolate.  Filter,  dis- 
solve in  it  one  pound  of  refined  sugar,  and  add  one  dram  of  oil  of 
lemons. 

An  excellent  cordial  physic. 

Compound  Syrup  of  Stillinfia.  —  Take  a  pound  each  of  queen's 
root  and  turkey  corn ;  half  a  pound  each  of^  pipsissewa  leaves  and 
tlder  flowers ;  and  four  ounces  each  of  prickly  ash  berries  and  carda- 
mom seeds.  Grind  all  the  articles,  mix,  and  place  them  in  a  jar,  and 
moisten  them  well  with  alcohol.  Let  them  stand  two  days ;  then 
place  them  in  a  percolator,  and  gradually  add  hot  water  till  two  pints 
are  obtained,  which  must  be  strained  and  set  aside.  Then  continue 
the  percolation  so  long  as  there  is  a  sensible  taste  of  the  spirit  Re- 
serve this  also.  Then  continue  the  percolation  till  what  is  obtained 
is  almost  tasteless.  Boil  down  this  last  till  the  addition  of  the  two 
reserved  tinctures  will  make  two  gallons  of  the  whole.  Now  add 
twelve  pounds  of  refined  sugar,  and  make  a  syrup. 


i 

m 
I 


:'^ji 


688 


MEDICINES  AND  THEIR  PF,EI»A  RATIONS. 


This  ia  one  of  the  Eclectic  medicines  ;  and  is  quite  an  effective 
alterative  for  syphilis,  scrofula,  etc.  Improved  by  adding  iodide  of 
potassium.     Dose,  from  a  teaspoonful  to  a  tablespoonful. 

Comi^ound  Syrap  of  Yellow  Dock.  —  Take  two  pounds  of  yellow 
dock  root,  one  pound  of  the  bark  of  the  root  of  false  bittersweet,  and 
half  a  pound  each  of  American  ivy  and  figwort  Make  a  syrup  ac* 
cording  to  the  directions  for  compound  syrup  of  stiilingia,  using  six- 
teen pounds  of  sugar,  and  making  two  gallons  of  syrup. 

A  valuable  preparation  for  scrofula.  Improved  by  iodide  of  pota.n- 
nium.     Dose,  a  tablespoonful,  three  or  four  times  a  day. 

Tinctures. 

Foa  a  description  of  the  method  of  making  tinctures,  see  page  588, 
I  will  siiiiply  add  here,  that  an  ethereal  tincture  is  one  which  is  made 
with  tther  as  the  solvent  instead  of  alcohol,  and  an  ammoniated  tinc- 
ture, cne  made  with  water  of  ammonia  as  the  solvent. 

Simple  tinctures,  in  which  only  one  medicinal  article  is  used,  are 
made  thus  : 

Tincture  of  Aconite.  —  Take  eight  ounces  of  powdered  aconite  root, 
and  one  pint  of  alcohol.  Mix,  and  let  them  stand  for  two  weeks,  fre- 
quently stirring.     Then  express,  and  filter  through  paper. 

Given  in  fevers  and  inflammatory  diseases.  Dose,  three  drops 
every  hour  or  two  in  a  little  water. 

In  the  above  maimer  all  simple  tinctures  are  made.  Some  mwii- 
cines  recjuire  alcohol  to  extract  their  active  principle ;  some  only 
diluted  alcohol. 

One  Ounce  to  the  Pint  of  Alcohol In  preparing  simple  tincturest 

from  the  following  articles,  alcohol  ia  used,  and  one  ounce  only  of  the 
mediciup  is  employed  to  the  pint,  namely: 

Castor,  SaftVon,  Lcptandria. 

One  Ounce  to  the  Pint  of  Dilated  Alcohol.  —  In  making  tinctures 
from  the  following  articles,  one  oun»^  is  used  to  the  pint  of  dilated 
alcohol : 

Iodine,  Quassia.  . 

Two  Ounces  to  a  Pint  of  Alcohol : 

Asisafietida,  Camphor,  Oil  of  Peppermint,  Oil  of  Spearmint,  Ben- 
zoin, Colchicum  seeds,  Lupulin. 

Tivo  Ounces  to  a  Pint  of  Diluted  '/icohol : 

Cardamom,  Cotton  Bark,  Cochineal,  Colombo,  Coichicum,  Ergot. 
GaIIh,  Hemlock,  Cubebs*,  Foxglove,  Black  Hellebc ./e,  Henbane,  Laciu- 
earium,  Ijobelia,  Pok«\  Shrubby  Trefoil,  Bloodroot,  Squill,  Valerian, 
Bitter:nvor,t,  Belladonna. 

Three  Onnces  to  a  Pint  of  VAlateA  Alcohol : 

Peruvian  Bark,  Rhatany,  Poison  Hemlock,  Sheep  Laurel,  Stramo- 
nium, White  Hellebore,  Yarrow,  Prickly  Elder,  Jalap. 


Fonr  Ounces  to  a  Pint  of  Alcohol : 

Nux  Vomica,  Ginger,  Guaiacum,  Black  Cohosh 

Four  Ounces  to  a  Pint  of  Diluted  Alcoliol : 

Yellow  Jessamine,  Prickly^ash  Berries,  Ergot,  Matico. 

The  following  tinctures  embrace  those  which  vary  from  the  above 
proportions  among  the  simple  tinctures,  and  also  the  compound  tino> 

tures : 

Tincture  of  Oranjpe  feel.  —  Take  three  and  a  half  ounces  of  dried 
orange  \)rie\^  and  one  quart  of  diluted  alcohol.  Macerate  for  seven 
days,  express  and  filter. 

Tincture  of  Bucliu.  —  Take  five  ounces  of  buchu,  and  one  quart  of 
diluted  alcohol.     Digest  seven  days ;  pour  off  the  clear  liquor,  and 


ulter. 


Tincture  of  Indian  Hemp.  —  Take  of  extract  of  Indian  Hemp 
(Cannabis  Indica)  one  ounce,  and  one  pint  of  alcohol.  Dissolve  th^ 
extract  in  the  spirit     Dose,  from  twenty  to  forty  drops. 

Tincture  of  Cantharides.  —  Take  ai  ounce  of  bruised  Spanish  flies, 
and  two  pints  of  diluted  alcohol.  Macerate  for  fourteen  days,  express 
arut  filter  through  paper. 

Dose,  from  twenty  drops  to  a  dram,  three  or  four  times  a  day. 

Tincture  of  €t)ycunc  Pepper.  —  Take  an  ounce  of  pulverized  cay- 
enne, and  two  pijits  of  diluted  alcohol.  Macerate  fourteen  days,  and 
filter  throngh  paper. 

TInctKfC  of  Cdteciiu.  —  Take  an  ounce  and  a  half  of  catechu,  an 
ounce  of  bruised  cinnamon,  and  one  pint  of  diluted  alcohol.  Let 
them  stand  together  two  weeks,  frequently  shaking;  then  express  and 
filter. 

Dose,  from  thirty  drops  to  a  tablespooisful. 

Tincture  of  Cinnamon. —  Take  an  ounce  and  a  half  of  powdered 
cinnamon,  and  one  pint  of  diluted  alcohol.  Let  them  stand  together 
for  two  weeks  ;  express  and  filter. 

Dose,  from  one  to  four  teaspoonfuls  in  sweetened  water. 

F'iiir  Vitriol.  —  Take  half  a  pint  of  alcohol ;  drop  into  it  seven 
fluid  drams  of  sulphuric  acid,  and  let  the  mixture  stand  three  days  ui 
a  close  vessel;  then  add  two  drams  *:.'  powdered  ginger,  and  three 
drams  of  pcwdered  cinnatnon.     Macerate  seven  days,  and  filter. 

Useful  in  diarrlitEU,  dysentery,  etc.  Dose,  from  five  to  twenty  drops, 
To  avoid  injury  to  the  teeth-  it  should  be  taken  through  a  quill,  or  else 
the  mouth  should  be  rinsed  immediately  after  swallowing  it 

Tincture  of  Loltclia.  —  Take  four  ounces  of  lobelia,  and  one  pint 
each  of  distilled  vinegar  and  alcohol.  Macerate  two  weeks,  express 
and  fdter. 

Dose,  as  a  nauseant  or  expectorant,  from  thirty  to  sixty  drops. 

Tincture  of  Opium  {Laudanum).  —  Take  two  and  a  half  ounces  of 

87 


II 


'V.Vr'i^ 


» ■  I 


ill  II 


Pi  ': 


69U 


MEDICINES  AND  THEIR  PREPARATIONS. 


opium,  and  two  pints  of  diluted  alcohol.  Macerate  fourteen  days, 
express,  and  filt^-r  through  paper.  Dose,  from  ten  to  twenty-five 
drops. 

Tincture  of  Tolu. —  Dissolve  one  ounce  of  Balsam  of  tolu  in  one 
pint  of  alcohol,  and  tilter. 

Tincture  of  Rliuhiirb. —  Take  three  ounces  of  bruised  rhubarb,  half 
an  ounce  of  bruised  cardamom,  and  a  quart  of  diluted  alcohol.  Mac- 
erate two  weeks,  exj>ress,  and  filter  through  paper. 

Tincture  of  Tii^inia  Sniilie  Root.  —  Take  three  ounces  of  bruised 
Virginia  snake  root,  and  one  quart  of  diluted  alcohol.  Macerate  two 
weeks,  express,  and  filter  through  paper. 

This  is  advantageously  added  to  the  infusion  of  Peruvian  bark,  in 
low  states  of  the  system.     Dose,  one  to  two  fluid  drams. 

Compound  Tincture  of  Aloes.  —  Take  three  ounces  of  powdered 
aloes,  one  ounce  of  safl'ron,  and  two  pints  of  tincture  of  myrrh.  Mac- 
erate fourteen  days,  and  filter. 

This  is  the  well  known  elixir  proprietatis,  or,  more  commonly,  elixtr 
pro.  It  is  considerably  used  in  female  disorders,  connected  with  sup- 
pressed, retained,  or  deficient  menstruation.  Dose,  one  to  two  fluid 
drams. 

Compouiul  Tincture  of  AssafcBtlda.  —  Take  half  an  ounce  each  of 
lupulin,  assafoetida,  in  small  pieces,  bruised  stramonium  seeds,  pow- 
dered valerian  root,  and  one  pint  and  a  half  of  alcohol ;  macerate  two 
weeks,  shaking  frequently,  then  express  and  filter. 

This  is  anodyne  and  antispasmodic,  and  is  used  in  epilepsy,  St 
Vitus's  dance,  and  hysterics.     Do.se,  a  teaspoonful. 

Compound  Tincture  of  Benzoin.  —  Take  three  ounces  of  benzoin, 
two  ounces  of  purified  storax,  one  ounce  of  balsam  of  tolu,  half  an 
ounce  of  powdered  aloes,  and  two  pints  of  alcohol.  Macerate  two 
weeks,  and  filter. 

This  is  used  in  chronic  diseases  of  the  air  passages.  Dose,  from 
thirty  to  sixty  drops. 

Compound  Tincture  of  Cardamom.  —  Take  «ix  drams  of  bruised 
cardamom,  two  ounces  of  bruised  caraway,  five  dratns  of  bruised 
cinnamon,  five  ounces  of  seeded  raisins,  one  dram  of  bruised  cochi- 
neal, and  two  pints  and  a  half  of  diluted  alcohol.  Macerate  two 
weeks,  and  filter. 

This  is  a  very  agreeable  aromatic ;  used  as  a  carminative,  and  to 
improve  other  preparations.     Dose,  one  or  two  fluid  drams. 

Compound  Tincture  of  Catechu.  —  Take  three  ounces  of  catechu, 
two  ounces  of  bruised  cinnamon,  and  two  pints  of  diluted  alcohol 
Macerate  fourtc^en  days,  express  and  filter. 

This  is  frequently  added  to  chalk  preparations  for  diarrhoea,  etc. 
Dose,  from  one  to  three  fluid  drams. 

Compound  Tincture  of  Cinnamon.  —  Take  one  ounce  of  bruised  cin- 
namon, half  an  ounce  of  bruised  cardamom  seeds,  three  drams  of 


I  in  one 


bruised  ginger,  and  two  pints  of  proof  spirits.     Macerate  fourteen 
days,  express,  and  filter. 

This  is  a  warm,  aromatic  tincture,  useful  in  spasms,  and  debility  of 
the  stomach.     Dose,  one  to  two  fluid  drams. 

Conipoiiiid  Tincture  of  Black  €olio.sli.  —  Take  one  fluid  ounce  of 
tincture  of  black  cohosh,  half  a  Huid  ounce  of  tincture  of  bloodruot, 
and  two  fluid  drams  of  tincture  of  poke  root.     Mix. 

This  is  used  in  diseases  of  the  lungs,  liver,  and  stomach.  Dose, 
from  twenty  to  sixty  dro|)s,  three  or  lour  times  a  day. 

Compound  Tincture  of  Blue  Cohosh.  —  Take  one  ounce  of  powdered 
blue  cohosh  root,  half  an  ounce  each  of  bruised  water  pepper  and 
ergot,  two  fluid  drams  of  oil  of  savin,  and  twelve  fluid  ounces  of 
alcohol ;  mix,  macerate  for  a  fortnight,  and  filter. 

A  uterine  tonic,  used  for  suppressed  and  painful  menstruation,  etc. 
Dose,  a  teaspoon ful,  two  or  three  times  a  day. 

Compound  Tinctiu'e  of  Colchlcuni. —  Mix  one  fluid  ounce  each  of 
tincture  of  black  cohosh  and  tincture  of  colchicum  seed. 

Used  for  inflammatory  rheumatism  and  gout  Dose,  ten  to  sixty 
drops. 

Compound  Tincture  of  Gentian.  —  Take  two  ounces  of  bruised 
gentian,  one  ounce  of  cange  peel,  half  an  ounce  of  bruised  carda- 
mom seeds,  and  two  pints  of  diluted  alcohol.  Macerate  fourteen 
days,  express,  and  filter. 

An  elegant  bitter,  much  used  in  dyspepsia,  and  as  an  addition  to 
tonic  mixtures  for  a  weakened  state  of  the  stomach.  Dose,  one  or 
two  fluid  drams. 

Compound  Tincture  of  Golden  Seal.  —  Take  one  ounce  each  of 
powdered  lobelia  seed  and  golden  seal,  and  one  pint  of  diluted  alco- 
hol.    Macerate  two  weeks,  express,  and  filter. 

This  is  used  as  a  local  application  to  diseased  mucous  membranes, 
in  leucorrhoea,  gleet,  etc. 

Ammoniated  Tincture  of  Gnaiac.  —  Take  four  ounces  of  powdered 
guaiac,  and  a  pint  and  a  half  of  aromatic  spirits  of  ammonia.  Mac- 
erate for  two  weeks,  and  filter. 

This  tincture  has  considerable  reputation  in  the  treatment  of  chronic 
rheumatism.     Dose,  one  or  two  fluid  drams. 

Compound  Tincture  of  Hemlock  ( Golden  Tincture).  —  Take  one 
ounce  each  of  powdered  balsam  of  tolu,  guaiacum,  gum  hemlock, 
and  gum  myrrh,  one  ounce  and  a  half  of  oil  of  hemlock,  one  ounce 
of  oil  of  winter  green,  and  four  pints  of  alcohol.  Mix,  let  them 
stand  fourteen  days,  shaking  frequently,  then  filter. 

This  is  used  by  the  Eclectics  for  rheumatism,  wind  colic,  water 
brash,  soreness  of  the  chest,  etc.  Dose,  a  teaspoonful  in  a  wineglass- 
fu)  of  water. 

Compound  Tincture  of  Hii^h  Cranberry.  —  Take  one  ounce  of  high 
cranberry  bark,  powdered,  half  an  ounce  each  of  powdered  lob«?fia 
Becd  and  bruised  skunk  cabbage  seed,  two  drams  each  of  bruisod 


f  ^ifr*-40^   * 


692 


BiEDICINES  AND  THEIR  PREPARATIONS. 


\  -.   *  s 


itramonium  seed,  powdered  bloodroot,  and  capsicum,  and  two  pints 
of  alcohol.     Macerate  two  weeks,  express,  and  filter. 

This  is  an  Eclectic  remedy,  and  is  useful  in  nervous  and  spasmodic 
complaints,  particularly  hysterics,  etc.  Dose,  from  twenty  drops  to  a 
teaspoonful. 

Compound  Tincture  of  Lavender.  —  Take ,  three  fluid  drams  of  oil 
of  lavender,  one  dram  and  a  half  of  oil  of  anise,  one  ounce  of  pow- 
dered cloves,  three  drams  of  mace,  one  ounce  of  raisins,  two  ounces 
of  red  Saunders,  and  one  gallon  of  Jamaica  rum.  Mix,  and  macerate 
fourteen  days  ;  then  express  and  filter. 

This  is  often  used  for  flatulence,  hysterics,  and  faintness.  Dose, 
from  one  to  three  teaspoonfuls,  in  water. 

Compound  Tincture  of  Lobelia  (Dr.  J.  King's  Expectorant  Tincture). 
—  Take  one  ounce  each  of  coarsely  powdered  lobelia,  bloodroot,  skunk 
cabbage,  wild  ginger,  and  pleurisy  root.  Place  them  in  a  vessel,  and 
pour  over  them  one  pint  of  boiling  water  or  vinegar,  and  cover  tightly. 
When  cold,  add  three  pints  of  alcohol.  Macerate  two  weeks,  then 
express  and  filter. 

A  valuable  emetic  for  infants  and  children,  in  croup,  hooping-cough, 
bronchitis,  and  convulsions.  Used  also  as  an  expectorant,  in  coughs, 
pleurisy,  etc.  Dose,  as  an  emetic  for  a  child,  half  a  teaspoonful  and 
upwards. 

Com^t>jund  Tincture  of  Lobelia  and  Capsicum.  —  Take  one  ounce 
each  of  powdered  lobelia,  capsicum,  and  skunk  cabbage,  and  one  pint 
of  diluted  alcohol.     Mix,  macerate  fourteen  days,  and  filter. 

A  prompt  antispasmodic  in  cramps,  spasms,  lock-jaw,  etc.  Dose, 
half  a  dram  to  a  dram. 

Compound  Tincture  of  Myrrh  {Hot  Drops).  —  Take  four  ounces  of 
bruised  myrrh,  two  ounces  of  capsicum,  and  four  pint.*  of  alcohol 
Mix,  macerate  a  fortnight,  and  filter. 

Applied  externally,  and  occasionally  given  internally  for  distress  oi 
stomach,  flatulence,  etc. 

Camphorated  Tincture  of  Opium.  —  Take  one  dram  each  of  pow 
dered  opium  and  benzoic  acid,  one  fluid  dram  of  oil  of  anise,  tw» 
ounces  of  clarified  honey,  two  scruples  of  camphor,  and  two  pints  of 
diluted  alcohol.     Macerate  fourteen  days,  and  filter. 

This  is  known  to  all  the  world  as  paregoric  elixir.  It  is  an  agree* 
able  anodyne  and  antispasmodic,  and  a  good  deal  used  among  chil- 
dren to  allay  cough,  and  to  relieve  pains,  diarrhoea,  etc. 

Compound  Tincture  of  Peruvian  Bark.  —  Take  two  ou.nces  of  red 
bark,  powdered,  one  ounce  and  a  half  of  bruised  oiange  peel,  three 
drams  of  bruised  Virginia  snake-root,  one  drain  each  of  saffron,  cut, 
and  red  saunders,  rasped,  and  twenty  fluid  ounces  of  diluted  alcohol. 
Macerate  two  weeks,  express,  and  filter. 

This  is  Huxhani's  tincture.  It  is  an  excellent  stomach  cordia',  and 
is  used  with  advantage  in  low  forms  of  fever,  etc.  Dose,  from  oue  to 
four  fluid  drams. 


;wo  pints 

Rasmodic 
ops  to  a 

ma  of  oil 
B  of  povr- 
ro  ounce* 
i  macerate 


9S. 


Dose, 


Tincture). 
oot,  skunk 
vessel,  and 
vrer  tightly, 
recks,  then 

)ing-cough, 

in  coughs, 

oonful  and 

one  ounce 

id  one  pint 

r. 

etc.    Dose, 

r  ounces  <J 
of  alcohol 

■  distress  ol 


,ch  of  pow 
anise,  tw» 
wo  pints  ot 

is  an  agree* 
among  chil* 

Kxces  of  red 
peel,  three 
saffron,  cut, 
ted  alcohol. 

cordial,  and 
from  oue  to 


MKDICINES  AND  THEIB  PBEPARATI0N8. 


693 


Compound  Tincture  of  Rhubarb  {Sweet  Tincture  of  Rhubarb).-^ 
Take  two  ounces  and  a  half  of  bruised  rhubarb,  six  drams  of  bruised 
liquorice  root,  three  drams  each  of  bruised  ginger  and  sailiron,  two 
ounces  of  refined  sugar,  and  one  quart  of  diluted  alcohol.  Macerate 
one  week,  express,  and  filter. 

A  warm,  gentle  aperient,  well  fitted  for  debilitated  states  of  the 
stomach.     Dose,  from  a  dram  or  two  to  an  ounce. 

Tincture  of  Senna  and  Jalap  (Efixir  Salulis).  —  Take  three  ounces 
of  senna,  one  ounce  of  powdered  jalap,  half  an  ounce  each  of  bruised 
coriander  and  caraway  seeds,  two  drams  of  bruised  cardamom  seeds, 
four  ounces  of  sugar,  and  three  pints  of  diluted  alcoliol.  Macerate 
two  weeks,  express,  and  filter. 

This  is  a  warm  cordial  purgative,  useful  in  costiveness,  and  gout 
attended  with  debility.     Dose,  two  fluid  drams  to  an  ounce. 

Compound  Tincture  of  Tamarac  {Bone's  Bitters).  —  Take  three 
ounces  each  of  tamarac  bark  and  juniper  berries,  two  ounces  of 
prickly-ash  bark,  one  ounce  and  a  half  each  of  wild-cherry  bark  and 
seneca  snake-root,  and  half  an  ounce  of  tansy  ;  powder  coarsely,  and 
mix ;  then  add  one  pint  and  a  half  of  whiskey,  and  let  them  stand 
twenty-four  hours ;  then  place  the  whole  in  a  vapor  dii«piacement 
apparatus,  and  force  through  the  mixture,  the  vapor  of  another  pint 
of  whiskey,  after  which,  steam  from  water  enough  lo  make  the  tinc- 
ture equal  to  six  quarts.  To  this  add  twelve  ounces  of  molasses,  and 
six  drams  of  thoroughly  dissolved  alcoholic  extract  of  mandrake. 

This  is  tonic,  diuretic,  and  aperient.  Useful  in  dyspepsia,  etc. 
Dose,  a  tablespoonful  three  times  a  day. 

Ammciiiated  Tincture  of  Valerian.  —  Take  four  ounces  of  bruised 
valerian,  and  one  quart  of  aromatic  spirit  of  ammonia.  Macerate 
two  weeks,  express,  and  filter. 

This  is  used  as  an  antispasmodic  in  hystr  ics,  and  other  nervous 
diseases.     Dose,  one  or  two  fluid  drams,  in  sweetened  water. 

Compound  Tincture  of  Virj^inia  8nake-root  ( Sudorific  Tincture).  — 
Take  eight  scruples  each,  in  coarse  powder,  of  Virginia  snake-roof, 
ipecacuanha,  safl'ron,  opium,  and  camphor,  and  one  pint  of  Holland 
gin,  or  proof  spirit.     Mix,  macerate  two  weeks,  express,  and  filter. 

This  tincture  tends  powerfully  to  induce  perspiration,  and  is  used 
for  such  purpose  when  it  is  desirable  to  procure  sleep,  etc.  Dose,  from 
ten  drops  to  a  teaspoonful,  every  hour  or  two,  in  catnip  or  balm  tea. 

Vinegars. 

Vine^r  of  Lobelia.  —  Take  two  ounces  of  powdered  lobelia  seed, 
and  one  pint  of  distilled  vinegar.  Macerate  in  a  close  vessel  one 
week  ;  then  express  and  filter,  and  add  one  fluid  ounce  of  alcohol. 

This  is  useful  as  an  emetic  and  expectorant;  externally,  it  is  val- 
aable  in  skin  diseases.  Dose,  one  to  four  teaspoonfuls.  as  often  as 
necessary. 


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1        i'   ''^=« 


6»4 


MEDICINES  AND  THEIR  PREPARATIONS. 


Vinefar  of  Squill.  —  Take  two  ounces  of  sliced  squill,  and  one  pint 
of  distilled  vinegar ;  macerate  in  a  close  glass  vessel  one  week  ;  tiien 
express,  strain,  and  add  one  fluid  ounce  of  alcohol. 

This  is  expectorant  and  diuretic,  and  is  sometimes  used  for  coughs, 
and  diseases  of  the  chest 

Miscellaneous. 

The  recipes  of  a  few  nopular  proprietary  medicines  are  given  here 
merely  as  matters  of  curiosity. 

Briiiiilrctli*s  Pills. —  T.Jte  two  pounds  of  aloes,  one  pound  of  gam- 
bogc,  four  ounces  of  extract  of  colocyiith,  half  a  pound  of  castile  soap, 
two  fluid  drams  of  oil  of  popperiuint,  and  one  fluid  dram  of  cinna- 
mon.    Mix,  and  form  into  pills. 

Brown's  Broncliiul  Troches.  —  Take  one  pound  of  pulverized  ex- 
tract of  li(|Uorice,  one  and  a  half  pounds  of  pulverized  sugar,  four 
ounces  of  pulverized  eubebs,  four  ounces  of  pulverized  gum  arable, 
and  one  ounce  of  pulverized  extract  of  conium.     Mix. 

Hunter's  Red  Droii.  —  Take  ten  grains  of  corrosive  sublimate, 
twelve  drops  of  muriatic  acid,  and  one  ilnid  ounce  of  compound 
spirits  of  lavender.  Dose,  five  to  twenty  drops  in  water,  or  white 
wine,  sufficient  to  produce  one  evacuation  daily,  but  not  over  two. 

Ayer's  Cherry  Pectoral.  —  Take  four  grains  of  acetate  of  morphia, 
two  fluid  drams  of  tincture  of  bloodroot,  three  Huid  drams  each  of 
antimonial  wine  and  wine  of  ipecacuanha,  and  hree  fluid  ounces  of 
syrup  of  wild  cherry.     Mix. 

Ntickenzle's  Ointment.  —  Take  four  ounces  of  powdered  sulphate 
of  zinc,  one  ounce  and  a  half  of  tar,  and  one  pint  of  lard;  mix,  and 
boil  slowly  one  hour,  stirring  all  the  time. 

For  tetter,  scald  head,  and  other  diseases  of  the  skin.  To  be  ap" 
plied  twice  a  day,  washing  the  part  with  castile  soap-suds  daily. 

Wood's  Hair  Restorative.  —  Take  four  drams  of  lac  sulphur,  two 
drams  of  sugar  of  lead,  and  one  pint  of  rose  water.     Mix. 

Frey's  Vennifujce.  —  Take  one  ounce  of  castor  oil,  one  ounce  of 
aromatic  syrup  of  rhubarb,  thirty  drops  of  oil  of  chenopodium,  five 
drops  of  croton  oil.     Mix. 

Conchlin's  Salve. —  Take  twelve  ounces  of  resin,  and  one  ounce  each 
of  beeswax,  mutton,  and  tallow ;  melt  together,  strain,  and  work  into 
rolls  in  cold  water. 


"ll",'lff"^|^'l|H« 


CANKER. 


695 


Canker*  —  Aptha  Communis. 

Very  few,  if  any,  standard  medical  writers  have  treated  of  canker. 
In  truth,  it  is  only  a  symptom  of  various  complaints,  and  not  itself  a 
disease.  It  has  accordingly  been  shut  out  from  medical  books.  Fol- 
lowing the  general  practice,  i  omitted  it  in  this  work.  I  now  regret 
the  omission,  and  place  it  here  at  the  end.  it  afHicts  —  yes,  afflicts 
—  sorely  afflicts^  numerous  persons,  who,  though  doubtless  atlceted  by 
some  constitutional  disturbance,  as  its  cause,  are  not  conscious  of 
any  complaint  except  this  single  manifestation  —  Canker.  You  find 
not  only  the  disease,  therefore,  but  complaints  respe(;ting  it,  in  almost 
everybody's  mouth — "  What  shall  I  do  for  the  canker?"  meets  us  at 
almost  every  turn.  "  I  am  sorely  alllicted  with  the  canker,"  says  one. 
"  I  am  literally  sick  with  the  canker,"  says  another.  And  a  third  says, 
"  I  can  neither  eat,  nor  converse,  nor  take  rest,  I  am  in  such  pain  from 
canker  in  my  mouth."  And  these  complaints  are  not  unnatural,  for 
the  sufferings  occasioned  by  this  aflection  are  indeetl  terrible. 

Canker  begins  in  the  form  of  small  blisters,  generally  upon  the 
tongue,  or  inside  of  the  cheeks  or  lips,  which,  after  a  time,  break  and 
form  little  ulcers,  which  are  oftentimes  very  sore  and  painful.  These 
dicers  will,  at  times,  not  only  multiply,  but  spread  themselves  to  large 
dimensions,  going  deep  into  the  flesh,  and  becoming  painful  almost 
'beyond  endurance.  In  many  cases,  the  parts  swell,  and  become  so 
sensitive  and  tender  that  it  is  almost  impossible  to  swallow  the 
blandest  food.  The  mouth  will  frequently  become  filled  with  saliva, 
which  runs  involuntarily  out,  to  the  great  annoyance  of  the  patient 

Treatment. —  Canker  is  frequently  dependent  on  a  deranged  state 
of  the  stomach  and  bowels.  When  this  is  the  case,  the  treatment 
may  begin  with  a  dose  of  gentle  physic  (12),  (15),  (19),  (26).  If  the 
stomach  be  quite  permanently  deranged,  let  this  be  followed  with  a 
somewhat  prolonged  use  of  prescription  No.  28,  or  37,  or  of  the  Neu- 
tralizing Cordial.  If  the  mouth  be  very  sore,  use  a  tea  of  slippery 
elm  bark,  or  flax-seed,  or  a  solution  of  gum  arable ;  and  as  the  in- 
flammation subsides,  touch  the  ulcerated  patches  with  luv^  stick  nitrate 
of  silver  (lunar  caustic) ;  or  use  gargle  No.  201,  or  202,  or  203,  or 
205,  or  20H,  or  209,  or  232,  or  243,  or  244,  or  sulphate  of  copper  8 
grains,  dissolved  in  two  ozs.  of  water.  A  tea  made  of  red  raspberry 
leaves,  or  blackberry  roots,  may  be  freely  used  as  a  drink. 

One  of  the  best  remedies  is  creosote.  About  ten  drops  may  be 
mixed  with  an  ounce  of  mucilage  of  gum  arable,  well  sweetened 
with  loaf  sugar.  Of  this,  a  dessert  spoonful  may  be  held  for  a  few 
moments  in  the  mouth,  and  then  swallowed,  from  two  to  four  timed 
a  day.  Recipe  205  is  not  only  useful  as  a  gargle,  but  may  be  re- 
duced by  adding  one  pint  of  water,  and  m&y  then  be  swallowed  four 
or  five  times  a  day,  in  doses  of  two  tablespoonfuls  at  a  time. 

The  diet  should  always  ne  CHisfully  regulated,  and  only  the  more 
simple  food  taken,  and  b\.  regular  meals. 


11    ^i: 


i:4) 


696 


DIPHTHERIA. 


Diphtheria.  —  Diphtheritis. 

During  the  past  year  the  public  heart  has  been  impressed,  and 
public  fears  extensively  excited,  by  a  new  epidemic  and  contagious 
disease,  called  diphtheria  —  from  a  Greek  word  signifying  skin.  I 
say  neto  disease,  for  it  has  been  stated  that  as  late  as  20  years  ago, 
no  medical  practitioner,  either  in  England  or  America,  had  any  per- 
sonal knowledge  or  experience  respecting  it. 

Yet  the  disease  had  existed  in  other  countries,  at  periods  of  time 
more  or  less  widely  separated,  from  quite  a  remote  antiquity.  Are- 
liBus  is  thought  to  have  described  it  as  early  as  the  second  century. 
Spain,  Italy,  and  Sicily  felt  its  ravages  in  the  sixteenth  and  seven- 
teenth centuries,  and  England,  France,  Germany,  Holland,  Italy, 
Sweden,  and  the  United  States  about  the  middle  of  the  eighteenth 
century ;  after  which  it  seems  to  have  disappeared,  and  been  little 
heard  of  till  quite  recently,  —  so  that  the  present  generation  of 
physicians  have  to  meet  it  as  a  new  disease. 

Diphtheria  is  evidently  a  contagious  epidemic.  It  would  not,  per- 
haps, be  far  out  of  the  way,  to  call  it  by  either  of  the  following  names : 
Epidemic  Croup,  Malignant  Croup,  Contagious  Croup.  Though 
originating,  it  is  thought,  in  certain  atmospheric  conditions,  it  shows  a 
remarkable  affinity  for  particular  localities,  and  exhibits  special  malig- 
nity and  fatality  in  individual  families.  Some  have  thought  it  to  be 
caused  by  the  parasitic  futigus  called  oidium  albicans,  which,  fasten- 
ing upon  the  mucous  membrane  of  the  throat,  causes  the  exudation 
of  matter,  which  hardens,  with  the  fungus,  into  a  skin,  or  membrane. 
Those  who  hold  this  view,  consider  the  contagiousness  of  the  disease 
to  consist  in  the  passage  of  the  fungus  from  one  person  to  another. 

Symptoms. —  The  incipient  stage  of  diphtheria  is  generally  only  a 
slight  feeling  of  illness  lasting  for  a  f<  vv  days,  more  or  less,  before  the 
more  serious  attack.  Sometimes  d'  ing  this  period  of  indisposition, 
there  is  slight  drowsiness  or  chili  mess,  followed  by  feverishness; 
sometimes  headache  and  aching  of  the  limbs.  Generally,  one  of  the 
first  things  complained  of  is  a  little  stiflfness  or  soreness  of  the  neck, 
with  a  pricking  sensation  about  the  roots  of  the  tongue.  An  almost 
characteristic  symptom  is  a  slightly  swollen  and  tender  condition  of 
the  glands  at  the  angles  of  the  lower  jaw.  The  tonsils,  one  or  both, 
are  usually  red  and  swollen,  —  sometimes  swollen,  but  not  red.  In 
young  children  the  redness  is  of  the  rose-color;  in  older  children  and 
adults,  of  a  crimson  or  deep  scarlet  The  uvula,  the  velum,  the 
arches  of  the  palate,  and  the  back  wall  of  the  pharynx,  generally 
show  the  intlammatiun.  Swallowing,  though  painful  sometimes,  is 
often  eab}'  enough,  even  to  the  end  of  bad  cases.  The  pulse  is 
usually  quickened  somewhat,  and  the  warmth  of  the  skin  is  raised  a 
little,  though  not  greatly,  above  the  healthy  standard. 

In  some  cases,  the  above  symptoms  constitute  the  whole  of  the 
complaint —  recovery  taking  place  without  serious  consequences.  In 
others,  they  are  but  the  beginning  of  more  alarming  indications.    Id 


^nws^l 


DIPHTHERIA. 


697 


such  instances  they  are  followed  by  the  exudation  upon  the  surface 
of  fibrinous  matter,  which  hardens  into  a  leathery  membrane.  This 
membrane,  if  not  broken  up  and  removed,  grows  thicker  and  stronger 
by  additions  to  its  under  surface,  until  it  obstructs  the  breathing 
and  strangles  the  patient.  The  exudation  first  shows  itself  upon  the 
tonsils,  or  some  neighboring  part,  in  the  form  of  white,  gray,  or  ash- 
colored  specks  or  patches,  which  gradually  enlarge  or  spread  until  they 
meet  and  form  one  continuous  prellicle.  This  membrane  sometimes 
extends  into  neighboring  parts,  as  the  back  passage?  to  the  nose,  and 
the  larynx,  wind-pipe,  bronchial  tubes,  and  gullet.  These  extensions 
make  the  case  all  the  more  dangerous  and  unmanageable.  1  may  add 
that  there  is  great  difference  in  the  time  occupied  by  different  cases 
in  running  their  course,  —  some  reaching  a  climax  only  after  several 
days'  continuance,  while  others  dash  on  to  a  fatal  termination  in  the 
brief  space  of  a  few  hours. 

Trentment. —  Blisters,  and  bleeding,  and  severe  purging,  and  what- 
ever else  may  tend  to  reduce  the  system,  are  to  be  carefully  and 
always  avoided.  They  invariably  do  mischief.  The  disease  itself 
generally  has  a  strangely  depressing  eflect  upon  the  vital  powers. 
Never  add  to  this  depression  by  any  exhaustive  treatment. 

iSubalances  are  in  use,  mentioned  below,  ti>  which  a  specific  action 
upon  the  diphtheritic  mucous  membrane  is  attributed,  either  disin- 
fectant or  parasiticidtil.  The  parusiticidal  action  is  based  upon  the 
undemonstrated  parasitic  nature  of  the  disease ;  the  disinfectant 
action  is,  in  most  instances,  chiefly  a  deodorizing  one,  though  a 
cleansing  one  also,  which  is  of  the  greatest  importance  for  the  com- 
foit  of  the  patient  and  for  the  greater  safety  of  his  attendants. 
These  substances  are  employed  in  the  dry  or  liquid  form,  by  insuf- 
flation or  by  inhalation,  —  in  the  latter  instance  several  times  a  day. 
The  remedy  to  be  especially  commended  is  common  sublimed  sul- 
phur, to  be  used  every  four  to  six  hours,  by  being  blowiji  through 
a  long  quill  upon  the  affected  parts,  and  allowed  to  remain  for  at 
least  a  half-hour,  without  being  disturbed  by  food,  drink,  or  gargles. 

This  use  of  sulphur  has  many  warm  advocates ;  it  is  harmless,  and 
cannot  interfere  with  the  action  of  most  other  remedies  likely  to  be 
employed. 

Gargles  are  often  used  with  great  advantage.  The  following  is 
excellent:  Chlorinated  soda,  one  ounce;  muriatic  tincture  of  iron, 
half  an  ounce;  water,  six  ounces;  use  every  half  hour  or  hour.  The 
following  is  also  a  good  gargle:  Chlorate  of  potash,  half  an  ounce; 
strong  hydrochloric  acid,  eighty  drops ;  water,  one  pint.  One  prac- 
titioner speaks  of  obtaining  great  success  by  the  use  of  the  tincture 
of  black  cohosh,  mixed  with  an  equal  quantity  of  water,  and  cm- 
ployed,  every  few  minutes,  in  two  teaspoonful  doses,  as  a  gargle.  Its 
use  should  begin  at  a  very  early  stage  of  the  disease. 

The  internal  tredtment  should  consist  mainly  of  antiseptics  and 
tonics.    The  muriatic  tincture  of  iron  is  highly  praised  in  this  disease, 
as  well  for  internal  use  as  for  external     Prescription  73  is  a  suitable 
88 


•    (1 


If! 


I  S      ' 


If     { 


11 


11  ■ 


698 


DIPHTHERIA. 


form  in  which  to  take  it.  If  ro8e-watcr  is  not  at  hand,  soft  water 
may  be  sabstitutcd.  If  there  hv  offensive  breath,  and  a  tendency  to 
rotting  of  the  tonsils,  a  little  chlorinated  soda,  or  chlorate  of  potu»|), 
may  be  added  to  the  above :  one  or  the  other  of  these  two  last-nanitd 
articles  may  sometimes  be  taken  alone.  The  following  is  a  good 
recipe  :  Pulv.  guaiacutn,  two  drams;  pulv.  gum  arabic,  one-half  drum ; 
pulv.  white  sugar,  one  dram;  water,  six  ounces:  mix,  and  then  add 
chlorate  of  potash  onit-half  dram.  Let  two  great  spoonfuls  of  thm 
be  taken  once  in  two  hours.  The  same  do}*e  may  be  taken,  with 
similar  frequency,  of  the  following:  Chlorate  of  potash,  one  dram; 
diluted  hydrochloric  acid,  two  drams;  muriatic  tincture  of  iron,  three 
drams;  water,  twelve  ounces;  mix.  This  mixture  may  al.'io  be  used 
as  a  gargle.  Should  there  be  great  depression  and  sinking,  —  as  there 
often  is,  —  carbonate  of  ammotiia  may  be  taken,  or  muriate  of  am- 
monia (13-1),  or  aromatic  spirit  of  ammonia,  presfri[)tion  135,  leaving 
out  the  laudanum.  Brandy  and  wines  are  often  used  with  advan- 
tage.  In  cases  of  great  depression,  if"  there  be  a  lendenoy  to  the 
formation  of  purple  spots  upon  the  flesh,  add  ten  to  fifteen  drops  of 
hydrochloric  acid  to  each  dose  of  prescription  73.  The  following  pre- 
scription is  likewise  a  useful  one  :  Quinine,  diluted  hydrochloric  acid, 
and  muriated  tincture  of  iron,  each  two  <1  ams;  cinnamon  water, 
twelve  ounces;  mix.  Dose,  two  great  spo  ifuls  three  times  a  day 
Or  the  following:  Muriated  tincture  of  ■.  on,  one  ounce;  diluted 
hydrochloric  acid,  two  drams  ;  cinnamon  water,  twelve  ounces.  Mix, 
and  takp  two  table-spoonfuls  every  four  hours. 

The  diet  should  generally  consist  of  that  which  is  nourishing  and 
easily  digested,  —  as  beef-tea,  chicken-broth,  eggs,  with  wine,  new 
milk,  arrowroot,  cream,  etc.  As  recovery  advances,  beefsteak,  lamb, 
chicken,  etc.,  may  be  taken.  Many  patients  die  of  pure  debility.  Let 
the  diet,  therefore,  be  such  as  to  guard  against  such  a  termination  of 
the  complaint.  Let  all  drinks  be  given  warm,  as  cold  drinks  tend  to 
aggravate  the  complaint.. 

When  recovery  begins  to  take  place,  use  all  possible  precautions 
against  a  relapse.  Let  exercise  taken  at  this  time  be  gentle,  and 
not  pushed  to  the  extent  of  great  fatigue.  The  blood  is  gen«'rally 
reduced  so  low,  that  sudden  death  may  result  from  overdoing. 

Especially,  let  all  cases  of  this  complaint  receive  early  attention. 
Throat  ails,  generally,  while  diphtheria  is  abroad,  should  have  prompt 
and  careful  treatment,  and  if  possible,  be  removed,  for  their  preseuca 
invites  an  attacL 


'^"i|«ii.|!l 


m 


OLD  AGE,  AND  ITS  DISEASES. 


LtFF.,  like  the  natural  day,  has  its  morning,  its  noon,  and  its  even* 
ing.  Each  period  has  its  sunshine  and  its  clouds  ;  its  light  and  its 
darkness;  its  fuir  weather  and  its  storms;  its  joys  and  its  sorrows. 
The  old  do  not  feel  the  exhilarating  brightnet»s  of  the  morning  of  life, 
nor  the  fervid  strength  of  its  noon  ;  but  they  often  experience  what  is 
better:  a  calm,  quiet  stillness,  and  peaceful  repose,  in  its  evetting. 

There  is,  perhaps,  no  one  thing — certaii.  iiot  many  things  — 
which  impress  the  reflective  mind  and  tender  heart  with  more  sad- 
ness, tlian  to  see  an  old  man,  bending  low  with  years,  with  little  or  no 
self-restraint;  the  passions  all  untamed,  except  so  far  as  age  has 
quenched  their  tires;  fretful,  peevish,  jealous,  complaining  ;  distrustful 
of  the  ways  of  Providence ;  doubting  the  integrity  of  any  human 
being;  surrounded  by  clouds  and  darkness  ;  and  stepping  down  grad- 
ually and  reluctantly!  amid  a  cold,  drizly,  sleety,  t  loral  rain,  into  a  dark, 
nncheered,  and  unillumined  grave. 

On  the  other  hand,  how  unspeakably  pleasant  it  is  to  see  the  silver- 
haired  pilgrim,  in  the  evening  time  of  life,  cheerful,  happy*,  trnsttul  in 
God  and  hopeful  of  men ;  the  winds  and  storms  of  life  bringing  little 
or  no  disturbance  of  his  peace  ;  bareing  the  head  reverently  and  bow- 
ing it  meekly  in  the  presence  of  great  afflictions,  and  lifting  it  up 
rejoicingly  when  blessings  fall  upon  it ;  converting,  by  the  soft,  sub- 
dued, and  beautiful  sunshine  which  he  spreads  around  him,  the  very 
nnpromising  elements  of  the  latest  autumn  into  the  finest  Indian 
summer  of  life ;  and  finally  sinking  down  peacefully  to  his  rest  amid 
the  golden  evening  sunlight,  and  leaving  the  sky,  long  after,  tinted 
with  colorings  more  beautiful  than  artists  ever  conceived. 

"  Why  weep  ye,  then,  for  him  who,  having  won 
1  he  hound  of  man's  appointed  yenrs,  at  last,  — 
Life'8  hlessings  all  enjoyed,  life's  labors  done,  — 

Serenely  to  his  final  rest  has  passed  : 
While  the  soft  memory  of  his  virtues  yet 
Lingers,  like  twilight  hues  when  the  bright  san  ii  setl " 

Beside  these  general  reflections,  it  is  proper  in  this  chapter  to  con- 
template the  old  from  several  points  of  view. 

They  are  Experienced  Persons,  and  we  may  learn  much  from  them. 
To  be  sure,  they  have,  in  most  cases,  lost  the  acuteness  of  their 


..1     M 


R 


I 


\i , 


'     .      M. 


[?m    'S;; 
'f^!;'^^ 

!*■.:'/'; 


i-iSfeS^-;  i-^:- 


f  i    ' 


(7  ■■>!■ 


11 


15^ 


senses.  They  do  not  hear,  or  see,  or  taste  as  sharply  as  the  young, 
or  even  always  think  as  quickly ;  yet  their  Judgments  are  foundpd  on 
a  large  experience  ;  their  decisions,  though  not  as  prompt,  or  emphatic, 
or  brilliant  as  those  of  younger  persons,  are  more  safe  and  reliable. 
They  are  worthy,  therefore,  of  our  respectful  confidence.  We  may 
seek  their  council  and  advice,  and  in  most  cases  follow  it  with  safety. 
True,  they  are  apt  to  be  conservative,  and  to  distrust  new  things  and 
ideas ;  but  these  new  things  and  ideas  are  matters  in  which  they  Imve 
had  no  experience  —  matters  which  belong  to  an  age  subi^eqnciit  to 
their  time  —  matters,  therefore,  which  lie  outside  the  sweep  of  their 
active  life,  and  respecting  which  they  should  not  be  expected  to  jiidm'. 
It  is  no  diHparageinent  to  them  to  say  that  they  are  not  fitted  to  judge 
of  those  new  thoughts  and  discoveries  which  have  swarmed  upon  the 
world  since  the  sun  of  their  life  has  been  sinking  low  in  the  wi'stcrii 
sky.  But  in  all  those  staple  maxims  and  ideas  which  underlie  human 
duties,  in  all  ages,  the  old  may  safely  be  taken  as  our  counsellors. 

Depositories  of  Family  History.  —  They  are  the  frail  depositories 
and  keepers  of  a  vast  deal  of  valuable  family  history,  anecdote,  and 
reminiscences  of  events  fast  fading  from  human  recollection.  Few 
errors  of  my  own  early  life  have  been  so  much  regretted  by  me  as  the 
neglect  to  learn  from  my  aged  relatives,  when  I  liad  the  opportunity, 
some  of  the  more  important  points  in  the  history  of  my  family.  My 
grandfather,  Col.  Gideon  "Warren,  —  a  first  cousin  of  Gen.  Joseph 
Warren,  and  a  personal  friend  of  Ethan  Allen,  —  lived  in  some  of  the 
towns  of  southern  Vermont,  and  finally  spent  his  last  days,  and  died, 
in  Hampton,  N.  Y.  There  stands  his  tombstone  to  this  day,  with 
the  following  beautiful  words  from  Young's  Night  Thoughts  engraved 
upon  it: 

"  An  angel's  arm  can't  snatch  me  from  the  f^ve ; 
Legions  of  angels  can't  contine  me  there. "  < 

These  few  facts  are  about  the  substance  of  what  I  know  of  his  his- 
tory. In  what  town  his  father  settled,  who  was  one  of  three  brothers 
who  immigrated  to  this  country,  or  who  were  his  brothers  and  sistfrs, 
or  what  became  of  them,  I  have  not  been  informed,  simply  becau.te 
I  did  not  obtain  the  information,  now  so  much  desired  by  me,  as  1 
might  easily  have  done,  between  thirty  and  forty  years  ago,  while 
spending  a  year  in  Hampton  fitting  for  college.  An  uncle  of  mini', 
Caleb  Warren,  was  then  living  in  Hampton,  an  old  man.  He  had 
learned  from  my  grandfather  the  full  histxiry  of  the  family  ;  and  from 
him  I  might  have  derived  knowledge  which  I  should  now  value  above 
price  —  knowledge  which  1  intend  yet  to  acquire,  if  the  pressure  of 
professional  business  shall  ever  be  so  lifted  from  me  that  I  can  com- 
mand time  for  the  investigation.  But  I  shall  never  cease  to  remember 
the  fact,  or  to  lament  my  misimprovement  of  it,  that  from  this  vener- 
able relative  I  might  have  learned  facts  and  put  them  on  record  in  one 
hour,  which  it  will  cost  roe  weeks  and  months  of  correspondence, 
travel,  and  the  searching  of  records  to  acquire.  I  say  to  all  young 
persons,  value  very  highly  the  knowledge  of  your  family  history,  which 


joa  may  easily  learn  from  your  parents,  grandparents,  uncles  and 
lants,  et4^,  and  esteem  those  very  highly  who  are  able  to  impart  it  to 
you.  Soon  these  living  records  will  be  suddenly  blotted  by  the  hand 
of  death ;  and  then  no  regret  for  past  negligence  will  enable  you  to 
repair  your  loss,  if  you  have  misimproved  your  opportunity. 

The  Fathers  of  oor  Race  anil  the  Founders  of  our  Institutions.— 

The  aged  people  who  yet  linger  among  us  are  our  fathers.  We 
have  our  existence,  through  God,  from  them,  and  from  others  who 
have  preceded  them  to  the  silent  land.  They  educated  the  present 
race.  All  that  is  valuable  in  the  moral  principle  and  mental  culture 
of  the  men  and  women  of  this  generation,  has  been  derived  from 
them.  Much  of  their  lives  was  spent  in  training  us,  mentally  and 
morally,  and  fitting  us  for  usefulness. 

Not  only  the  fine  moral  and  intellectual  characters  which  are  found 
everywhere,  acting  like  salt  and  leaven  in  human  society,  are  the  work 
of  their  hands,  but  society,  and  government  itself,  have  been  handed 
down  to  us  by  them,  with  much  valuable  instruction  as  to  the  means 
of  their  preservation.  We  can  scarcely  conceive  the  amount  of  obli- 
gation our  fathers  have  laid  upon  us  in  giving  us  these  vast  blessing!*. 
The  men  who  have  been  the  means  of  bringing  us  into  life  ;  who  have 
educated  and  trained  us  ;  who  have  preserved  our  governm«uit  and 
passed  it  into  our  hands  unbroken  ;  who  have  built  and  enlarged  our 
colleges,  established  and  improved  our  unequalled  common  schools ; 
hivi;  founded  and  endowed  our  charitable  institutions,  and  thus  made 
our  land  famous  throughout  the  world,  are  certainly  worthy  —  those 
of  them  who  are  yet  among  us  —  of  our  constant  regard  and  ven- 
eration. 

Loneliness  of  the  An^ed.  —  The  old  are  left,  in  some  sense,  alone  in 
the  world.  The  age  in  which  they  had  their  active  being  has  gone 
by.  The  world  has  slid  frotn  under  them ;  and  they  stand  far  out,  as 
it  were,  on  a  narrow  neck  of  land  between  this  world  and  the  next, 
from  which  they  hear  strange  sounds  coming  to  them  from  the  moving 
mass  of  beings  of  whom  they  are  soon  to  take  leave.  Most  of  the 
companions  with  whom  they  started  in  the  journey  of  life  have,  one 
by  one,  dropped  away  from  their  side,  and  the  younger  and  stirring 
multitude  who  have  come  after  them,  are  moved  by  new,  and  to  them 
strange,  thoughts  and  aspirations.  The  throng  of  younger  men  is 
driven  forward  by  impulses  which  they  never  felt,  and  in  paths  which 
they  never  trod.  Manners,  speech,  dress,  modes  of  doing  business  — 
all  have  changed.  The  old-fashioned  fire-place,  the  stage-coach,  the 
spinning-wheel,  the  hand-loom,  the  polite  yes  sir,  and  no  madam,  the 
boy's  bow  and  the  girl's  courtesy  to  strangers  in  the  street,  —  these 
all  —  some  of  them  useful  and  some  of  no  further  value  —  have  dis- 
appeared, never  more  to  be  enjoyed  by  those  who  so  much  prized 
them  in  their  day. 

What  wonder  if  at  times  a  sense  of  loneliness  and  desolation 
«hould  steal  into  the  minds  of  the  aged  ?     It  is  not  without  cause 


m 


.  i 


n    11'  l.fr        ( 


■I  i 


that  they  often  yiold  to  melancholy  rcHections.  The  young  have  their 
companions,  and  their  sports.  The  companions  of  the  old  have  mostly 
gone;  an<t  for  sporta  they  have  no  agility.  Cut  off  from  the  })r>'scnf, 
they  are  thrown  upon  the  pasi,  and  too  often  look  gloomily  \o  the 
future.  They  should  he  sympathized  with  and  encouraged.  We 
«1:<  nid  sit  l)y  their  side,  and  talk  with  them  of  the  manners  and  events 
of  ()th<*r  days.  Their  conversation  is  often  instructive  i'.s  well  as 
amusing.  Would  we  engage  in  it  'vith  right  feelings  towards  ilic 
old,  it  would  be  to  us  a  sourc«!  both  of  profit  and  pleasure.  To  ;i 
right-minded  person,  few  things  are  more  pleasurable  than  to  sit  by 
ijiteiligcnt  aged  persons,  co/ily  seated  in  a  large  armed-chair,  luid 
listen  to  their  tales  of  personal  adventure  and  experience.  'I'licy 
enter  upon  such  narratives  with  so  much  animation,  and  live  over 
the  past  with  such  (evident  satisfaction,  that  the  benevolent  peison 
would  find  pica.sure  in  engaging  thern  in  that  conversation  for  this 
reason  altnje. 

llelpIfHS  l»4'}H^iidt'iK'i>  «f  the  Atred.  —  No  one  thing  »houId  tend  more 
to  excite  our  |»ity,  compassion,  and  kindly  feelings  for  old  people,  tiian 
their  helplessness  and  dependence.  It  is  one  of  the  best  indications 
of  humanity  to  deal  gently  with  the  weak.  The  old  are  in  their 
Hccond  childhood.  In  their  day,  they  have  been  strong  and  vigorous 
—  laboring,  many  of  them,  in  season  and  out  of  sc.ison,  to  support 
their  families  and  gain  a  eotnpetence.  They  have  felled  the  primitive 
forests,  and  brought  the  soil  under  the  dominion  of  the  plough  and 
hoe;  they  have  constructed  turnpikes  and  built  bridges;  made  .■iliip.H 
and  sail«>d  them  over  stormy  seas ,  whitened  every  harbor  with  the 
emblems  of  commerce  ;  tilled  every  city  with  the  beautiful  creations 
of  art,  aiul  the  useful  productions  of  mv!chanical  handicraft;  created 
syatems  of  education  and  philanthropy ;  framed  strong  governments 
and  worked  them, —  in  a  word,  have  carried  the  world  upon  tluir 
ahoulders,  without  bending  or  giving  tokens  of  exhaustion.  But  a 
multitude  of  years  have  robbed  th(!m  of  the  strength  which  did  all 
these  thiiigs.  They  now  totter  like  a  young  child.  The  brain  which 
conceived  and  the  arm  which  executed,  are  alike  feeble.  How  proper 
that  nmch  which  is  kindly  should  now  be  done  for  those  who  have 
done  so  much  for  us  and  for  the  world  I  Oh,  let  the  old  have  a  warm 
place  in  the  aft'eotions!  Supply,  as  far  as  jwssible,  all  their  want-. 
Go  with  them,  in  spirit,  into  the  shadows  of  evening,  w?thin  whic  h 
they  are  retiring,  and  there  liold  them  up.  Be  a  staff'  to  thern  in 
their  weakness ;  and,  .1  it  be  possible,  Avhen  the  shades  deepen  around 
them,  lift  the  curtains  of  the  future,  and  le'  in  upon  thern,  though 
it  be  nev«!r  so  few.  some  rays  of  light  from  the  heavenly  world. 

From  these  general  remarks,  I  pass  to  consider  — 


xi  mil 


The  Changes  (}ccnrring  in  Advanced  Life. 

fjno'.VTr?,  maturity,  and  decline  are  the  three  periods  which  divide 
and  measure  human  life. 


have  their 
ve  mostly 
le  pr.'siMit, 
lily  to  llie 
i^fd.  We 
iiid  events 
J"  well  as 
wnrds  1  lu- 
re. To  ;i 
I  to  sit  by 
rhiiir,  and 
V.V.  They 
live  over 
int  person 
>ii  for  thi.s 


tend  more 
;ople,  tlian 
ndicatioiis 
re  in  their 
d  vigorous 
to  support 
;  primitive 
lough  and 
nade  .<hips 
r  wi*h  the 
I  creations 
created 
vernirients 
poll  I  heir 
But  a 
ich  did  all 
iin  which 
»w  pri>per 
who  have 
re  a  warm 
•ir  want". 
lin  whii  li 
them  ill 
en  uroiHul 
M,  though 
irld. 


lich  divide 


if= 


OLD  AGE,  AND  ITS  DISEASES. 


703 


During  growth,  the  deposit  of  new  matter  takes  place  more  rap- 
idly than  the  decay  or  waste  which  i«  also  going  on. 

During  healthy  maturity,  waste  and  increase  are  exactly  equal, 
the  one  taking  place  just  as  rapidly  as  the  other. 

The  decline  of  old  age  reverses  the  order  of  growth,  and  waste 
outstrips  addition.  The  newly  deposited  matter  comesj  but  not  so 
ra}>idly  as  tlu^  old  is  east  away. 

l>i'('lilliiis(  Ajfe  may  be  said  to  extend  from  fifty  to  sixty. 

Incipient  Old  \%e.  from  sixty  to  seventy. 

Kipe  Old  Age  from  seventy  to  eighty. 

Decrepitude  or  Second  Infancy  from  eighty  to  the  end  of  life. 

During  all  these  periods,  particularly  during  the  latter,  important 
strueturpl  and  other  changes  'e  oc(!urring  in  the  human  system. 
Files,  apoplexy,  paralysis,  disea^<  s  of  the  liver,  kidneys,  and  bladder, 
with  organic  changes  af  the  heart,  dropsy,  chronic  aflections  of  the 
breathing  organs,  gt)ut,  etc.,  frequently  appear. 

No  fear  of  Death.  —  It  is  a  wise  and  merciful  provision  of  Provi 
dence,  that  as  old  age  advances,  and  the  natural  end  of  life  draws 
near,  the  dread  of  death  diminishes.  As  the  aged  gradually  lose 
their  hold  upon  life,  they  do  so  with  less  and  less  reluctance,  until 
finally  they  let  go  willingly,  and  part  from  it  even  with  joy.  Persons 
passing  from  life  at  the  age  of  iMghty  or  upwards,  generally  look 
forward  to  death  with  more  of  pleasure  than  of  fear.  It  is  one  good 
reason  why  it  is  desirable  to  live  to* great  age,  that  life  may  come  to 
a  close  without  those  harrassing  fears  which  so  many  dread. 


Preservation  of  Old  People's  Health. 

It  is  proper  here  to  speak  of  the  hygiene  of  old  age,  or  the  means  of 
preserving  aged  people's  health. 

It  is  natural  to  desire  a  continuance  of  life ;  and  except  in  the  case 
of  the  cxtren»ely  old,  there  is  a  generai  wish  for  its  prolongation. 
I  Those  who  are  born  of  parents  who  have  lived  long,  are  more  likely 
to  attain  length  of  days  than  those  who  have  descended  from  short- 
lived ancestors;  yet  the  inlluence  of  correct  habits  may  add  quite  as 
umny  years  to  their  lives. 

Re^nilar  llabita.  —  The  old  feel  <he  evil  influence  of  irregular  habits 
mneli  more  than  the  young.  It  is  seldom  that  any  change  of  habit 
long  indulged,  is  well  borne  by  the  aged.  So  true  is  this,  that  the  at- 
tempt to  correct  some  habits  of  evil  tendency  is  sometitm-s  danger- 
ous to  the  old  so  much  have  they  lost  the  power  of  adapting 
themselves  to  change.  The  discontinuance  of  the  habitual  use  of 
spirit,  or  tobacco,  or  opium  by  an  old  person,  —  though  the  use  of 
t:iltier  is  of  acknowledged  evil  tendency,  will  frenuently  prove  fatal. 
It  13  almost  necessary  that  the  habits  of  the  aged  snould  lumain  as 


^'Iplt 


i 


704 


OLD  AGE,  AND  ITS  D'iSEASES. 


they  are.     What  an  impressive  lesson  this  fact  fives  the  young  on 
the  necetisity  of  forming  good  habits  in  early  life  I 

Even  the  hours  of  taking  meals  should  not  be  changed  in  the 
decline  of  life.  Removing  to  new  climates,  and  forming  new  social 
relations  by  those  advanced  in  years,  is  not  favorable  to  length  of 
days.  Old  trees  do  not  often  take  root  and  live  long  when  transferred 
to  a  new  soil. 

Diet.  —  The  food  of  old  people  should  of  course  be  easy  of  diges- 
tion. It  is  often  the  case  that  they  bear  made  dishes  such  as  "  haah," 
so  called,  better  than  plain  boiled  or  roasted  meat.  This  can  only  be 
explained  on  the  ground  that  the  meat  is  chopped  fine,  and  is  more 
thoroughly  cooked. 

Node  of  Cookinff  Heats.  —  This  leads  me  to  speak  of  the  beat 
methods  of  (tooking  meats  so  that  they  may  be  tender. 

The  flesh  of  all  warm-blooded  animals  is  identical  in  composition 
with  that  of  human  beings.  That  the  flesh  ^i  animals  used  as  food, 
therefore,  may  form  flesh  in  the  human  body  in  the  easiest  manner, 
none  of  its  essential  constituents  or  parts  should  be  taken  from  it 
during  the  process  of  cooking.  If  any  one  of  its  constituents  is 
extracted,  it  will  no  longer  be  like  hutnan  flesh ;  and  that  lost  part 
will  have  to  be  resupplied  before  it  can  become  a  part  of  the  franu;  of 
man. 

Flesh  is  composed  of  two  parts  —  that  which  can  be  dis?olvp^  ^nd 
that  which  cannot.  The  separation  between  these  two  parts  .  *  >'  .  ^v 
or  less  completely  effected  in  boiling  according  to  the  amount  of  water 
used,  and  the  length  of  time  employed  in  the  process. 

In  making  soup,  we  have  no  objection  to  a  separation  between  thf 
hard  and  juicy  parts  of  the  meat,  because  the  latter  passes  into  the 
water  and  helps  form  the  soup.  Hence  the  proper  way  is  to  put  the 
meat  into  cold  water  when  it  is  put  over  the  fire,  and  let  it  come  to 
the  boiling  point  very  gradually ;  during  which  time  the  ju«'y  part 
has  a  chance  to  dissolve  out,  and,  uniting  with  the  water,  make  rjch 
soup. 

But  when  the  meat  is  to  be  boiled  simply,  and  eat  as  boiled  meat, 
we  should  aim  to  retain  the  juice  within  it,  that  we  may  retain  the 
whole  of  it.  To  do  this,  we  must  put  the  meat  into  water  which  i> 
briskly  boiling  over  the  fire.  The  juice  of  the  meat  contains  a  larg< 
quantity  of  albumen,  a  substance  just  like  the  white  of  egg;  and 
putting  the  meat  suddenly  into  boiling  water  almost  instantly  hardens 
this  albumen  all  around  the  surface,  just  as  boiling  water  kardeii^ 
white  of  egg,  and  this  prevents  all  the  juice  of  the  inner  pt»ni«»nol 
the  meat  from  running  out  into  the  water  and  being  lost.  Kt'ep  the 
meat  in  the  briskly-boiling  water  a  few  minutes,  then  pour  in  »  little 
cold  wat»T  to  reduee  the  temperaturt^  slightly,  and  keep  it  in  thi»«  !*ome- 
wliat  reduced  temperature  until  it  is  done  through. 

Broiling  and  roasting  are  pretty  generally  understood,  bikI  ai^ 
done  well  enough  wluire  persons  are  disposed  to  take  pains.  Krvin. 
is  an  abomination  :  and  should  be  banished  from  all  civilized  huut^** 
holds. 


OLD  AGE,  AND  ITS  DISEASES. 


705 


Milk  is  an  cxeullcnturticlo  of  diet  for  old  persons.  Except  in  sonio 
few  cases  where  it  disajjrecs  with  the  stomach,  it  is  nnion^  the  veiy 
best.  Sometiuies,  when  it  disaj^rees  with  a  weak  stomach,  a  little  liine- 
Wiitcr  added  to  it  will  make  all  rijrht.  Artificial  ass'  milk,  which  will 
•fciicrally  set  we!!  on  a<r(ul  [)eople's  stomaclis,  may  he  made  hy  dis- 
s()l\  in<j  on«^  (  unce  of  pulverized  sugar  of  milk  in  one  pint  of  skinnned 
cow's  milk. 

Potailoes,  beets,  carrots,  parsnips,  and aspara<j;us  are  lu^althful ;  peas, 
lii'.iiis.  ial)lMi<r<'s,  etc.,  had  better  not  be  largely  indnlgtul  in. 

|{lpe  Fruits,  t:ikcn  in  moderation,  are  us(>fu! ;  i)ut  sliould  be  eaten 
Ml  meal  time,  not  between  meal.-;.  Among  thes«s  ripi'  apples,  peais, 
pciu  ln's,  plums,  strawberries,  currants,  and  grapes  are  luxuries  in 
wliieh  not  even  the  old.st  persons  need  fear  to  indulge  to  a  reason- 
alile  extent. 

IMalii  Puddings  and  t^les  are  not  entirely  obj«'etionable  ;  but  all  rich 
iiiiil  liigli-seasoued  arlii'lcs  ofpjistry  should  be  strictly  rejected  by  the 
old,  as  they  shoidd,  in  fact,  by  all  classes. 

Wine,  etc.  — If  any  persons  in  the  world  may  indulge  in  a  little 
wiin!  for  their  stomach's  .sake,  it  is  the  old.  Ihit  tnen  they,  if  they 
li:i\c  not  lieeu  accuslouud  U)  its  use,  often  get  along  very  well  without 
il ;  and  wlu'u  they  vM\  do  so  it  is  better,  for  vaiioiis  n^asons,  espet'ially 
tiiiit  their  ex.imple  may  liave  a  good  inthience  w  ith  others.  \N'hcn  the 
fVi'lilc  vitality  of  tl\«'  aged  seems  to  rcMjuiro  it,  especially  if  th«!y  have 
Im'ci)  ill  I  lie  habit  of  leaning  upon  it,  they  should  be  encouraged  to 
use  it.  And  if  tlu^y  chance  to  lie  poor,  and  cannot  procure  it  them- 
>M"lvcs,  for  tri«Mi<ls  to  withhold  it  from  them  on  tlje  ground  of  economy, 
or  from  tln!  feeling  of  grudging  stinginess,  is  nothing  loss  than  inhu- 
iiwiiity  and  cruelty. 

To  these  remarks  u|)on  diet,  I  add  :  the  old  slumld  never  cat  to 
*'x<  I'Ks  or  replet'o"..  They  should  eat  slowly,  and  chew  their  food  >  «ry 
thoroughly 

SaH<*eptibllit>  to  Cold.  — Aged  people  suffer  very  much  from  cold 
lumdsMiKl  feet,  uiid,  indeed,  from  languid  circulation  and  low  tom- 
IM'iiutir"  genendiy.  The  heart,  like  all  their  other  muscles,  has 
\»<(,fne  feeldc.  and  .sends  the  blcMxl  very  lazily  along  the  arteries. 
Tlio  clothing  of  the  ohl  shoidd  Ikj  thicker  ttn<l  warmer  than  that  ol 
yoiuig«'r  |M'ople.  We  must  prevent  the  escape  of  what  little  animal 
liwit  tliefe  is  by  HnnucI  worn  next  to  the  skin,  and  l»v  woollen  clothes 
i(t'iM rally  -  they  being  bud  conductors  of  heat.  I'liless  very  tleKhy, 
tlipy  .seldom  siitf'er  from  beat,  c-ven  when  their  llannels  are  continued 
'Migli  the  Kiiffimer. 

il  i.-  dining  winter  night*  tl»si(  the  old  are  ajM  to  suffer  most  from 
'I'l.  (hi  going  to  bed,  then  fore,  tliey  shuuld  be  warm  :  i\ud  in  very 
"M  nights  should  luive  a  heated  ^lone,  or  n  bottle  tilled  with  hot 
^wtlci.  at  their  feet.  Tim  <  /unnunuation  of  animal  heat,  i»articularly 
ti<»iii  thi-  young,  is  loiter  o\«'n  than  thi>  (o  support  the  vital  •  nergics 
"J  age ;  uud  ^/iiie  writers  have  recommended  that  the  vital  wurmth 


•» 


JSSSSZ 


luwa 


ru6 


OLD  AGE,  AND  ITS  DISEASES. 


of  the  old  should  be  kept  up  by  lettinji  the  young"  of  our  own  spcci«'s 
sleep  with  them.  The  humanity  of  this  suggestion  is  very  question- 
able. The  aged  would  doubtless  be  bcuetitod  by  sueh  a  [)rocee<liiig ; 
but  the  young  would  be  injured.  Whatevc^r  vitality  should  be  gaiiuul 
by  one  would  be  lost  by  the  other.  Whih;  a  few  might  be  added  to 
the  limited  days  of  the  aged,  many  would  be  (piite  as  likely  to  be 
subtmcted  from  those  of  the  young.  1  would  muih  sooner  recom- 
mend that  old  people  attjieh  to  themselves,  and  take  to  their  bed,  uii 
artct'tionate,  clean,  and  silken-haired  English  terrier  dog.  Such  an 
animal,  usually  as  clean  as  a  child,  would  impart  warmth  and  vitality 
:  t  night,  and  be  a  true,  artcctionate,  and  an  anmsing  companion 
(luiing  many  a  lonely  hour  of  the  day.  Whatever  may  be  said 
against  this  recommendation,  —  and  of  course  some  over-nice  people 
will  object, —  I  insist  that  it  is  in  every  sense  fur  more  pro})er  than 
the  exi)edient  adopted  with  King  David,  when  he  "  was  old  and 
stricken  in  years,"  and  after  "they  covered  him  with  clothes,  but  he 
gat  no  heat."     (1  Kings  i.  I.) 

Mortality  in  Cold  Weather.  —  Far  more  of  the  old  peoi)le  die  in 
winter  than  in  sunnner,  or,  indeed,  in  any  other  season.  For  this 
reason,  old  people  should  bo  very  careful  how  they  expose  themselves 
during  the  coldest  days  of  the  winter. 

If  th-^'-e  be  any  change  which  the  old  are  likely  to  bear  with  im- 
punity or  advantage,  it  is  from  a  cold  to  &  warm  climate  in  their  latter 
years.  The  wealthy  Romans,  when  they  grew  old,  were  taken  t<) 
Naples. 

'  Care  of  the  Skin.  —  Attention  to  the  skin,  always  im{X)rtimt  to 
health,  is  very  essentially  so  in  the  latter  years  of  life.  The  scarf- 
skin  of  the  old  tends  to  become  dry,  and  peel  off.  This  may  be  })r«'- 
ventv-'d  in  a  great  measure  by  regular  washing  with  tepid  water,  and 
rubl  »ng.  If  the  bath  cannot  be  endured,  not  even  the  sponge-bath,  let 
fric'jon  alone  be  employed.  For  friction,  either  the  naked  hand,  a  |)i('((' 
ot  tlannel,  or  the  flosh-brush  may  be  used.  In  rubbing  the  belly,  the 
hand  should  follov^r  the  course  of  the  largo  bowel ;  that  is,  in  tin' 
region  of  the  stomach  pass  across  from  right  to  left,  down  on  the  lel't. 
across  on  the  lower  parts  of  the  bowels,  up  on  the  right,  etc.  \t\ 
this  metho<l,  const ipntion  arid  a  windy  condition  of  tlu^  stimiach  jmhI 
lM)wel8  may  frecjucutly  be  rt!niovod,or  rend^ied  less  distressing. 

Exercise.  —  Alway-'  important,  inall  |H'riods  of  life,  exercise  doo 
not  lose  its  advantages  in  old  agt'.  Hut  the  aged  should  always  oxcr- 
cise  with  moderation.  The  violence  u^ed  i«  youth  would  break  tin- 
iMincs,  and  do  various  kinds  of  mischief  \*x>jv  it  indulged  by  the  old. 
('arriage  exercise  i>  very  suitjible  tor  old  npo{»le,  but  the  more  activf 
exercise  of  hoivbmk  riding,  walking,  imm  even  working  in  the  gar- 
<len,  should  not  l>t  omitted  —  VKMtriiig  always  in  mii'd  that  great 
fatigue  is  injurious. 

Hleep.  —  Age<l  i)eoplo  should  4:^  alKnit  as  much  sleep  as  naturr  ask'^ 
for.     They  should  retire  early  ;Mid  not  be  iu  lmat«t  to  rise  with  the 


i'l 


OLD  AGE,   AXI)    ITS   DISEASES. 


707 


dawn.     They  require  more  sleej)  than  jiersoiis  in  middle  life.     Kight 
(0  ten  hours  in  the  twenty-toiu"  is  not  too  much. 

Sleeplessness.  —  Thou«rl»  tlie  old  r(M|uirc  n  «roo(l  dt-ai  of  sleep,  it  is 
uiiloitunate  that  many  of  them  can  sleep  hut  little.  A  large  propor- 
tion of  persons  far  a(lvanced  in  life,  complain  of  inahility  to  sleep. 
Many  old  j)eople  deceive  themM'lvcs,  and  really  sic<'p  nmch  more 
than  they  are  aware.  \'et  they  often  persist  that  tlu^v  sh'ep  none  at 
all,  night  after  night.  Their  case  is  illustrated  hy  an  old  lady  whose 
doctor  entered  her  room  and  found  her  sleejjing  very  soundly  and 
i-omtbrtal)ly.  The  noise  of  a  i)erson  entering  the  room  awoke  her 
^oon  after,  when,  ruhhing  her  eyes,  she  turned  to  thedoi'tor,  and  said 
all  hhe  wanted  was  sleep,  that  she  had  slept  none  for  a  month  ;  and 
unless  he  could  give  h  r  something  to  bring  sleep,  she  must  die. 

Medical  art,  1  am  sorry  to  say,  fre(|uently  fails  to  In-ing  relief,  when 
there  is  real  want  of  sleep.  Narcotics  should  always  be  avoided  if 
jHWitiible.  They  do  too  nnich  mischief;  yet  it  is  necessary,  sometimes, 
to  resort  to  them.  Much  may  be  done  sometimes  l)y  taking  an  earlier 
or  a  lighter  supper.  Early  rising,  and  exercise  in  the  open  air,  will 
often  bring  sleep  at  night.  Occasionally  a  glass  of  wine,  or  a  little 
spirit  of  any  kind,  taken  just  before  retiring,  will  bring  the  needed 
sleep. 

Electricity.  —  In  connection  with  sleep,  the  disturbing  and  the  tran- 
(|iiillizing  inrtuence  of  electricity  and  magnetism  has  receivird  soim^ 
attention  within  a  few  years.  A  (jlerman  philosopher  (-ontends  that 
terrestrial  magnetism  exerts  on  persons  of  u  sensitive  organization  a 
very  soothing  influence,  when  placed  in  {)roper  relations  with  its  cur- 
rents, and  a  disturbing  impression  when  otherwise  situated.  He 
cites  cases,  to  show  that  lying  from  east  to  west  is  so  intolerable  that 
persons  of  delicuey  cannot  endure  it ;  while  the  horiz»)ntal  position 
iVom  north  to  south,  with  the  head  south,  is  more  agreeable  ;  and  most 
ajrreouble  and  tranquillizing  with  the  head  to  the  noith.  A  (Jerman 
surgeon  is  mentioned  in  Reichenl>ack's  Alemoirs,  who  always  woke 
Ciirly  in  the  morning,  and  turning  his  head  where  his  feet  had  lu'cn, 
invariably  fell  into  a  sound  slumber,  which  was  mons  refreshing  than 
that  of  tlu!  night.  When  h<^  chanced  to  omit  this,  he  felt  ill  all  day. 
Observing  that  the  head  of  his  bed  was  directed  to  the  south,  Itei«;h- 
I'uliack  persuaded  him  to  tiun  it  to  the  north  ;  and  ever  alter  he  blc>j)t 
M)undly  till  the  jn'oper  time  to  rise  in  the  morning. 

Without  pronouncing  upon  the  correctness  of  this  theory,  I  \  ill 
-imply  say  that  in  my  winter  residence  in  town,  the  head  of  my  i)ed 
IS  to  the  south.  I  sleep /oZeraWy  well;  but  not  as  well  as  at  my 
»uniin(!r  residence  a  little  out  of  town,  where  the  head  of  my  bed  is 
Inwards  iho  north.  How  nuuh  tlui  stillness  of  the  country,  and  the 
LMvater  purity  of  its  atmos[)herc  may  contribute  to  this  difference,  I 
will  not  pretend  to  decide. 


Ilf\-  '■'"" 


■t 


Medical  Treatment  of  the  Old. 

In  prescrihin*;  medicine  for  old  people,  we  should  bear  in  mind  the 
difference  between  the  sexes.  W'onicki  in  advanced  life  are  less  ex- 
citable, and  enjoy  better  health,  fre«|uently,  than  in  early  life.  Old 
men,  on  the  contrary,  are  more  nervous,  in  their  latter  years,  and 
conse(iuently  more  easily  affected. 

The  physician  cannot  rely  on  the  reaction  of  the  system  in  old  age. 
Wiy  must  do  more  by  his  remedies,  and  depend  less  upon  nature  to 
help  him  out  of  straits. 

The  small  jiower  of  rallying  in  the  systems  of  the  old,  puts  nil 
blood-letting,  severe  i)urging,  etc.,  entirely  out  of  the  (luestion.  the 
man  is  near  enough  to  insanity  who,  except  in  some  very  rate  case, 
bleeds  the  young,  lie  who  takes  a  drop  of  lilood  from  the  old,  should 
be  put  in  a  straight-jacket  and  sent  to  the  insane  hospital. 

Larger  Doses.  —  The  tor[)id  condition  of  the  system  in  old  age,  fre- 
quently recjuires  larger  doses  of  medicine  to  nuike  an  impression. 

Fluid  Medicines.  —  Pills  and  i)owders  sometimes  pass  through  the 
stomach  and  bowels  in  the  same  state  in  which  they  entered.  Fluids 
are  more  readily  appropriated  —  especially  when  the  more  active  me- 
dicinal ingredient  is  mixed  with  wine,  or  some  stinmlating  tincture, 
or  aromatic  water.  These  things  rouse  up  the  torpid  stomach  aud 
bowels,  and  cause  the  medicine  to  take  effect. 

Medicine  by  Rectum.  —  When  the  disease  is  situated  in  the  imme- 
diate neighborhood  of  the  lower  bowel,  as  the  bladder,  etc.,  it  is 
sometimes  better  to  administer  the  medicine  by  injection  into  the 
rectum. 

Suitable  Medicines  for  the  Old.  — The  acids,  the  alkalies,  and  the 
neutnil  salts  are  unsuitable  to  be  administered  much  to  old  people. 
All  metallic  medicines  must  be  given  sparingly,  and  with  caution. 
Iodine  and  iodide  of  potassium  are  not  very  well  borne.  Narcotics 
must  sometimes  be  used  to  some  extent.  Marsh  and  drastic  purga- 
tives are  out  of  the  question,  except  in  some  few  instances  in  which 
they  may  be  given  sparingly  in  connection  with  compound  tincture 
of  gentian,  or  some  other  stinudating  tonic.  Sulphur  is  a  valuable 
remedy  for  aged  i)eof)le.  So  are  the  stimulant  tonics,  bitters,  astrin- 
gents, gum-resins,  balsams,  etc.,  together  with  the  various  carmina- 
tives, as  anise,  coriander,  fennel,  casearilla,  ginger,  etc. 

Surgical  Operations.  —  Some  of  the  smaller  operations  in  surgery 
need  not  Iw  forbidden  in  llje  ca.s»)  of  the  old  ;  but  great  operations  arc 

There  is  not  lecupcrative  power  enough  to 

Diseases  of  tLe  Old. 

Most  of  the  diseases  which  afHict  aged  people  are  of  course  much 
the  same  with  those  which  come  upon  people  at  all  periods  of  life. 


not  to  Ik>  thought  of. 
bear  them. 


mmitm 


Wt 


ii'miiiai  IMiiliillii 


;nri3' 


■•'■■■  iftll 


These  having  all  l)cen  treated  of  in  the  previous  pages  of  this  Imok, 
do  not  require  to  ho  gone  over  particularly  again.  There  are  a  few 
complaints,  however,  which  are  peculiar  to  the  old,  of  which  I  must 
briefly  speak. 

Bronchial  Fluz.  —  Bronchorrhcea. 

A  MORE  than  usual  amount  of  nuicous  expectoration,  accompanied 
with  cough,  is  very  common  with  old  i)eople  —  so  common  that  in 
many  cases  they  think  very  little  of  it,  even  when  the  expectoration 
becomes  very  profuse.  This  discharge,  however,  from  the  mucous 
surface  of  the  lironchial  tubes,  is  very  apt  to  be  attended  by  shortness 
of  breath  on  making  even  very  slight  exertion  ;  and  the  whole  trouble 
is  aggravated  in  dam|)  weather,  and  by  constipation,  and  the  stoppage 
of  leucorrlio'a  in  females,  or  the  interruption  of  in8en8il>le  persi)iration 
through  the  skin. 

Slow  progress.  — This  complaint  makes  very  slow  progress,  as  a 
general  rule,  often  continuing  many  years  without  doing  any  great 
mischief.  It  is  apt,  however,  to  degenerate  into  a  mischievous  con- 
dition in  the  end  ;  and  should,  therefore,  as  a  general  thing,  receive 
8ome  attention. 

Treatment. —  Attend  carefully  to  the  skin.  Keep  it  in  as  healthy  a 
condition  as  possible,  by  regular  and  faithful  bathing  and  friction. 
This  isof  i)rinie  importance. 

C^are  nuist  be  had  not  to  suppress  the  discharge  too  suddenly.  It 
mny  lie  necessary,  at  times,  to  use  some  expectorant  (see  (;xpeetorant8 
among  the  prescriptions)  to  make  the  raising  easier.  Hut  when  it  is 
thoroughly  loosened  up,  we  should  begin  to  supj)ress  it  by  astringent 
inhalations.  For  this  purpose  Inhalant  No.  4  is  excellent.  It  might 
be  well,  however,  to  begin  with  the  Inhalant  N(».  '>,  which  is  slightly 
styptic. 

If  idcers  on  the  h^gs  have  recently  healed,  they  should  be  o[)ened, 
or  lilisters  applied  in  their  vicinity. 

Removal  to  a  dri/  climate  is  a  valuable  remedy ,  provifJ«-d  tl*»»  cli- 
mate is  n(>t  too  hot,  and  is  healthfid  in  every  other  re.s|>ect. 

Other  Diseases. — The  other  diseases  with  which  old  persons  are 
nttlicted  are  so  connnon  to  all  ages,  that  I  do  little  more  than  nanje 
them,  adding  a  few  general  remarks. 

Asthma. — The  asthma,  en-  intermittent  ditliculty  of  breathing  of 
tile  old,  is  connected  with  various  other  troubles,  as  chronic  inflatnina- 
tion  of  the  bronchial  tubes.  !iir  in  the  lung  tissue,  swelling  of  the 
lungs,  enlargement  and  dilatation  of  the  heart,  and  diseases  of  its 
valves,  etc.  It  is  also  dependent  on  impurities  of  the  blood,  and  is 
t'omu'cted  witn  torpid  action  of  the  kidneys.  It  is  impossible,  some- 
limes,  to  say  which  of  these  conditions  it  is  dependent  upon.  As  far 
as  may  be,  however,  the  cause  must  be  searched  out ;  and  then,  while 


l*#i.^i.'f' 


710 


OLD  AGE,   AND   ITS   DISEASES. 


i' 


ill 


tho  goncml  remedies  for  usthina  nmnt  ho  employed,  the  particular 
thiii«i^  with  which  it  i»  connected  must  ulso  receive  attention,  especially 
if  it  1)0  connected  with  derun<;ement  of  tho  kidneys. 

Asthmatic  old  |)eoplo  aro  almost  always  dyspeptics.  Tho  stomach 
and  howels,  therefore,  re(|uiro  particular  attention.  Tho  warm  pur- 
<;ativos,  combined  withalkalies,  are  generally  useful :  as  rhulmrhand 
soda,  equal  parts,  or  Mettauer's  Aperient,  with  a  little  tincture  of 
ginger  or  tincture  of  cayenne  in  it.  A  very  valuable  preparation  is 
compound  tincture  of  gentian  and  tincture  of  columbo,  two  ounces 
each,  ono  half  ounce  of  tincture  of  ginger,  and  half  an  ounce  of  bi- 
carbonate of  soda.  Mi.x,  and  take  a  teaspoonful  as  occasion  may 
require. 

Apoplexy  and  Paralysis.  —  The  nervous  system  biiiug  weakened  in 
aged  people,  the  way  is  opened  for  greater  frerjuency  of  attack  from 
apoplexy  and  paralysis.  The  exciting  cause  may  be  hypenvniia, 
too  much  blood  ;  or  ana>mia,  too  little  blood.  It  may  be  general 
debility,  or  gout,  or  a  poisoned  state  of  the  blood. 

The  treatment  is  to  be  conducted  mu(;h  on  the  same  principles  us 
when  these  diseases  occur  in  younger  subjects. 

1  pass  over  numerous  ccMuplaints  which  may  be  said  to  be  soujewlmt 
more  conunon  in  advanced  life  than  at  earlier  j)eriods.  They  are  so 
fully  treate<l  in  previous  })ages  of  this  book,  that  it  is  deemed  needless 
even  to  name  them  here.  There  is,  however,  ono  other  class  of  dis- 
eases occurring  so  very  often  in  old  age,  and  in  so  many  eases  mak- 
ing advanced  life  a  burden,  that  I  camiot  pass  them  wholly  in  silence. 
I  refer  to 

Diseases  of  the  Urinary  Organs.  — These  afHict  tho  old,  not  only 
very  commonly,  but  very  severely'.  An  old  man  who  reaches  the  age 
of  seventy  or  eighty  without  experiencing  some  serious  trouble  from 
deranged  kidneys,  diseased  bladder  or  prostate  gland,  or  gall  stones, 
or  gravel,  or  unhealthy  urinary  deposits  of  some  sort,  may  think  him- 
self greatly  favored. 

Treatment.  —  It  is  not  necessary  here  to  go  over  the  whole  ground 
of  treatment.  That  is  done  in  other  parts  of  the  book.  I  will  say, 
however,  that  a  surgical  operation  for  stone  in  the  bladder  is  not  oftoa 
to  be  thought  of  in  the  case  of  old  people.  Other  remedies  must  Iw 
sought.  And  among  these,  none  hold  out  so  good  a  chance  of  relief 
as  tho  free  drinking  of  the  alkaline  bicarbonates  dissolved  in  water. 
This  will  frequently  dissolve  stones  formed  of  uric  acid,  urate  of  am- 
monia, and  triple  i)hosphates. 


Pulmonic  Cherry  Cordial. 

WfLD-CHERRT  bark,  ground,  10  pounds ;  ipecac  root,  20  ounces; 
bloodroot,  24  ounces;  squill  root,  bruised,  12  ounces;  pulverized 
liquorice  root,  5  ounces  ;  cochineal,  bruised,  2  ounces  ;  anise  seed,  32 
ounces;  fennel  seed,  8  ounces ;  orange  peel,  Ifi  ounces;  acetate  of 


"    pi  ,.'in.wi 


■ffl 


OLD  AGE,  AND   ITS  DISEASES. 


11 


morphine,  12  drams  ;  ulcohol,  8  gallons  ;  wiiter,  8<riillons  ;  pulverized 
white  8ugHr,  40  pounds ;  sulphuric  acid,  1  ounce. 

Directions/or  making.  —  Grind  all  the  articles  to  a  coarse  powder 
except  those  directed  to  he  hruiscd  or  pulveri/ed,  and  put  them  aU 
to  the  alcohol  except  the  wild-cherry  hark,  the  water,  the  sugar,  and 
the  sulphuric  aci<l.  Let  them  stand  one  week,  shakin«j  or  stirrinjj: 
thoroughly  twice  a  day.  Then,  having  kept  the  wild-cherry  hark  tw(» 
days  in  a  covered  vessel,  with  water  enough  u|)on  it  to  wet  it  through, 
place  it  in  a  percolator,  and  run  eight  gallons  of  wat«'r  through  it. 
Add  this  to  the  alcohol  and  other  ingredients.  Let  tho  whole  sUind 
three  days  longer,  stirring  as  hcfore,  twice  a  day.  Draw  oil',  and  filter 
through  paper.  Noiv  add  the  sugar,  and  lastly  the  sulphuric  aiiid. 
The  acid  is  intended  mainly  to  improve  the  color,  by  acting  chemi- 
cally upon  the  cochineal.  The  color  is  a  tine  cherry  red,  tinged  with 
orange. 

1  Ijave  given  the  directions  for  making  sixteen  gallon^  —  tliishcing 
the  smallest  <|uantity  in  which  I  make  it.  Any  person  can  easily 
make  the  calcidation  for  reducing  the  quantity. 

This  is  the  |)reparation  whica  1  mentioui'd  on  page  22t»  of  this 
book.  Its  insertion  at  the  proper  |)lace  was  omitted  by  mistake  ;  and 
I  thought  I  would  not  mar  tho  order  of  the  hook  by  inserting  it  out 
of  place.  I  have  much  regretted  this.  Had  I  inserted  it  anywhere, 
it  would  have  saved  mo  the  answering  of  a  greater  numl)er  of  letters 
than  I  <'are  to  conjecture. 

Upon  no  other  preparation  of  medicine  I  have  ever  compounded 
have  1  bestowed  as  much  thought  and  care  as  upon  this.  For  five 
years  I  was  incessantly  experimenting,  making  and  trying  new  com- 
binations ;  and  this  is  the  result.  The  assertion  previously  made  that 
this  is  the  "  best  cough  preparation  ever  made,"  I  see  no  cause  to 
modify  in  the  smallest  degree.  Were  it  kept  in  every  apothecary 
shop,  and  were  physicians  to  prescribe  in  pulmonary  complaints, 
adding  a  little  syrup  of  squill  or  wine  of  ipecac  when  a  more  ex|)ec- 
torant  effect  is  wanted,  or  a  little  morphine  if  greater  narcotism  is 
sought,  it  would  save  them  much  trouble  in  compounding  cough 
syrups,  and  give  them  nmch  more  satisfactory  results.  I  have  com- 
|iared  its  cft'ect,  again  and  again,  with  the  best  other  pre))arations  in 
use,  and  I  pledge  my  word  that  it  will  succeed  in  tw^ice  as  many  cases 
as  any  other  comiX)und  that  may  be  chosen.  Let  physicians  try  it ; 
and  I  will  be  responsible  for  every  hair's  breadth  in  which  they  find 
this  proportion  of  successful  results  abridged. 


i^Ji 


fii 


« 


PHYSICAL  CULTURE -THE  NEW  GYMNASTICS. 


In  America  the  noblest  interests  of  the  race  have  reached  unpar- 
alleled developments.  In  no  other  country,  in  no  otjier  age,  has 
mental  culture  l)ecn  so  complete  and  universal.  It  is  an  era  in  the 
progress  of  the  race.  The  fruits  of  labor  which  in  other  times  and 
lands  have  been  wasted  upon  the  abnormal  life  of  the  few,  have  here, 
like  air  and  light,  the  two  great  representative  gifts  of  Heaven,  found 
their  way  to  the  normal  life  of  the  million.  The  grand  ideal  results 
of  the  philosopher's  dreams  seem  within  our  gras[). 

I^it  in  this  hour  of  triumi)h  the  national  life  is  jeopardized  by 
physical  exhaustion.  While  the  admiring  world  looks  on,  our  bodies 
upon  which  as  a  foundation  our  higher  faculties  must  rest,  crumble 
and  give  way.  Precocious  brains  are  borne  about  by  doubtful  spines; 
brilliant  talents  are  linked  with  dying  bodies. 

Hut  in  the  light  which  now  begins  to  dawn,  this  rock  in  our  nation's 
pathway  is  clearly  seen,  and  the  discovery  must  result  in  the  ado|)- 
tion  of  vigorous  measures.  Alieady  the  leading  educators  of  the 
country  are  aroused,  and  to  use  the  language  of  that  veteran  educa- 
tional magazine,  the  "  Massachusetts  Teacher,"  "  To  Dr.  Lewis, 
more  than  to  any  other  man,  is  the  country  indebted  for  the  present 
deep  practical  interest  in  physical  culture.  He  has  done  a  noble 
work." 

And  in  introducing  the  "New  Gymnastics"  invented  and  de- 
veloped by  Dr.  Dio  Lewis,  of  Boston,  it  may  be  proper  to  say  that 
Dr.  Lewis  is  a  regularly  educated  physician.  From  the  beginning  oi 
his  professional  career  he  evinced  the  most  earnest  interest  in  sanitary 
questions.  Located  in  HuHTalo,  N.  Y.,  during  those  memorable  cholera 
seasons  1849  and  18.51,  in  the  midst  of  an  immense  pmctice,  he  called 
public  attention  to  ceitain  pi'eventive  sanitary  regulations  with  such 
earnestness  and  force,  that  hearty  municipal  recognition  and  action 
were  secured. 

Some  years  since  the  Doctor  abandoned  the  practice  of  his  pro- 
fession, and  entered  the  field  as  a  lecturer  upon  sanitary  science, 
lloth  in  this  country  and  abroad  all  the  great  health  questions  were 
ably  discussed.  Three  winters  were  devoted  to  lecturing  in  our  South- 
ern States.  In  many  Southern  cities  a  profound  interest  was  elicited. 
About  twenty  pieces  of  silver  plate  were  presented  to  the  lecturer  hy 


'Vp^m 


the  various  cities  visited.     The  citizens  of  Richmond,  Va.,  presented 
Dr.  Lewis  with  an  entire  tea  service  of  splendid  silver  plate. 

A  few  years  aijo,  Dr.  Lewis  began  his  investigations  in  the  depail- 
iiicnt  of  gynnmstic  training.  The  public  is  now  pretty  well  informed 
in  reference  to  his  labors  in  this  field.  The  journals  and  magazines 
of  the  country  have  spoken  out  in  hearty  eonunendation  of  "Z>r. 
Lfwi»^8  New  Gymnastics  "     A  few  of  these  notices  may  l>e  given. 


"  We  look  upon  Dr.  Lewis  as  one  of  the  bcnefhctors  of  his  race." —  Grarp  Grerniennd. 

"  Success  to  Dr.  Lewis's  Oymna.siuni.  No  better  Institution  exists."  —  The  Knick- 
erbocker. 

"  It  was  my  privilege  to  welcome  Dr.  Lewis  fit  his  very  first  arrival  here,  and 
everything  since  then  tins  only  confirmed  my  confidence  In  his  ability  to  superintend 
tills  system.  '*  —  Sev.  Dr.  Kirk. 

"  We  shall  look  for  great  results  in  the  physical  development  of  the  nation,  if  this 
admirable  system  should  be  generally  adopted."  —  Boston  Traveller. 

"  Every  muscle  of  the  body  is  brought  Into  motion  without  straining  or  unpleas- 
ant eiTort.  Many  of  the  attitudes  are  graceful  and  striking.  In  a  word,  it  is  poetry 
in  motion,  and  motion  set  to  music."  —  iV.  Y.  Tribune. 

"  We  are  glad  to  hear  that  this  simple  apparatus  and  Ingenious  series  of  exercises 
arc  being  introduced  into  many  of  the  best  schools  of  the  State."  —  Boston  Courier. 

"TheBo.ston  (Jymnusium  has  sent  a  graduate  to  our  city  who  is  teaching  large 
classes,  composed  of  our  gravest  divines,  physicians,  and  others.  Ladies  mingle  in 
the  happy  crowd."  —  iV.  1'.  Times. 

"  This  .system  avoids  the  objections  of  other  systems.  I  have  witnessed  Its  effects 
in  several  .■*cliools,  and  can  say  they  are  all  good  without  exception  " —  President 
Felton,  in  an  address  at  Dr.  Lewis's  Oymnasium,  of  which  he  was  the  presiding  officer 
up  to  the  time  of  his  death. 

He  has  recently  i.ssued  a  handsome  volume,  known  as  "  T/ie  New 
Gyinnastics for  Men,  Women,  and  Children,''  through  TicUnor  & 
Fields — .1  beautiful  volume,  full  of  illustrative  cuts.  The  inwk  has 
been  so  generally  noticed  by  the  j)ress  of  the  country  that  all  have 
learned  of  its  features.     A  single  notice  or  two  may  be  given. 

"Dr.  Lewi.s's  book  is  the  most  practical,  sensible  work  on  this  subject,  extant  In 
any  language."  —  Continental  Monthly. 

"  Dr.  Lewis  has  given  us  far  the  best  and  most  practical  of  all  publications  on  the 
siihject  of  physical  culture."  —  N.  Y.  Independent. 

This  vigorous  worker  in  the  field  of  physical  education  has  recently 
cHtablished  in  Boston  a  Normal  Institute  for  physical  education,  in 
which  he  is  preparing  teachers  of  the  New  Gymnastics.  About  seventy 
persons  of  either  se.\  have  already  been  fitted,  and  have  gone  out  to 
teach  N>arly  every' progi'cssive  school  in  the  Northern  States  has 
men  or  »,  s  of  the  New  Gymnastics  in  its  daily  drill.  And  so  far  as 
teachen,  <;}.n  be  obtained,  the  schools  have  adcled  a  gynmast  to  their 
<'orp9  -4'  tfiichers.  There  is  room  for  a  thousand  or  ten  thou.sand 
lalMMcrs  in  the  new  profession.  Persons  of  cither  sex  may  find  in  this 
callii  g  heullh,  usefulness,  and  large  profit. 

In  addition  to  the  New  Gymnastics,  the  graduates  go  out  prepared 


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PHYSICAL  •  CULTURE. 


to  teach  elocution,  and  to  act  as  guides  in  all  other  departments  of 
physical  culture.  Dr.  Walter  Channing,  .Prof.  Leonard  the  elocu- 
tionist, and  other  well-knoA\  n  scientific  gentlemen  assist  Dr.  Lewis  in 
fitting  the  pupils  for  their  important  work.  We  are  satisfied  that 
this  new  profession  is  to  become  one  of  much  dignity  and  impoitanoe. 
Those  who  enter  the  field  early  will  have  reason  to  congratulate 
themselves. 


THE  NEW   GYMI^ASTICS. 

BY   DIO   LEWIS,    M.    D. 

T^E  apparatus  used  in  my  system  of  gymnastics  is  all  light. 
This  is  its  distinctive  peculiarity.  The  dumb-bell  weighs  from  one  to 
four  pounds.  In  the  system  heretofore  in  vogue,  dumb-bells  weighing 
as  much  as  150  lbs.  have  been  used. 

Perhaps  no  other  piece  of  apparatus,  common  to  the  two  systems, 
will  so  well  illustrate  the  superiority  of  the  new  system. 


Dumb-Bell    Exercises. 

For  more  than  two  thousand  years  the  dumb-bell  has  been  in  use 
as  a  means  of  physical  culture.  It  was  highly  prized  by  the  Greeks. 
Many  advantages  are  justly  claimed  in  its  behalf.  If  used  in  private, 
it  occupies  little  space  either  at  rest  or  in  action.  For  the  same  rea.ion 
it  is  excellent  in  the  training  of  large  classes.  Although  not  to  l>e 
compared  with  the  New  Gymnastic  ring,  the  dumb-bell  deserves  its 
great  popularity. 

Among  the  Greeks  it  had  a  peculiar  shape,  and  in  this  respect  has 
undergone  many  changes,  of  which  something  will  be  said  hereafter. 
Its  present  shape  is  well  known.  A  practical  suggestion  upon  this 
point  may  not  be  amiss.  The  handle  should  be  at  least  half  an  inch 
longer  than  the  width  of  the  hand,  of  such  size  as  can  be  easily 
grasped,  with  a  slight  swell  in  the  middle.  The  manufacturer  must 
not  forget  there  is  a  wide  di^ierence  between  the  hand  of  a  little  girl 
and  that  of  a  large  man. 

Heretofore  dumb-bells  have  been  made  of  metals,  The  weight  in 
this  country  has  usually  been  considerable.  The  general  policy  at 
present  is  to  employ  those  as  heavy  as  the  health-seeker  can  put  up. 
This  is  wrong.  In  the  great  German  gymnastic  institutes,  dumb- 
bells were  formerly  employed  weighing  from  fifty  to  one  hundred 
pounds,  but  now  Schreber  and  other  distinguished  authors  con- 
demn such  weights,  and  advocate  those  weighmg  from  two  to  five 
pounds.    I  think  those  weighing  two  pounds  are  heavy  enough  for 


PHYSICAL   CULTURE. 


715 


I   all   lijjht. 


any  man :  and  as  it  is  important  that  they  ho  of  considerahle  size,  I 
introduced,  some  years  ago,  those  made  of  wood.  Every  year  my 
faith  grows  stronger  in  their  superiority. 

In  my  early  experience  as  a  teacher  of  Gymnastics,  I  ndvoeated 
iicavy  dumh-bells,  prescribing  for  those  who  couUl  j)ut  uj)  one  hun- 
dred pounds,  a  bell  of  that  weight.  \s  my  success  had  always  been 
with  heavy  weights,  i)ridc  led  me  to  continue  their  use  long  after  1 
(l(ml)1(!d  the  wisdom  of  such  a  course.  For  some  years  I  liave  em- 
ployed only  those  made  of  wood. 

I  know  it  will  be  said  that  dunih-bolis  of  two  pounds  weight  will 
do  for  women  and  children,  but  cannot  answer  the  rcniuirenients  of 
stiong  men. 

The  weight  of  the  dumb-bell  turns  entirely  on  the  maimer  in  which 
il  is  used.  If  only  lifted  over  the  head,  one  or  two  pounds  woukl  be 
iilisurdly  light;  Itut  if  used  as  we  employ  them,  then  one  weighing 
ten  j)ounds  is  bey<md  the  strength  of  the  strongest.  No  man  can 
enter  one  of  my  classes,  of  little  girls  even,  and  go  through  the  exer- 
cises with  bells  weighing  ten  pounds  each. 

We  had  a  good  opportunity  to  laugh  at  a  class  of  young  men  last 
year,  who,  upon  entering  the  gymnasium,  organized  an  insurrection 
against  the  wooden  dumb-ludls,  and  through  a  connnittee  asked  me  to 
jirocure  iron  ones.  1  (n'dered  a  quantity  weighing  three  pounds  each  ; 
they  used  them  part  of  one  evening,  and  when  asked  the  following 
evening  which  they  would  have,  replied,  "The  wooden  ones  will  do  !" 

A  just  statement  of  the  issue  is  this  :  if  you  only  lift  the  dumb-bell 
from  the  floor,  put  it  up,  and  then  put  it  down  again,  of  course  it 
should  be  heavy,  or  there  is  no  exercise  ;  but  if  you  vyould  use  it  in  a 
great  variety  of  ways,  assuming  a  hundred  graceful  attitudes,  and 
bringing  the  muscles  into  use  in  every  direction,  re(]uiring  skill  and 
followed  by  u  harmonious  development,  the  bell  nuist  be  light. 

There  need  be  no  controversy  between  the  light  weight  and  the 
heavy  weight  party  on  this  point.  We  of  the  light  weight  party 
agree  that  if  the  bell  is  to  be  used  as  the  heavy  weight  party  uses  it, 
it  must  be  heavy  ;  but  if  as  wc  use  it,  then  it  must  be  light.  If  they 
of  the  heavy  weight  party  think  not,  we  only  ask  them  to  try  it. 

The  only  question  which  remains  is  that  which  lies  between  all 
heavy  and  light  gymnastics,  viz. :  whether  strength  or  flexibility  is  to 
he  preferred.  Without  entering  upon  a  discussion  of  the  i)hysiologi- 
cal  principles  which  underlie  this  subject,  I  will  simply  say  that  I 
prefe"  the  latter.  The  Hanlon  brothers  and  Heenan  are  physiologi- 
cally considered  greatly  superior  to  heavy  lifters. 

Hut  here  I  ought  to  say  that  no  man  can  be  flexible  without  a  good 
degree  of  strength.  It  is  not,  however,  that  kind  of  strength  involved 
in  great  lifting.  Heenan  is  a  very  strong  man,  can  strike  a  blow 
twice  as  hard  as  Windship,  but  cannot  lift  seven  hundred  pounds 
nor  put  up  a  hundred-pound  dumb-bell.  W^m.  Hanlon,  who  is 
probably  the  finest  gymnast,  with  the  exception  of  Blondin,  ever  seen 
on  this  continent,  cannot  lift  six  hundred  pounds.     Such  men  have  a 


r  :f-^ 


great  fear  of  lifting.  They  know,  almost  by  instinct,  that  it  spoils 
their  muscles. 

One  of  the  finest  gymnasts  in  the  country  told  me  that  in  several 
attempts  to  lift  five  lumdred  pounds  he  failed,  and  that  he  should 
never  try  it  again.  This  same  gynmast  owns  a  fine  horse.  Ask  liini 
t<)  lend  that  horse  to  draw  before  a  cart  and  he  will  refuse,  hecauso 
such  labor  would  make  the  anijnal  stifi",  and  unfit  him  for  li'fht, 
graceful  movements  l)efore  the  carriage. 

The  same  physiological  law  holds  true  of  man:  liftin^r  great 
weights  art'ects  him  as  drawing  heavy  loads  atfects  the  horse.  So  I'ni' 
from  man's  body  being  an  exception  to  this  law,  it  bears  with  peculiar 
force  upon  him.  Moving  great  weights  through  small  spaces  pro- 
duces a  slow,  inelastic,  inHexil)le  man.  No  matter  how  fiexible  a 
young  man  may  be,  let  him  join  a  circus  company,  and  lift  the  can- 
non twice  a  day  for  two  or  three  years,  and  he  will  Jiecome  as  intlox- 
ible  as  a  cart-horse.  No  matter  how  elastic  the  colt  is  when  firjst 
harnessed  to  the  cart,  he  will  soon  l)ecome  so  Inelastic  that  he  is  unfit 
to  serve  before  a  (carriage. 

Men,  women,  and  children  should  be  strong,  but  it  should  be  the 
strength  of  grace,  flexibility,  agility,  and  endurance  ;  it  should  not  he 
the  strength  of  a  gieat  lifter.  I  alluded  to  the  gymnastics  of  the 
circus.  Let  all  who  are  curious  in  regard  to  the  point  1  nm  discuss- 
ing, visit  it.  Permit  me  to  call  special  attention  to  three  features  — 
to  the  man  who  lifts  the  cannon,  to  the  india-rubber  man,  and  to  the 
general  performer.  The  lifter  and  the  india-rubber  man  constitute 
the  two  mischievous  extremes.  It  is  impossiI)le  that  in  either  there 
should  be  the  highest  physiological  conditions  ;  but,  in  the  persons 
of  the  rianlon  brothers,  who  are  general  performers,  is  found  the 
model  gynmast.  They  c;in  neither  lift  great  weights  nor  tie  them- 
selves into  knots,  but  they  occupy  a  point  between  these  two  ex- 
tremes. They  possess  both  strength  and  fiexibility,  and  reseniltlc 
fine,  active,  agile,  vigorous  carriage-horses,  which  occupy  a  point  be- 
tween the  slow  cart-horse  and  the  long-legged,  loose-jointed  animal. 

With  heavy  dumb-bells  the  extent  of  motions  is  very  slight,  and  of 
course  the  range  and  freedom  of  action  will  be  correspon<lingly  so. 
This  is  a  point  of  great  importance.  The  limbs,  and  indeed  the  en- 
tire body,  should  have  the  widest  and  freest  range  of  motion.  It  is 
only  thus  that  our  performances  in  the  business  or  pleasures  of  lilc 
become  most  effective.  A  comi)lete,  equable  circulation  of  the  blood 
is  thereby  most  perfectly  secured.  And  this,  I  may  remark,  is  in 
one  aspect  the  physiological  j)uri)ose  of  all  exercise.  The  race-horse 
has  a  much  more  vigorous  circulation  than  the  cart-horse.  It  is  a 
fact  not  unfamiliar  with  horsemen,  that  when  a  horse  is  transferred 
from  slow,  heavy  work  to  the  carriage,  the  surface  veins  about  tho 
neck  and  legs  begin  at  once  to  enlarge ;  when  the  change  is  made 
from  the  carriage  to  the  (art,  the  reverse  is  the  result. 

And  when  we  consider  that  the  principal  object  of  all  physical 
training  is  an  elastic,  vigorous  condition  of  the  nervous  system,  th'< 


PHYSICAL  CULTUUK, 


717 


superiority  of  light  gymnastics  bceonies  still  more  obvious.  The 
nervous  system  is  the  fundtuncntal  fact  of  our  earthly  life.  All  other 
pints  of  the  organism  exist  and  work,  for  it.  It  controls  all,  and  is 
tlie  seat  of  pain  and  pleasure. 

The  in)pressions  upon  the  stomach,  for  example,  resulting  in  a  bet- 
tor or  worse  digestion,  must  bo  made  through  the  nerves.  This  su- 
picnie  control  of  the  nervous  system  is  forcibly  illustrated  in  the 
(li;mge  made  by  joyful  or  siid  tidings. 

The  overdue  ship  is  believed  to  have  gone  down  with  lier  valuable, 
uninsured  cargo.  Her  owner  ))aces  the  wharf,  sallow  and  wan  ; 
appetite  and  digestion  gone.  She  iieaves  in  sight !  She  lies  at  the 
uliarf  The  hap|)y  man  goc's  aboard,  he.'u-s  all  is  safe,  and,  taking  the 
ofHfers  t(>  a  hotel,  devours  with  them  a  dozen  monstrous  eonii)ounds, 
with  the  keenest  appetite,  and  without  a  subsecjuent  pang. 

I  amcontident  that  the  loyal  jjoople  of  this  country  havi;  eaten  and 
digested,  since  Koanoke  and  Donelson,  as  they  had  not  before  since 
Sumter. 

Could  we  have  an  unbroken  succession  of  good  news,  we  should  all 
have  good  digestion  without  a  gymnasium.  But  in  a  world  of  vexa- 
tion and  disappointment,  we  are  driven  to  the  necessity  of  nmsclcj 
<'ulture,  and  other  hygienic  expedients,  to  give  the  nervous  system 
that  sui)port  atul  vitality  which  our  Htfnl  surroundings  deny. 

If  we  would  make  our  muscle-training  contriJ)utive  in  tlie  highest 
degree  to  the  healthful  elasticity  of  our  nerves,  the  exercise  nmst  1)0 
siuh  as  will  bring  into  varied  combinations  and  play  all  our  nmsdes 
and  nerves.  Those  exercises  which  require  great  accuracy,  skill,  and 
dash  are  just  those  which  secure  this  happy  and  complete  intermar- 
riage of  nerve  and  muscle.  If  any  one  doubts  that  boxing  and  small 
sword  will  do  more  to  give  elastitity  and  tone  to  the  nervous  system 
than  lifting  kegs  of  nails,  then  I  will  give  him  over  to  the  heavy  lifters. 

Another  point  I  take  the  liberty  to  urge.  Without  accuracy  in  the 
performance  of  the  feats,  the  interest  must  be.  transient.  This  prin- 
ciple is  strikingly  exemplified  in  military  training.  Those  who  have 
studied  our  infantry  drill  have  been  struck  with  its  simplicity,  and 
have  wondered  tlmt  men  could  go  through  with  its  details  every  day 
for  years  without  disgust.  If  the  drill-master  permits  carelessness, 
then  authority  alone  can  force  the  men  through  the  evolutions  ;  but 
if  he  enforce  the  greatest  precision,  they  return  to  their  task  every 
morning  for  twenty  years  with  fresh  and  increasing  interest. 

What  precision,  permit  me  to  ask,  is  possi!)le  in  "putting  up"  a 
heavy  dumb-bell?  But  in  the  new  dund>-bell  exercises  there  is 
opportunity  and  necessity  for  all  the  accuracy  and  skill  which  are 
found  in  the  most  elaborate  military  drills. 

I  have  been  a  teacher  of  boxing  ami  fencing,  and  I  say  with  con- 
fidence that,  in  neither  nor  both  is  there  such  a  tield  for  fine  posturing, 
wide,  graceful  action,  and  studied  accuracy,  as  is  to  be  found  in  the 
new  series  of  dumb-bell  exercises. 

But,  it  is  said,  if  you  use  bells  weighing  only  two  pounds,  you 


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PHYSICAL  CULTUKE. 


must  work  an  hour  to  reach  the  excn-cise  which  the  heavy  ones  would 
furnish  in  five  minutes.  I  need  not  inform  those  who  have  practised 
the  new  series  with  the  li<^ht  bells,  that  this  objection  is  made  in 
ignorance.  If  you  simply  "put  up"  the  liuht  l)cll,  it  is  true  ;  but  it 
you  use  it  as  herein  described  and  illustrated,  it  is  not  true.  On  \\v^ 
contrary,  in  less  than  tive  minutes  legs,  hips,  back,  arms,  shoulders, 
neck,  lungs,  and  heart  will  each  and  all  make  the  most  emi)li;itie 
remonstrance  against  even  a  quarter  of  an  hour's  practice  of  siu;h 
feats. 

At  this  point  it  may  be  urged  that  those  exercises  which  hasten  the 
action  of  the  thoracic  viscera  to  any  considerable  degree  are  simply 
exhaustive.  '  'his  is  another  blunder  of  the  "  big-muscle  "  men.  Thcv 
seem  to  think  j'ou  can  determine  every  man's  constitution  and  health 
by  the  tape-line  ;  and  that  all  exercises  whose  results  are  not  diitor- 
minable  by  measurement  are  worthless. 

I  need  scarcely  say,  there  are  certain  conditions  of  brain  muscle, 
and  of  every  other  tissue,  far  more  important  than  size  ;  but  what  1 
desire  to  urge  more  particularly  in  this  connection,  is  the  importance, 
the  great  ph;siological  advantages,  of  just  those  exercises  in  which 
the  lungs  and  heart  are  brought  into  active  play.  These  organs  are 
no  exce[)tions  to  the  law  that  exercise  is  the  principal  condition  of 
development.  Their  vigorous  training  adds  more  to  the  stock  of 
vitality  than  that  of  other  organs.  A  man  may  stand  still  and  lift 
kegs  of  nails  and  heavy  dumb-bells  until  his  shoulders  and  arms  niv. 
Sampsonian ;  he  will  contribute  far  less  to  his  health  and  longevity 
than  by  a  daily  run  of  a  mile  or  two. 

Speaking  in  a  general  way,  those  exercises  in  which  the  lungs  and 
heart  are  made  to  go  at  a  vigorous  rate,  are  to  be  ranked  among  the 
most  useful.  The  "double-quick  "  of  the  soldier  contributes  more  in 
five  miimtes  to  his  digestion  and  endurancs,  than  the  ordinary  drill  in 
two  hours. 

I  have  said  an  elastic  tone  of  the  nervous  system  is  the  physiological 
purpose  of  all  physical  training.  If  one  may  be  allowed  such  an  analy- 
sis, I  would  add  that  we  exercise  our  muscles  to  invigorate  the  thoracic 
and  abdominal  viscera.  These  in  their  turn  support  and  invigonilc 
the  nervous  system.  All  exercises  which  operate  more  directly  up>>ii 
these  internal  organs,  as,  for  example,  laughing,  deep  breathing,  and 
running,  contribute  most  effectly  to  the  stamina  of  the  brain  and 
nerves.  It  h:  only  this  mania  for  monstrous  arms  and  shoulders  that 
could  have  misled  the  intelligent  gymnast  on  this  point. 

But,  finally,  it  is  said  you  certainly  cannot  deny  that  rapid  motions, 
with  great  sweep,  exhaust  more  than  slow  motions  through  limited 
spaces.  A  great  lifter  said  to  me  the  other  day,  "Do  you  pretend  to 
deny  that  a  locomotive  with  a  light  train,  flying  at  the  rate  of  forty 
miles  an  hour,  consumes  mare  fuel  than  one  with  a  heavy  train  mov- 
ing at  the  rate  of  five  miles  ?"  I  did  not  attempt  to  deny  it.  "  Well. 
then,"  he  added,  with  an  air  of  triumph,  "what  have  you  to  saji  now 
about  these  great  sweeping  feats  with  your  light  dumb-bells,  as  coni- 


mr 


|i;iiod  with  the  slow  })utting  up  of  heavy  ones  ?"  I  replied  hy  askin<^ 
liiiii  another  (luestion.  "Do  you  pretend  to  deny  that  when  you 
drive  your  horse  ten  miles  within  an  hour,  l)etbre  a  lijjht  carriafre, 
Ik;  is  more  exhausted  than  by  drawing  a  load  two  milcis  anhour?  " 
"That's  my  doetrine,  exactly,"  said  he.  "Then,"  I  asked,  "why 
don't  you  always  drive  two  miles  an  hour?"  "But  my  patients 
would  all  die,"  replied  my  friend.  I  did  not  say  aloud  what  was 
parsing  in  my  mind,  —  that  the  danger  to  his  patients  might  he  less 
tliiiu  he  imagined,  —  hut  1  suggested  that  nearly  every  man,  as  well 
;is  (ivery  horse,  had  duties  in  this  life  which  involved  the  neressity 
of  rapid  and  vigorous  motions;  that  were  this  slow  movement 
iienerally  adopted,  every  phase  of  human  life  would  be  stripped  of 
jirogress,  success,  and  glory. 

As  our  artificial  training  is  designed  to  fit  us  for  the  more  suc(;t^ss- 
ful  performanve  of  the  Imsiness  of  life,  I  suggest  that  the  training 
should  be,  in  character,  somewhat  preparatory  for  those  duties.  If 
you  would  train  a  horse  for  the  carriage,  you  would  not  do  it  by 
driving  at  a  slow  pace  before  a  heavy  load.  If  you  did,  the  first  fast 
drive  would  go  hard  with  him. 

Just  so  with  a  man.  If  he  is  to  lift  hogsheads  of  sugar,  or  kegs  of 
nails,  as  a  business,  he  may  be  trained  by  heavy  lifting ;  but  if  h'ts 
l)usiness  requires  the  average  velocity  and  free  motions  of  human 
occupations,  then  upon  the  basis  of  his  heavy  slow  training,  he  will 
iind  himself,  in  actual  life,  in  the  condition  of  the  dray  horse,  who  is 
jjushtcl  before  the  light  carriage  at  a  high  speed. 

Perhaps  it  is  not  improper  to  add,  that,  to  me,  all  this  talk  al)out 
expenditure  of  vitality,  is  full  of  sophistry.  Teachers  and  writers 
speak  of  our  stock  of  vitality,  as  if  it  was  a  vault  of  gold,  upon  which 
you  cannot  draw  without  lessening  the  quantity,  whereas,  it  is  rather 
like  the  mind  or  heart  enlarged  by  action,  inci'eased  by  expenditure. 

When  Daniel  Boone  was  living  alone  in  Kentucky,  his  intellectual 
exercises  were,  doubtless,  of  the  quiet,  slow,  heavy  character.  Other 
white  men  joined  him.  Under  the  social  stimulus,  his  thinking 
became  more  sprightly.  Suppose  that  in  time  he  had  come  to  write 
vigorously,  and  to  speak  in  the  most  eloquent,  brilliant  manner,  does 
uiiy  one  imagine  that  he  would  have  lost  in  mental  vigor  and  dash 
hy  the  process?  AVould  not  the  brain,  which  had  only  slo.v exercise 
in  his  isolated  life,  become  bold,  brilliant,  and  dashing,  by  bold, 
brilliant,  and  dashing  efforts? 

A  farm  boy  has  slow-,  heavy  muscles.  He  has  been  accustomed 
to  heavy  exercises.  He  is  transferred  to  the  circus,  and  performs, 
altera  few  years'  training,  a  hundred  beautiful,  splendid  feats.  He 
at  length  reaches  the  matchless  Zampillaerstation  of  Wm.  Hinlon. 
Does  any  one  think  that  his  body  has  lost  power  in  this  brilliant 
education  ? 

Is  it  true  that  in  either  intellectual  or  physical  training,  bold, 
brilliant  efforts,  under  proper  conditions  and  limitations,  exhaust  the 
powers  of  life?     On  the  contrary,  is  it  not  true  that  we  find  in  vig- 


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720 


PHYSICAL   CULTURE. 


oroiis,  l)o1d,  dashing^,  In'illiant  efforts  the  only  source  of  vigorous, 
hold,  dashing,  and  brilliant  powers? 

In  this  discussion  I  have  not  considered  the  (roatnient  of  invalids. 
The  principles  presented  are  applicable  t.o  the  training  of  children 
and  adults  of  average  vitality. 

In  a  work  upon  which  I  am  now  engaged,  devoted  to  the  "  Move- 
ment Cure,"  to  bo  published  early  in  ItiO.'J,  I  shall  advocate,  and  for 
n'Msons  which  will  appear  in  the  work,  an  entirely  ditlerent  policy. 

In  the  nu'an  time,  1  will  rest  upon  the  general  statement,  that  all 
persons  of  both  sexes,  and  of  every  age,  who  are  possessed  of  avciji-ic 
vitality,  shoidd,  in  the  dei)artm(Mit  of  })hysical  education,  employ  liiiht 
apparatus,  and  execute  a  great  variety  of  feats,  which  re(iuire  skill, 
accuracy,  courage,  dash,  presence  of  mind,  quick  eye  and  hand,  —  in 
Itrief,  which  demands  a  vigorous  and  c()mi)lc!te  exercise  of  all  the 
])o\vers  and  faculties  with  which  the  Creator  has  endowed  us  ;  whiio 
deformed  and  diseased  persons  should  be  treated  in  consonance  with 
the  philosophy  of  the  Siredish  Movement  Cure,  in  which  the  movc- 
nuMits  are  slow  and  limited. 

It  is  but  justice  to  the  following  scries  of  exercises  with  dumb-bolls, 
as  well  as  to  myself,  to  state  that  not  only  are  they,  with  two  or 
three  exce}itions,  \\\\  own  invention,  but  the  wisdom  of  the  precise 
urrangcjuent  given,  as  well  as  the  l)alance  of  exercise  in  all  the  nius- 
I'lcs  of  the  body  and  limbs,  have  been  well  proved  by  an  extensive 
use  for  several  years. 

It  must  not  be  forgotten  that,  in  all  the  dumb-bell  exercises  the 
pupil  should,  as  a  beginning  jjosition,  stand  with  his  heels  together, 
the  toes  separated  so  as  to  make  l)etween  the  feet  a  right  angle,  and 
the  arms  hanging  by  the  sides,  with  the  dumb-bells  horizontal  and 
parallel  to  each  other. 

Not  only  in  all  the  exercises,  but  in  all  the  changes  from  one  exer- 
cise to  another,  the  pupil  must  keep  time  to  the  music.  In  the 
al)sence  of  other  musical  instruments,  a  drum  may  be  employed  to 
mark  the  time ;  and  even  without  this  it  may  be  kept  by  counting 
one,  two  ;  one,  two ;  one,  two. 

It  nuist  1)6  remembered  that  in  no  case  should  the  pupil  bend  the 
legs  at  the  knee,  or  his  arms  at  the  elbow,  unless  it  is  so  directed.  No 
rule  in  the  dundwbell  exercises  is  so  important  as  this.  If  it  be  for- 
gotten, exercises  with  dumb-bells  will  lose  more  than  half  their  value. 

No.  1.  The  position  is  shown  in /^/r/.  1.  Tbuml)s  outward.  Bells 
exactly  horizontal.  Turn  the  thumb  ends  of  t\  e  l)ells  to  the  hips,  and 
then  back  again  to  the  i)osition  shown  in  tliNf  figure.  Repeat  ten 
times.  Let  the  change  be  made  with  the  grea»  \st  accuracy.  AVhcii 
it  is  well  done,  no  matter  which  end  is  at  the  li  p,  a  straight  rod  run 
through  one  dujub-bell,  lengthwise,  would  rv  \he  same  time  run 
through  the  centre  of  the  other. 

In  this  and  all  subsequent  duml>-bell  exercises,  the  pupil  must  he 
careful  not  to  bend  the  elbows.  When  exceptiorvj  to  this  rule  occur, 
they  will  be  plainly  indicated.         . 


PHYSICAL  CULTURE. 


721 


a  one  exer- 


No.  2.  Position  seen  Fig.  2.  Keep  the  elbows  pressed  against 
the  sides,  and  twist  the  hells  so  the  ends  are  exactly  reversed.  Be 
8ure  they  are  exactly  in  line  with  each  other,  and  the  forearms  par- 
allel.    Repeat  ten  times. 


Figure  1. 


Figure  2. 


No.  3.  In  passing  from  No.  2  to  No.  3,  bring  the  bells  to  the  chest, 
and  on  the  next  beat  to  the  position  in  Fig.  3.  The  palms  of  the 
hands  are  upward.  Bells  exactly  horizontal  and  parallel  to  each 
other.  Turn  the  hands  over,  knuckles  upward.  Bells  now  exactly  in 
the  same  position  as  br^ore.     Repeat  ten  times. 


Fitfiire  i. 


FIgiiri;  4. 


No.  4.     In  passing  from  No.  3  to  No.  4,  bring  the  bells  to  the  chest, 
and  on  the  next  beat  to  the  position  in  Fig.  4.     The  palms  forward. 

91 


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722 


PHYSICAL  CULTUUE. 


Twist  the  bolls  so  the  knuckles  are  forwiird.  Repeat  ten  times.  Arms 
to  be  kept  parallel  from  first  to  last. 

No.  f).  rosition  as  in  Fig.  ii.  In  passini;  fron'  No.  4  to  No.  5, 
bring  the  ])ells  to  the  chest.  Twist  the  arms  so  that  the  l)clls  are 
exactly  reversed. 

It  will  l)e  seen  in  the  figure,  the  j)alnis  are  upward.  W'len  the 
l»ells  are  revc^rsed,  th<?  knuckles  are  u[)war(l.  Keej)  the  arms  paiallel. 
Jiepeat  ten  times. 

In  i)assing  from  one  exercise  to  another,  I  have  spoken  of  bringing 
{!io  bells  to  the  chest.  They  should  strike  the  chest  exactly  at  the 
;  jiat  shown  in  Fiff.  6. 


Figure  6. 


Figure  6. 


No.  6.  Thrust  the  two  bells  down  by  the  side  of  the  legs.  Bring 
to  the  chest,  and  thrust  them  sideways.  Bring  to  the  chest  and 
thrust  them  upward.     Bring  to  the  chest  and  thrust  them  forwaid. 

Repeat  these  four  tJirustsfive  times. 

When  the  down  thrust  is  made,  the  pupil  must  be  careful  that  at 
the  lowest  point  the  bells  are  precisely  horizontal,  and  parallel  to  oaoli 
other.  When  the  side  thrust  is  made,  the  arms  must  be  horizontal, 
the  bells  perpendicular  and  parallel  to  each  other.  When  the  upward 
thrust  is  made,  the  arms  must  be  accurately  perpendicular,  bells 
parallel  and  horizontal. 

When  the  forward  thrust  is  executed,  the  arms  must  be  exactly 
horizontal,  and  the  bells  perpendicular  and  parallel. 

No.  7.  Kaise  the  right-hand  bell  from  the  side  of  the  leg  into  the 
arm-pit,  five  times.  {Fig-  7.)  Left,  five  times.  Alternately  and 
simultaneouslv,  five  times. 

Be  sine  that  each  time  when  the  bells  come  into  the  arm-pits  they 
are  exactly  horizontal. 

No.  8.  Passing  from  No.  7  to  No.  8,  bring  the  bells  to  the  chest ; 
on  the  next  beat  to  the  top  of  the  shoulders  ;  on  the  next  beat  carry  up 


(f  hringing 


the  right,  reaching  accurately  the  position  seen  in  Fig.  8.    Repeat  Jive 
times.  Left  the  same.  Alternately  and  simultaneously,  auch  Jive  times. 


Figure  7. 


Figure  8. 


No.  9.  Passing  from  No.  8  to  No.  9,  bring  the  bells  to  the  chest 
(the  dotted  lines  in  Fig.  9  show  it),  then  down  by  the  sides ;  in  all, 
as  usual,  keeping  good  time  to  the  music.     Now  carry  the  right  bell 


Figure  9. 


Figure  10. 


to  the  chest,  then  up,  reaching  the  position  shown  in  Fig.  9.  Return 
to  the  hip,  marking  one  beat  on  the  chest  in  going  down,  liepeat 
ten  limes.   Left,  the  same.   Alternately  and  simultaneously,  ten  times. 


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724 


PHYSICAL  CULTURE. 


No.  10.  Bring  th«  bells  to  the  chest.  Strike  out  the  right  one  in 
front,  arm  precisely  horizontal,  bell  perpendicular.  {Fig.  10.)  Ue- 
peut  twenty  times.  Left,  the  same.  Alternately  and  simultaneously, 
twenty  timen. 

As  usual,  keep  the  chest  well  forward,  and  the  shoulders  drawn 
far  l)ack. 

No.  11.  Holding  the  bells  in  the  position  seen  in  Fig.  11,  hrin^' 
them  with  great  force  into  the  position  seen  in  the  dotted  line,  forty 
times.  In  beginning  this  elbow-thrust  backward,  it  is  well  to  tir,s| 
raise  the  bells  a  foot,  that  they  may  be  brought  back  with  more  force, 
and  more  directly  into  the  position  seen  in  the  dotted  lines.  But  in 
carrying  them  forward  again,  it  should  be  first  into  the  position  seen 
in  the  figure. 


FIffuro  11. 


msure  la. 


No.  12.  Stamp  the  left  foot,  then  the  right,  then  charge  out  into 
the  position  seen  in  Fig.  12.  Make  sure  that  the  leg  behind,  in  this 
and  all  subsequent  charges^  is  kept  entirely  straight,  while  the  one 
forward  is  placed  as  shown  in  the  figure.  Holding  the  arms  as  illus- 
trated, force  the  entire  person  into  the  position  of  the  dotted  lines, 
five  times.  There  should  be  no  motion  in*  the  shoulder  joints.  The 
chest  is  pushed  far  forward,  and  the  shoulders  drawn  well  back.  These 
directions  are  applicable  to  all  charging  exercises,  in  which  a  different 
course  is  not  plainly  indicated. 

It  will  be  observed  that  the  charge  in  No.  12  is  exactly  sideways. 

Rise  to  the  perpendicular  again,  stamp  with  the  right  foot,  then  the 
left,  and  lastly  charge  out  on  the  left  side,  and  repeat  the  perfora- 
ance  of  the  right  side^we  times. 

No.  13.  Rise  to  the  perpendicular,  stamp  with  the  left  foot,  then 
with  the  right,  then  charge  out  as  shown  in  Fig.  13.  Undti  the 
directions  given  in  No.  12,  sink  five  times. 

Same  on  the  left  side,  of  course  with  the  intermediate  stamping. 


rilYSlCAL  CULTUUE. 


725 


I        No.  14.     After  the  ro<j;iiIjir  ntjunping,  the  pupil  whould  charge   in 
the  manner  illustrated  in  Fig.  14.     Sink  five  times. 
Same  on  the  left  side, 
luthis,  us  in  Figa.  12  and  13,  i\w  charging  is  exactly  sideways. 


FlKiir.,-  i:t-14. 


No.  15.  St'iiid  upright,  hands  by  the  side,  liaise  the  right  hand, 
as  shown  in  Fig.  15,  five  times.  Lel't,  the  same.  Alternately  and 
simu'i  ineously,  five  times. 


Figure  IS. 


Figure  16. 


In  this  the  arm  is  carried  up  with  a  quick,  strong  effort,  and  ar- 
rested at  the  horizontal  line,  precisely  as  if  it  had  struck  a  rock. 
When  it  is  brought  back  to  the  side  again,  it  is  with  the  same  force 
and  sudden  arrest.  This  and  the  next  one  arc  k,mong  the  most 
severe  of  the  dumb-bell  exercises. 


726 


PHYSICAL  CULTURE. 


No.  16.  Assuming  the  position  seen  in  Fig.  16,  force  back  tiie 
right  arm,  as  seen  in  the  dotted  line,  tive  times.  Left  the  same.  Al- 
ternately and  simultaneously,  five  times. 

The  arm  must  not  be  bent  at  the  elbow. 

The  directions  given  in  No.  15,  in  regard  to  force  and  sudden 
arrest,  are  applicable  to  this  exercise. 


Figure  17. 


Figure  18. 


No.  17.     Beginning  as  in  No.  15,  with  the  arms  hanging,  combino 
th'^  two  exercises,  Nos.  15  an*.'  TO/  in  one  sweep,  reaching  the  posi- 


Figure  19. 


Figure  20. 


tion  of  the  dotted  line  in  Fig.  17.     Repeat  five  times, 
the  same.     Alternately  and  simultaneously,  five  times. 


Left  hand 


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PHYSICAL  CULTURE. 


727 


No.  18.  Stand  upright,  arms  hanging.  Raij^e  the  right  arm  to 
the  horizontal,  at  the  side,  with  the  palm  up.  Repeat  Hve  times. 
Left,  the  same.  Alternately  and  simultaneously,  five  times.  The 
position  of  one  of  the  arms  is  seen  in  Fig.  17. 

No.  19.  Having  the  arms  extended  at  the  sides  as  shown  in  J^iff. 
18,  raise  the  right  aim  to  the  position  seen  in  the  dotted  line,  five 
times.     Left,  tlie  same.     Alternately  and  simultaneously,  five  times. 

In  raising  the  dumb-hells  over  the  head,  be  careful  that  they  are 
in  such  a  position  that,  when  the  two  are  up  together,  they  are 
exactly  horizontal  and  parallel  to  each  other. 

No.  20.  Xieginning  as  in  No.  18,  arms  hanging,  combine  Nos.  17 
and  18,  in  one  sweep,  each  arm  five  times.  Alternately  and  simul- 
taneously, the  same. 


Flyure  21. 


Figure  22. 


No.  21,  Standing  upright,  arms  hanging,  charge  into  the  position 
shown  in  Fig.  19  ;  remaining  thus,  thrust  the  arms  in  front,  in  a 
horizontal  line,  five  times,  alternately  and  simultaneously.  Rising  to 
the  perpendicular,  stamp  with  the  right  foot,  then  the  left,  then  charge 
out  with  the  left  foot,  and  repeat  the  exercises  with  the  arms. 

It  will  be  seen  by  the  figure  that  the  leg  behind  is  kept  entirely 
straight  and  ret-ts  on  the  toe.  The  special  point  in  this  exercise  is 
to  reach  the  duml)-bell  as  far  forward  as  possible. 

No.  22.  Standing  as  represented  in  Fiff.  20,  force  the  right  arm 
into  the  position  shown  in  the  dotted  line,  five  times.  Left  the  same. 
Alternately  and  simultaneously,  five  times. 

In  this  exercise  keep  the  body  as  erect  as  possible. 


iiiiH^H 

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728 


PHYSICAL  CULTURE. 


No.  23.  Having  the  «irms  perpe'^dicular 
over  the  head,  perform  the  same  exercise 
as  in  the  last  number,  with  right  hand,  lelt 
hand,  then  alternately  and  simultaneously. 
No.  24.  Placing  the  feet  in  position  of 
Fig.  21,  raise  the  arms  with  great  force 
from  the  hanging  position  to  that  seen  in 
Fig.  21.  On  the  next  beat  bring  the  arms 
to  the  position  seen  in  Fig.  22  ;  on  the 
next  to  that  seen  in  Fig.  23  ;  on  the  next 
beat  sweep  back  to  the  position  seen  in 
Fig.  22  ;  then  to  the  position  seen  in  Fig. 
21.     Repeal  Jive  timea.     Stamp  right  and 

left,  then  step  out  with  the  left  foot,  then  swing  the  arms  over  the 

head,  performing  the  same  exercise  on  the  left  side. 
In  this  exercise  neither  arms  nor  legs  should  be  bent. 
No.  25.     Stand  erect,  arms  h(n-izontal  in  front  and  parallel  to  each 

other.     Carry  the  right  hand  backward  in  the  horizontal  plane  {Fig. 

24)  as  far  as  possible  ;  return  it.     Repeat  ten  times.     Left  the  same ; 

alternately  and  simultaneously,  ten  times. 


Figure  23. 


Figure  24. 


Figure  25. 


No.  26.  Stiinding  erect,  arms  hanging,  stamp  with  the  left  foot ; 
then  with  the  right ;  then  charge  into  the  position  seen  in  Fig.  2."), 
and  thrust  the  arms  in  a  direct  line  upward,  alternately  and  simul- 
taneously, ten  times.  Assuming  the  erect  position,  drop  the  arms 
l)y  the  side,  stam{)  the  right  foot,  then  the  left,  and  charge  out  on 
the  left  side  ;  repeat  the  exercise  Avith  the  arms. 

In  this  exercise,  it  will  be  seen,  the  leg  behind  is  straight,  that 
charged  forward,  considerably  bent. 


rpe'^dicular 
le  exercise 
it  hand,  left 
Itaneously. 
position  of 
ffrcat  force 
jat  seen  in 
iir  the  arms 
i2  ;  on  the 
n  tlie  next 
)n  seen  in 
?en  in  Fiff. 
1  right  and 
s  over  the 


llel  to  each 
)hine  (Fig. 
t  the  same ; 


^ 


left  foot ; 
n  Fig.  2.'), 
and  siniul- 
>  the  arms 
•ge  out  on 

aight,  that 


PHYSICAL  CULTURE. 


729 


No.  27.     As  in  nearly  all  other  exercises,  begin  with  the  heels 


Figure  26. 


Figure  27. 


together,  body  erect,  chest  forward,  shoulders  back,  arms  hanging, 
dumb-bells  horizontal  and  parallel  to  each  other.     Step  diagonally 


I,    I 


i 


Figure  28. 


Figure  29. 


backward  with  the  right  foot,  as  seen  in  Fig.  26,  and  repeat  the 
exercises  in  No.  26.     Same  with  the  left  foot. 

92 


> 


730 


PHYSICAL  CULTURE. 


In  this  exercise  the  forward  leg  is  kept  straight,  that  behind  is  l)ent 
as  much  as  possible. 

No.  28.  Bells  on  the  chest.  Carry  the  right  arm  out  at  the  side, 
thrusting  it  as  far  back  as  possible  ;  suddenly  bring  it  back  to  the 
chest  in  a  circle  as  if  grasping  a  large  body  standing  in  front.  Repeat 
five  times.     Left  hand,  same.  Alternately  and  sinudtancously,  saiuc 

In  this  exercise  the  arms  should  he 
kept  in  the  horizontal  plane,  and  should 
in  the  performance  of  the  exorcise  enclose 
as  large  an  armful  of  the  imaginary 
objects  as  possible. 

No.  2D.  Standing  erect,  arms  liiiiiiiinjr 
at  the  side,  suddenly  turning  the  body  to 
one  side  as  far  as  you  can  twist  it  Avitli- 
out  moving  the  feet,  carry  the  arms  to 
the  position  seen  in  Flf/.  '21 .  Bring  thorn 
back  to  the  sides,  Avhile  at  the  same  tnue 
you  bring  the  body  to  tlie  first  position. 
Swing  the  arms  up  on  the  other  side,  and 
so  continue,  alternating  twenty  times. 
No.  30.  Standing  erect,  arms  hanging, 
bring  the  bells  to  the  chest,  then  to  the 
floor,  as  shown  in  the  dotted  line  in  Fig. 
28  ;  then  rising,  bring  the  dumb-bells  again 
to  the  chest,  and  on  the  next  beat  thrust 
them  as  far  upw^ard  as  possible,  rising  on 


Figure  30. 


the  toes ;  then  back  to  the  chest.      Repeat  twenty  times. 


'  Figure  81. 

No.  31.     Standing  erect,  dumb-bells  on  the  shoulders  (rat  on  the 


PHYSICAL   CULTURE. 


731 


chest) ,  thrust  the  right  arm  out  at  the  side  as  seen  in  Fig.  29,  ten 
times.     Left,  the  same.     Altcrn-itely  nnd  simultaneously,  the  same. 

No.  32.  Standing  erect,  arms  hanging,  nuuy  the  arms  to  the  hori- 
zontnl  in  front ;  then  to  the  position  over  the  head  seen  in  Fig.  30  ; 
now  down  to  tlie  horizontal  again,  and  then  to  the  floor  as  seen  in 
the  dotted  lino.     Repeat  ten  times. 

In  this  exercise  there  must  be  no  bending  at  the  knees  or  elbows. 

No.  33.     Standing  erect,  arms  hanging,  charge  out  with  the  right 


Figure  32.  ^ 

foot,  and  sweep  the  left  arm  as  shown  in  Fig.  31 ;  on  the  next  beat 
return  to  the  first  possition.  Repeat  five  times.  Same  on  the  left 
side.     Alternately,  five  times. 

No,  34.  Standing  erect,  arms  hanging,  without  moving  the  body 
carry  the  right  foot  out  sideways,  lifting  it  from  the  floor,  and  bring- 
ing it  back  to  the  other  foot,  without  bending  the  knee,  five  times  ; 
then  charge  into  the  position  seen  in  Fig.  32,  and  return  to  the  firet 
position,  five  times. 

The  arm  which  is  brought  over  the  head  nuist  be  canned  in  a 
direct  line  from  the  side  to  the  position  over  the  head,  and  not 
brought  toward  the  front  of  the  body  in  ita  passage  up  or  down. 


^ 


BagEzercises. 

The  use  of  small  hags  filled  with  beajis,  for  gymnastic  exercises, 
was  suggested  to  my  mind  six  years  since,  while  attempting  to 
devise  a  series  of  games  willi  large  rubber  balls.  Throwing  and 
catching  objects  in  certain  ways,  requiring  skill  and  i)resence  of  mind, 
affords  not  only  good  exercise  of  the  muscles  of  the  arms  and  u[)iK'r 
half  of  the  ])ody,  but  cultivates  a  quickness  of  eye  and  coolr.css  of 
nerve  very  desirable.  Appreciating  this,  I  employed  large  niblHi 
balls,  but  was  constantly  annoyed  at  the  irregularities  resulting  froi:; 
the  diflScuIty  in  catching  them.  When  the  balls  were  but  ijartinlly 
inflated,  it  was  observed  the  hand  could  better  seize  them.  This  nt 
length  suggested  the  bean  bags.  Six  years'  use  of  these  bags  lias 
resulted  in  the  adoption  of  the  following,  as  the  best  size  and  sliaiw. 
The  material  is  a  strong  bed-ticking.  Bags  for  young  children 
should  be,  before  sewing  seven  inches  square  :  forhulies,  nine  inches; 
for  ladies  and  gentlemen  exercising  together,  ten  inches  ;  for  gentle- 
men alone,  twelve  inches.  Sew  them  with  strong  linen  or  silk 
thread,  doul>led,  nearly  three  quarters  of  an  inch  from  the  edge, 
leaving  a  small  opening  at  one  corner  to  pour  in  the  beans.  Fill  the 
bags  three  quartei-s  full,  and  they  are  ready  for  use.  Jf  used  daily, 
once  in  two  weeks  they  should  be  em^jtied  and  washed.  To  allow 
them  to  be  i)layed  with  after  they  are  soiled,  is  })retty  sure  to  furnish 
much  dust  for  the  lungs  of  the  plnyers,  beside  soiling  the  hands  and 
clothes.  There  cannot  be  too  much  ca^e  exercisvjd  in  regard  to  this 
point  of  cleanliness.  Before  the  beans  are  used  the  first  lime,  they 
should  be  ri)ised  with  water  until  it  runs  from  them  quite  clean,  when 
they  nuist  be  dried  ;  and  every  month  or  two  afterwards  this  cleans- 
ing should  be  repeated. 

The  dirty  carelessness  with  which  these  bag  exercises  are  gener- 
ally managed,  makes  them  a  positive  nuisance. 

Premising  this  indispensal)le  preparation  and  care  of  the  bags,  1 
shall  now  proceed  to  give  those  exercises  which  I  have  found  best 
adapted  to  schools  and  gynmasiums. 

Fig.    1  represents  a   series   of  hoops  lashed  between  two  stroiiT 

ropes  and  stretched  across  !!.;• 
room,  the  ropes  fastened  on  tlio 
side  of  the  room  into  staples,  and 
on  the  other  rumiing  throuiih 
pulleys.  By  these  means  the 
ropes  may  be  drawn  very  taut. 
It  is  well  to  fasten  the  staples  and  pulleys  into  slides,  that  the  hoops 
may  be  altered  for  persons  of  difl'erent  ages. 

Nearly  all  the  exercises  with  bags  are  greatly  improved  by  throw- 
ing them  through  the  hoops.  It  will  be  ol)served  the  cut  srepresent 
the  player  as  throwing  the  bags  quite  high.  This  has  reference  to 
the  hoops.  But  the  bags  may  be  thrown  between  the  players  without 
the  hoops. 


(XXXX) 


Figure  1. 


PHYSICAL  CULTURE. 


783 


;se    baj^s  has 


;  for  gcntlo- 


s   are  gener- 


No.  1.  Arrange  yourself  in  two  classes.  Classes  face  each 
other,  six  feet  apart.  Members  of  one  class  will  each  have  a  bag. 
The  other  class  will  have  no  bags.  Each  person  will  play  with  the 
one  standing  exactly  opposite.     Hold  the  bags  under  your  chins 


Figure  2.  Figures. 

{Fig.  2).  When  one  gives  the  work,  each  couple  is  to  throw  its  bag 
backwards  and  forward  ten  times,  counting  both  ways.  At  the  be- 
ginning of  this  and  the  following  exercises,  the  leader  will  announce 
how  many  times  the  bag  is  to  be  thrown. 


Figure  4.  Figure  5.  Fisure  6. 

Each  coui)le  will  play  as  rapidly  as  possible,  and  as  estth  finishes, 
the  two  players  will  hold  up  their  hands,  and  cry  out  the  number  in 
a  loud  voice.  Now  ready  !  One,  two,  thuee  ! !  The  bag  is  always 
to  ho  thrown  fi-om  the  chest,  never  to  be  thrown  from  the  lap. 

No.  2.     Same  as  the  last,  except  the  bag  is  thrown  and  caught 


with  the  right  hand. 


The  position  is  well  shown  in  Fig.  3. 


''ii 


734 


PHYSICAL  CULTURE. 


No.  3.  Same  as  the  last,  but  with  the  left  hand.  When  the  rif'ht 
hand  throws,  the  partner's  right  hand  must  catch,  and  so  with  the  loft. 

No.  4.  In  this  one,  the  bag  is  thrown  with  both  hands,  from  the 
position  seen  in  Fig  4. 


Figure  7. 


Figure  8. 


Figure  9. 


No.  5.  Same  as  the  last,  except  the  bag  is  thrown  with  the  right 
hand,  as  shown  in  Fig.  5.  The  unoccupied  hand  in  this  and  all  other 
single-handed  bag  exercises  is  to  be  held  on  the  corresponding  side, 
with  the  arm  akimbo. 

No.  6.     Same  as  the  last,  except  with  the  left  hand. 

No.  7.  The  bag  is  to  be  thrown  over  the  head  from  the  position 
seen  in  F/'q.  6. 


Figure  II. 


Figure  12. 


Figure  10. 

No.  8.  To  be  thrown  from  the  position  seen  in  Fig.  7,  with  the 
right  hand.  The  one  who  catches  must  receive  it,  while  the  left  hand 
grasps  the  arm  in  the  same  way. 

No.  9.     Same  as  the  last,  only  using  the  left  hand. 

No.  10.     Standing  with  your  right  side  toward  your  partner,  hold 


PHYSICAL  CULTURE. 


735 


llio  bag  on  the  point  of  the  elbow,  l)eiiig  sure  to  keep  the  foreunn 
vertical  {Fig.  8);  throw  from  this  posilioii  the  number  of  times  an- 
nounced by  the  leader.     To  bo  caught  in  the  hands. 

No.  1 1.  Same  as  the  last,  except  the  left  side  is  turned,  and  the 
\n>Z  is  thrown  from  the  left  elbow. 

NO.  12.  Hold  the  bag  as  represented  in  Fig.  9,  and  toss  to  your 
parliu-r.  He  will  of  course  return  in  the  same  manner  to  you,  and 
thus  it  will  1)0  tossed  backward  and  forward  the  number  of  times  in- 
(liciited  by  the  leader.  As  in  all  the  other  exercises  thus  far  given, 
(lull  coui)le  ui)ou  reaching  the  indicated  number,  will  hold  up  their 
hands  and  cry  out  that  number  in  a  1  jud  voice. 

No.  13.     Turning  your  right  side  to  your  partner,  throw  from  the 


Figure  13. 


Figure  14. 


FiRure  15. 


position  represented  in  Fig.  10.  Your  partner  catches  the  bag,  stand- 
ing in  the  same  attitude. 

No.  14.  Same  as  the  last,  except  you  turn  your  left  side  to  your 
partner,  and  throw  with  the  left  hand,  either  without  bending  the 
knees,  as  seen  in  Fig.  11,  or  bending  them,  as  seen  in  Fig.  10. 

No.  15.  Again  turn  your  right  side  to  your  partner,  and  throw  the 
hag  from  the  position  seen  in  Fig.  12. 

No.  16.  Same  as  the  last,  except  turning  the  left  side,  you  throw 
with  the  left  hand. 

No.  17.  Turn  your  back  to  your  partner,  and  bend  backwards,  so 
that  you  can  see  him.  He  bends  back,  so  that  he  may  see  you,  and 
then  you  throw  the  bag  to  him  as  represented  in  Fig.  13.  Always 
cry  ready!  that  he  may  not  be  kept  waiting  too  long  in  a.i  uncom- 
fortable position. 

No.  18.  Face  your  partner,  and  throw  from  the  position  repre- 
sented in  Fig,  14,  holaing  the  bag  on  the  back  of  the  hand. 

No.  19.     Same  as  the  last,  except  the  left  hand  is  employed. 

No.  20.  Face  your  partner,  and  throw  the  bag  around  the  back 
and  over  the  opposite  shoulder,  as  shown  in  Fig.  15. 

No.  21.     Same  as  the  last,  except  you  see  the  other  hand. 


736 


PHYSICAL  CULTUUE. 


No.  22.  Each  couple  having  ten  bags,  you  throw  to  your  part- 
ner, and  he  catches  as  many  aa  he  can  hold,  folding  his  arms.  (Fig. 
10.)  This  one  will  not  ordinarily  be  played  in  class,  as  the  number 
of  bags  will  scarcely  be  sufficient. 

No.  23.  The  two  classes  will  stand  as  represented  in  Fitf.  17. 
Place  ten  bags  on  a  chair  or  box  at  the  feet  of  the  first  player  of  eacli 


'S 


claws.  The  leader  gives  the  word,  one,  two,  three/  and  the  two  claflsc 
compete  in  passing  the  bags  over  their  heads  backwards,  to  the  foot 
of  the  class,  when  they  whirl  round  and  immediately  pass  them  bacU. 
The  class  which  has  the  entire  ten  on  the  chair  or  box  at  its  hoaci, 
tirst,  counts  one  in  the  game.  It  is  usual  to  make  the  jamei  three, 
live,  or  ten. 


Figure  IS. 


Figure  17. 


No.  24.  Let  the  two  classes  face  each  other  again,  and  pass  the 
bags  as  in  the  last,  except  that  they  are  carried  along  in  front  and  as 
high  as  the  chest,  being  careful  not  to  stoop  forward. 

No.  25.  Let  the  bags  he  all  placed  at  the  head  of  one  of  the 
classes.  We  will  call  this  class  No.  1 ;  the  other,  class  No.  2.  The 
tirst  player  in  class  No.  1  throws  a  bag  to  the  first  player  in  class  No. 
2,  who  throws  it  back  to  the  second  player  in  class  No.  1,  who  throw.s 
it  back  to  the  second  player  in  class  No.  2,  who  in  turn,  throws  it  to 
the  third  player  in  class  No.  1,  and  so  oti,  working  it  down  to  the  foot 
of  the  class. 

But  one  bag  is  not  allowed  to  make  the  trip  alone ;  all  follow,  one 
after  another,  in  rapid  succession. 

In  this  game,  the  bags  are  all  thrown  from  the  chest  with  both 
hands,  as  represented  some  pages  back,  in  No.  1  of  the  bag  exercises. 

No.  26.  The  whole  company  may  now  be  divided  into  trios,  eacli 
trio  playing  with  three  bags,  as  represented  in  Fiff.  18.  Each  one 
throws  the  bag  to  the  player  at  his  right  hand,  and  at  the  same  time 
catches  the  bag  thrown  from  the  player  at  his  left. 


PHYSICAL  CULTURE. 


737 


To  secure  the  proper  distance  between 
the  players  for  this  game,  they  should 
take  each  other  by  the  hands,  and  pull- 
ing hard,  they  will  have  the  right  position. 
Eiich  player  must  look  constantly  at  the 
one  from  whom  he  receives  the  bags,  and 
never  for  a  moment  at  the  one  to  whom 
he  throws.  If  they  forget  this  rule,  the 
bags  will  soon  fall  to  the  floor. 

No.  27.  Same  as  the  last,  except  the 
bags  are  passed  the  opposite  way. 

No.  28.  The  company  is  again  divi- 
ded into  couples,  and  each  couple  plays 
with  two,  three,  four,  or  more  bags.  A 
throws  a  bag  with  his  right  hand  to  B, 
who  catches  it  with  his  left  hand,  and 
immediately  changing  it  to  his  right, 
throws  it  back  to  A,  who  catches  it 
with  his  left,  and  who,  changing  it  to  his  right,  throws  it  back  agaia 
to  B  (^Fig.  19).  Two,  three,  four,  or  five  bags  can  be  made  to  per- 
form this  circle  between  two  players  at  the  same  time. 


Figure  18. 


!  ';l' 


\^ 


Figure.  19. 

The  bags,  in  this  as  in  all  the  other  bag  exercises,  except  one,  should 
be  thrown,  and  not  tossed. 

No.  29.  Same  as  the  last,  except  the  bags  are  thrown  with  the 
left,  and  caught  with  the  right  hand. 

No.  30.  Now  the  players  will  stand  in  two  classes  again,  the  classes 
to  be  six  feet  apart,  and  the  players  in  each  party  to  be  six  feet  from 
each  other.  Place  six  bags  on  a  chair  at  the  head  of  each  class.  Upon 
the  word  one,  two^  three!  the  first  player  in  each  class  seizes  a  bag 
and  runs  with  it  to  the  second  player,  who  carries  it  to  the  third,  who 
in  turn  rushes  to  the  fourth,  and  so  on  to  the  foot  of  the  class.  But 
one  bag  is  not  allowed  to  make  the  journey  alone.  One  at  a  time,  the 
93 


'    ! 


I   '•^1- 


'     i 

^i 


738 


PHYSICAL  CULTURE. 


whole  six  arc  hurried  onward.  Instantlvt  and  without  any  signal,  they 
are  sent  bueit  to  the  head  of  the  class  in  the  same  order.  The  class 
which  has  its  six  bags  on  the  chair  at  the  head  of  the  class  first,  counts 
one  in  the  game. 


Exercises  with  Rings. 

This  series  of  exercises  is  entirely  new,  and  beyond  all  comparison, 
the  best  ever  devised.  Physiologists  and  gymnasts  have  everywhere 
bestowed  upon  it  the  most  unqualified  commendation.  Indeed  it  is 
difficult  to  conceive  any  other  possible  series  so  complete  in  a  physio- 
logical point  of  view,  and  so  happily  adapted  to  family,  school,  and 
general  use. 

If  a  man  were  as  strong  as  Sampson,  he  would  find  in  the  use  of 


Figure  1. 


Figure  2. 


these  rings,  with  another  man  of  equal  strength,  the  fullest  opportu- 
nity to  exert  his  utmost  strength  ;  while  the  frailest  child,  engaged 
with  one  of  equal  strength,  would  never  be  injured. 

There  is  not  a  muscle  in  the  entire  body  which  may  not  be  brought 
into  direct  play  through  the  medium  of  the  rings.  And  if  one  partic- 
ular muscle,  or  set  of  muscles  is  especially  deficient  or  weak,  the  ex- 
ercises may  be  concentrated  upon  that  muscle  or  set  of  muscles. 

Wherever  these  rings  are  introduced,  they  will  obtaia  the  highest 
favor  and  awaken  the  most  earnest  enthusiasm. 

The  ring  is  generally  turned  from  cherry  wood,  and  when  finished 
measures  six  inches  in  diameter,  while  the  body  is  one  inch  thick.  It 
should  be  highly  polished,  especially  on  the  inner  part  Fig:  1.  gives 
a  good  idea  of  the  ring. 

No.  1.  Standing  in  the  position  represented  in  Fig.  2,  the  end  of 
the  right  toe  against  the  right  toe  of  your  partner,  the  toes  meeting  on 


niYSICAL  CULTURE. 


739 


a  stmight  line  drfivvn  through  tho  entire  hull,  on  which  nil  the  pinyers 
stiuul,  unci  phu'inj;  the  left  ibot  sit  right  angles  with  the  right  foot,  as 
seen  in  tlie  figure,  pull  hard  and  twist  the  right  arm  hard  from  right 
to  left  and  left  to  right  ten  times,  keeping  time  to  the  nmsie. 

Be  careful  in  this,  as  in  all  other  exercises  with  the  ring,  to  draw  the 
shoulders  well  back  and  keep  the  head  erect. 

No.  2.  Same  as  the  last,  but  using  the  loft  hand,  with  the  left  fool 
forward. 


Figure  S. 


Figure  4. 


No.  3.  Join  both  hands  vrith  two  rings,  and  plr  e  the  right  toe 
against  your  partner's  right  toe,  as  in  No.  1,  being  sure  to  keep  the 
foot  which  is  behind  at  right  angles  with  the  one  in  front  (which  I 


Figure  6. 


Figure  6. 


may  say  here,  is  to  be  looked  after  with  much  care  through  this  whole 
series,  whenever  it  is  possible),  then  pull  hard,  ten  times,  and  twist 
the  arms,  keeping  time  to  the  music. 

No.  4.     Exactly  the  same  as  the  last,  but  with  the  left  foot  forward. 

No.  5.     Without  letting  go  tb  '  rings,  turn  back  to  back,  place  the 


^ 


1 


740 


PHYSICAL  CULTURE. 


outside  of  your  left  foot  against  the  same  of  your  partner,  in  the  same 
way  you  would  push  against  the  wall  of  the  room,  and  pulling  hard 
in  the  position  represented  in  Fig.  3,  twist  hard  ten  times,  keeping 
time  to  the  music. 

No.  6.     Same  as  the  last,  but  with  the  right  foot  behind. 

No.  7.  Turn  face  to  face,  raise  the  hand:*  us  high  as  you  can  over 
the  head,  and,  standing  about  two  feet  and  a  iialf  apart,  bring  the  rings 
down  to  the  floor  without  bending  the  knees,  as  represented  in  Fig.  4, 
ten  times,  and  all  the  following  e:«.ercises  ten  times.  In  the  perform- 
ance of  this  you  must  not  bend  the  elbows,  which  you  can  avoid  doing 


Figure  7. 


Figure  8, 


by  carrying  the  rings  outward  at  each  side.  (In  the  ring  exercises, 
when  your  pupils,  standing  their  faces  toward  each  other,  turn  their 
backs,  see  that  they  do  not  let  go  the  rings). 

No.  8.  Standing  as  in  the  last  exercise,  but  only  two  feet  apart, 
place  the  rings  in  the  position  seen  in  Fig.  5.  Now  as  the  arms  on 
one  side  rise,  the  arms  on  the  other  side  fall,  keeping  time  to  the  music. 
Be  careful  not  to  bend  the  arms  at  the  elbows,  which  of  course  can 
be  prevented  in  this  as  in  many  other  exercises,  by  carrying  the  hands 
outward  at  the  side.  In  this  exercise  a  great  deal  of  force  should  be 
used,  so  that  when  the  ring  is  carried  up  on  one  side,  it  goes  far  be- 
yond the  perpendicular  line,  the  bodies  of  the  players  bending  freely. 

No.  9.  Same  as  the  last,  except  the  two  rings  go  up  and  dowa 
simultaneously. 

No.  10.  Standing  as  in  the  last  two  exercises,  the  hcirds  hanging 
down  as  low  as  may  be,  and  keeping  them  in  the  same  relation  to 
each  other,  swing  them  from  side  to  side  as  far  as  you  can. 

No.  11,  Same  as  the  last,  except  that  instead  of  swinging  the 
hands  from  side  to  side,  they  make  a  complete  circle,  being  carried 
over  the  head,  as  well  as  down  between  the  bodies  of  the  players. 

No.  12.  Same  as  the  last,  except  the  circle  is  made  the  opposite 
way. 


in  the  same 
yuUing  hard 
les,  keeping 

i. 

roa  can  over 
ing  the  rings 
ed  iu  Fig.  4, 
the  perform- 
1  avoid  doing 


ing  exercises, 
ler,  turn  their 

ro  feet  apart, 
s  the  arms  on 
to  the  music, 
of  course  can 
ing  the  hands 
rce  should  be 
goes  far  be- 
nding freely. 
ip  and  dowa 

apds  hanging 
le  relation  to 
an. 

swinging  the 
being  carried 
e  players, 
the  opposite 


No.  13.  Back  to  back,  as  seen  in  Fig".  6,  thrust  the  rings  up  with 
great  force,  each  player  keeping  his  two  arms  exactly  parallel. 

No.  14.  From  the  same  position  seen  in  Fig-.  6,  thrust  the  rings 
out  sidewise,  as  in  all  the  other  exercises,  ten  times. 

No.  15.  Same  as  the  last,  except  the  rings  are  thrust  downward 
by  the  hips. 

No.  16.     The  last  three,  consecutively,  ten  times. 

No.  17.  Take  the  position  seen  in  Fig.  7 ;  your  partner  the  same. 
The  inside  of  your  left  foot  to  the  inside  of  his  left.  Draw  your  left 
hand  as  far  back  past  your  left  side  as  possible,  dragging  your  partner's 
right  hand  after  it.  At  the  same  time  he  has  done  the  same  thing 
with  his  left.  Do  the  same  with  your  right  hands.  And  so  continue 
to  alternate.  Do  this  strongly,  pushing  your  hand  past  your  partner's 
side  as  far  as  possible,  at  the  same  time  pulling  his  hand  as  far  past 
yours  as  possible. 

No.  18.  Same  as  the  last,  except  the  right  foot  is  forward.  Be 
sure  in  this,  as  in  all  others,  that  your  two  feet  ar-e  at  right  angles. 

No.  19.  Same  as  the  last  two,  except  the  feet  go  with  the  hands. 
When  you  thrust  your  right  hand  forward,  the  right  foot  goes  forward 
too.     When  the  left  hand  goes  forward,  the  left  foot  goes  with  it. 

If  this  be  well  done,  the  feet  and  hands  making  long  sweeps  to  the 


Figure  9. 


Figure  10. 


music,  it  not  only  presents  a  6ne,  animated  appearance  to  the  specta- 
tors, but  brings  all  the  muscles  of  the  body  and  limbs  into  fine  play. 

No.  20.  Back  to  back,  touching  each  other's  heels.  Each  lunge 
out  vv'ith  tht!  right  foot  in  the  direction  the  toe  points,  the  feet  being 
at  right  angles,  and  raise  the  hands  over  the  head  so  they  touch,  thus 
reacliing  the  position  seen  in  Fig:  8.  Now  back,  heels  together,  arms 
at  the  side,  lunge  out  with  the  loft  feet  in  the  same  way,  and  thus 
alternate,  keeping  time  to  the  music. 

No.  21.  Standing  as  represented  in  Fig.  9,  your  partner  the  same, 
with  the  inside  of  his  left  foot  to  the  inside  of  your  left  foot,  and  hold- 
ing the 'rings  as  shown  in  the  figure,  push  them  vigorously  toward 


I"  ^^,  i .. ' 


.1 


A 


■f  ■"   ' 


742 


PHYSICAL  CULTURE. 


your  partner,  simultaneously  thrusting  them  past  his  body  as  far  as 
possible.     He  pushes  them  back  in  the  same  manner,  and  so  on. 

No.  22.  Same  as  the  last,  except  the  right  foot  is  pushed  forward, 
instead  of  the  left. 

No.  23.  Stand  back  to  back,  heels  all  together  ;  both  step  out  side- 
wise  in  the  same  direction  as  far  as  you  can  reach,  and  at  the  same 
instant  raise  the'  hands  on  the  same  side  as  high  as  you  can,  then  re- 
turning to  the  upright  position,  hands  by  your  sides,  charge  out  at  the 
other  side  in  a  similar  manner.  When  this  has  been  done  both  ways, 
as  in  every  other  exercise,  ten  times ;  the  leader  cries  "  alternately," 
and  you  continue  to  change  sideways  as  before,  only  in  opposite 
directions  as  represented  in  Fig:  10 


Figure  U. 


Figure  12. 


No.  24.  Standing  face  to  face,  two  feet  apart,  charge  sideways  as 
in  the  last  exercise,  and  as  seen  in  Fig:  11.  In  alternation  with  this, 
charge  the  opposite  way.  After  the  regular  number  of  times,  the 
teacher  cries  "  alternately,"  and  you  charge  out  sideways  with  your 
right  foot  in  opposite  ways,  as  seen  in  Fig.  12  ;  alternate  with  the  left 
foot. 

No.  2o.  Standing  back  to  back,  charge,  your  faces  both  in  one  di- 
rection, with  bodies  fronting  the  same,  as  shown  in  Fig.  13.  When 
the  teacher  cries  ^'■change  I  "  you  must  change  sides  with  each  other, 
still  facing  in  the  same  direction.  Keep  time  to  the  music  with  your 
feet,  when  changing  sides,  and  as  soon  as  you  make  the  change,  go 
on  with  the  charging,  using,  of  course,  the  other  hands  and  feet. 

No.  26.  Joining  only  with  your  right  hands,  and  standing  apart 
far  enough  to  make  the  arms  st.aight  and  horizontal  between  you, 
charge  as  seen  in  Fig.  14 ;  the  left  hand  and  foot  the  same. 

No.  27.  Joining  with  both  hands,  charge  right  and  left  alternately, 
each  time,  as  represented  in  Fig.  14. 

No.  28.  Stand,  each  with  his  own  heels  together,  as  seen  in  Fig. 
15,  and  perform  the  exercise  ejcliibited  in  the  figure.     As  the  hands 


PHYSICAL  CULTURE. 


743 


on  one  side  go  up,  the  hands  on  the  other  go  down.  So  alternate  the 
regular  number  of  times,  when  you  will  do  the  same  simultaneously, 
the  hands  on  both  sides  rising  and  falling  together. 


Figure  13. 


Figure  14. 


No.  29.  Standing  as  seen  in  Fig:  16,  except  that  the  inside  of  the 
right  foot  should  be  exhibited  as  pressing  against  the  inaide  of  your 
partner's  right  foot,  you  draw  back  from  each  other  as  far  as  you  can, 


Figure  15. 


Figure  16. 


and  then  come  up,  touching  each  other's  chesits,  all  without  bending 
the  elbows. 
No.  30.     Same,  with  the  left  foot  forward. 


If    ,1 


744 


PHYSICAL  CULTURE. 


No.  31.  Standing  as  seen  in  F^.  17,  draw  far  away  from  cacn 
other,  keeping  the  arms  precisely  horizontal.  In:mediately  approach- 
ing each  other  again,  touch  the  shoulders  as  in  the  figure,  and  so  con- 
tinue  ten  times,  keeping  time  to  the  music. 

No.  32.     Same  as  the  last,  with  the  feet  changed. 


Figure  17.  Figure  18. 

No.  33.  Standing  face  to  face,  raise  the  hands  on  one  side  as  in 
Fig:  18.  As  these  hands  are  brought  down  to  the  side,  raise  those  on 
the  other  side  in  like  manner,  and  so  alternate  ten  times. 

No.  34.  Back  to  back,  and  raise  the  arms  on  one  side  as  in  Fig.  18, 
but  carry  the  hands  completely  over  the  heads  and  down  on  the  other 
side  of  the  body.  Alternate  with  the  arms  on  the  other  side,  ten 
times. 


Figure  1».  Figure  20. 

No.  35.  Carry  the  hands  all  over  together,  as  seen  in  Fig.  19. 
Change  thus  from  side  to  side,  twenty  times,  always  keeping  time  to 
the  music. 

No.  36.     Turn  face  to  face,  and  now  back  to  back,  and  again  face 


,.  ", 


■I  *■  ll  •'ft',' 


'■\''^{r, 


rom  cacn 
approach- 
id  so  con* 


e  side  as  in 
lise  those  on 

s  in  Fig.  18, 
on  the  other 
ler  side,  ten 


n  in  Fiff.  19- 
leping  time  to 

ud  again  face 


PHYSICAL  CULTURE. 


74t 


to  ftt«!e,  and  so  continue  to  change,  alternating  the  sides  toward  which 
yon^  turn. 

No.  37.  Perform  the  exercise  seen  in  Fig.  20,  being  sure  that  you 
draw  the  arm  of  your  partner  directly  into  your  axilla  or  armpit 
After  alternating  twenty  times,  then  draw  the  arms  back  and  forth 
simultaneously,  ten  times. 

No.  38.  Join  right  hands  with  your  partner  with  one  ring,  and 
stand  apart  so  that  your  arras  are  straight  and  horizontal.  Advance 
your  right  foot  two  feet,  keeping  the  two  feet  at  a  right  angle.  Now 
puKh  you;  chests  as  near  together  as  you  can,  without  bending  your 
knees  or  elbows,  as  seen  in  Fig.  21.  Now  drawing  the  arms  back  to 
the  horizontal  on  the  next  beat  of  the  music,  carry  the  hands  down 
as  low  as  possible  without  bending  knees  or  elbows  on  the  next  beat. 
Now  back  to  the  horizontal,  and  then  up  as  high  as  possible,  and  so 
continue  ten  times. 

No.  89.  Same  with  the  left  hands,  the  left  foot  being  pushed  for- 
ward. 


Figure  21. 


Figure  22. 


No.  40.  Join  the  right  hands  again,  holding  them  in  the  horizontal 
position.  Now  push  them  sidewise  as  far  as  possible  without  bend- 
ing knees  or  elbows.  On  the  next  beat  bring  the  arms  back  to  the 
straight  line  between  you,  and  now  carry  them  sidewise  the  other  way, 
and  so  continue  ten  times. 

No.  41.     Left  hands  the  same. 

No.  42.  Join  right  hands  again.  Instead  of  thrusting  the  hands 
directly  upward,  or  sidewise,  carry  them  obliquely  upward,  and  after 
bringing  them  back  to  the  straight,  horizontal  line,  carry  obliquely 
downward,  and  so  continue  ten  times,  being  careful  not  to  bend  kn-^es 
or  elbows. 

No.  43.  Still  use  the  right  hands,  and  carry  them  obliquely  upward 
the  other  way,  and  downward  the  other  way. 

Nos.  44  and  45.     Same  with  the  left  hands. 


^  :!■ '-k-F 


'f  '",1 


746 


PHYSICAL  CULTURE. 


No.  46.  Back  to  lack,  and  plice  the  outside  of  the  left  foot  against 
the  outside  of  yoir  partner's  left  foot.  Right  foot  well  forward. 
Now  raise  the  hands  over  the.  head  as  seen  in  Fig:  22  (I  see  the  artist 
has  not  placed  the  outsides  of  the  left  feet  against  each  other,  as  he 
should  have  done),  and  draw  away  ^rom  each  other,  bending  the  knee 


Figure  23.  Figure  24. 

of  the  leg  which  is. pushed  forward,  and  thus  sink  down  somewhat. 
As  you  come  back,  touch  your  shoulders  against  tliose  of  your  part- 
ner, and  thus  repeat  ten  times. 

No.  47.    Same,  with  a  change  of  feet. 

In  the  last  two  exercises,  as  you  draw  away,  you  must  not  pull  on 
the  rings  a  single  ounce.  If  this  be  forgotten,  your  backs  may  be 
hurt. 

No.  48.     Face  to  face,  join  the  right  hands,  and  place  the  tips  of 

the  right  toes  against  each  other,  and  the  left 
feet  at  right  angles  two  feet  behind.  Whirl 
the  right  hands,  making  as  large  a  circle  as 
possible  without  bending  the  elbows  or  knees. 
After  whirling  ten  times  one  way,  then  whirl 
ten  times  the  other  way. 

No.  49.     Same  with  left  hands. 
No.  50.     Back  to  back,  two  feet  apart,  each 
with  his  own  heels  together.    Raise  the  hands 
as  high  as  possible  over  the  head,  and  bring 
them  down  as  seen  in  Fig:  23,  five  times. 

No.  51.    Join   the   right   hands,  and  turn 
your  right  side  toward  your  partner,  iieepiiig 
the  right  arms  straight  between  you.     Both 
must  now  step  straight  forward  with  the  right 
Figure  25.  foot  as  far  as  you  can  reach,  while  the  right 

arms  are  kept  horizontal,  as  seen  in  Fig.  24. 

No.  52.  Face  the  opposite  way,  and  use  the  left  arms  and  feet  in 
the  same  manner. 


i  and  feet  in 


PHYSICAL  CULTURE. 


747 


No.  53.  Stand  as  shown  in  Fig.  25.  Pull  your  arms  directly  for- 
ward, which  of  course  will  draw  your  partner's  arms  directly  back- 
wards. Then  he  draws  yours  backwards  in  like  manner,  and  so 
continue  ten  times. 

No.  54.  Back  to  back,  your  shoulders  touching  your  partner.  Arms 
perpendicular,  over  the  head.  Dnivv  your  right  arm  directly  forward. 
Siinuhaneously  with  this  your  partner  does  the  same  thing.  Now 
the  left  arms  the  same;  and  so  continue  to  altcrnule,  ten  times.  And 
last,  draw  both  of  your  arms  forward  ;  immediately  your  partner  does 
the  same,  and  so  continue  to  alternate,  ten  times. 

These  are  not  a  quarter  of  tlie  possible  exercises  with  the  rings; 
but,  after  a  long*  use  of  them,  with  much  study  and  irmurnerable 
experiments,  I  believe  this  series  gives  the  best  variety,  and  is  suffi- 
ciently extended.  Besides,  this  series  is  admirably  eaU^ulated  to  de- 
velop those  particular  muscles  which  are  almost  universally  deiicient 
in  the  people  of  the  United  States. 


' 

Exercises    with  Wands. 

A  STRAIGHT,  smooth  stick,  one  inch  in  diameter  and  four  feet  long 
(three  feet  for  children),  with  round  ends,  is  known  in  this  gymnasium 
as  a  "  Wand,"  and  is  highly  prized.  It  is  used  to  cultivate  flexibility, 
and  is  ecpially  useful  to  persons  of  all  ages  and  degrees  of  strength. 

As  a  stiff,  inflexible  condition  of  the  ligaments  and  muscles  con- 
nected with  the  shoulders  is  the  principal  obstacle  in  the  way  of 
beginners,  and  as  the  wand  is  the  best  known  means  to  remove  this 
stillness,  it  should  be  made  prominent  during  the  first  few  weeks  or 
monthiiof  training. 

It  is  perhaps  umiecessary  to  say  that  the  symmetrical  development 
of  the  upper  half  of  the  body  turns  entirely  upon  the  freedom  with 
which  one  can  use  the  shoulder  joint.  This  is  sufficiently  obvious 
when  we  reflect  that  exercise  of  the  body  above  the  waist  depends 
upon  the  arms,  and  of  course  upon  the  degree  of  freedom  with  which 
we  can  use  the  arms. 

While  it  cannot  be  denied  that  certain  muscles  about  the  shoulders 
and  chest  may  be  developed  to  any  degree,  and  the  shoulders  remain 
dmoping  and  stiff,  it  is  quite  as  undeniable  that  general  and  symmet- 
rical development  of  that  part  of  the  body  (which  is  almost  univer- 
sally distorted  and  deficient  among  Americans),  can  be  achieved  only 
by  complete  liberty  about  the  shoulder  joint,  through  which  as  a  ful- 
crum or  centre,  all  considerable  training  of  the  upper  part  of  the  body 
is  derived. 

I  h"d  pursued  the  study  of  Gymnastic  Culture  but  a  short  time, 
before  I  saw  the  great  importance  of  the  wand,  in  a  system  of  training 
adapted  to  the  American  people. 


i 

j 

..fi' 

1 

to  ■;:,':■•;■))".■■...■  '.■>,:? 


r*?^ 


748 


PHYSICAL  CULTURE. 


I  have  invented  a  very  extended  series  Oi  these  exercises,  some  of 
which  are  here  described  and  illustrated. 

No.  1.  Divide  the  wand  into  three  equal  parts  with  the  hands,  and 
hold  it  as  represented  in  Fiff.  1.  Thrust  it  downward  close  by  the 
legs  with  much  force,  and  again  bring  it  up  by  the  chin,  holding  the 
eibows  high,  as  seen  in  the  figure,  and  so  continue  twenty  times. 


Figure  1. 


Figure  2. 


No.  2.  From  the  position  seen  in  Fig.  1,  carry  the  wand  directly 
upward  as  high  as  you  can  reach,  and  back  to  the  chin,  ten  times. 

No.  3.  From  the  highest  position  of  No.  2,  bring  the  wand  down 
to  the  knees  and  back  again,  twenty  times,  without  bending  the  elbows. 


Figure  8.  Figure  4. 

No.  4.     Holding  the  wand  high  over  the  head,  bring  it  down  on  the 
back  of  the  neck,  ten  times,  as  seen  in  jp^.  2. 

No.  6.     Same  as  thi  last,  except  every  second  time  the  wand  i» 


PHYSICAL  CULTURE 


749 


brought  down  to  the  chin,  being  careful  that  every  time  that  the 
wand  is  carried  upward,  it  is  carried  as  high  as  pos- 
sible,  and  with  much  force. 

No.  6.  Hands  over  the  head,  but  this  time  at  the 
ends  of  the  wand,  as  seen  in  Fig.  3,  and  now  bring  it 
down  behind  as  seen  in  Fig.  4,  twenty  times,  being 
very  careful  not  to  bend  the  elbows. 

No.  7.  Same  as  last,  (.xc»?pt  that  every  second  time 
the  wand  is  brought  down  to  the  knees  in  front. 

No.  8.  Hold  the  wand  directly  overhead,  hands 
grasping  the  ends,  and  carry  it  from  side  to  side  (Fig. 
5),  being  very  careful  not  to  bend  the  elbows,  and  yet 
the  wand  must  come  to  the  perpendicular  on  either 
side. 

No.  9.  Hold  the  wand  directly  in  front,  and  per- 
pendicular, with  the  hands  in  the  middle  of  it,  six 
inches  apart,  and  the  arms  as  nearly  horizontal  as  pos- 
sible. Keeping  the  arms  stiff,  whirl  the  wand  from 
side  to  side  as  far  as  you  can. 

No.  10.  Standing  erect,  heels  together,  put  the  wand  out  with 
your  right  hand  midway  between  two  lines,  one  of  which  runs  directly 
forward,  and  the  other  at  right  angles  with  this,  at  your  side  ;  which 
dire(!tion  we  shall  call  diagonally  forward.  Let  the  wand  rest  on  the 
door,  at  a  point  removed  as  far  from  your  feet  as  possible,  keeping 


Figure  6. 


Figure  6.  Figure  7. 

your  body  and  the  wand  perpendicular,  and  the  arm  horizontal.  The. 
elbow  must  not  be  bent.  Step  out  as  seen  in  Fig.  6,  the  foot  passing' 
behind  the  wand,  as  seen  in  the  figure.  In  doing  this  you  must  not 
bend  the  elbow,  nor  must  you  move  the  wand.  It  will  be  seen  that 
the  shoulders  scarcely  move,  the  motion  being  confined  to  the  legs  and 
lower  part  of  the  body.     Charge  thus  ten  times. 

No.  11.     Same  as  the  last,  but  with  left  hand  and  foot. 

No.  12.  Stand  erect.  Carry  the  wand  out  with  the  left  hand  di- 
agonally forward,  as  far  as  you  can  reach.     Step  out  to  the  wand 


■'■,■-.  t ' 


750 


PHYSICAL  CULTURE. 


with  the  left  foot.  Let  the  foot  remain  there.  Now  the  body  \»  to 
rise  and  fall  as  far  as  possible.  {Fig"'  7).  Don't  bend  the  knee  of  the 
right  leg.     Keep  the  shoulders  and  head  well  back. 

No.  13,     Same  as  the  last,  on  the  right  side. 

No.  14.  Stand  as  seen  in  Fig.  8.  Thrust  the  arms  straight  for- 
ward, and  back  again  to  the  chest,  ten  times,  keeping  the  wand  all 
the  time  perpendicular. 

No.  15.  At  the  conclusion  of  the  last  exercise,  when  the  arms  are 
thrust  forward,  bring  the  wand  into  the  position  seen  in  Fig.  9.  Then 
carry  it  right  back  to  the  position  seen  in  front,  with  the  arms  straight 
and  horizontal.  Now  bring  it  down  on  the  left  side,  and  so  continue 
ten  times  to  each  side.  ; 

No.  16.     In  concluding  the  last,  when  the  arms  are  extended  in 


Figure  8. 


Fignre  10. 


Figure  9. 

front,  bring  the  hands  and  wand  to  the  position  seen  in  Fig.  8.  Carry 
it  diagonally  forward  and  upward  on  the  left  side,  as  seen  in  Fig.  10. 
Bring  it  back  to  the  chest  again,  and  thrust  it  out  on  the  right  aidv. 
Alternate  twenty  times. 

No.  17.  As  you  thrust  out  the  wand  on  the  right  side,  step  out  the 
foot  in  the  same  direction.  Be  sure  it  is  neither  forward  nor  at  thf 
side,  but  diagonally  forward.  {Fig.  11).  Alternate  between  the  right 
and  left  side  twenty  times. 

No.  18.  Same  as  the  last,  except  that  the  wand  goes  to  the  right  a.s 
the  left  foot  charges  to  the  left,  and  the  left  arm  and  wand  to  the  left, 
while  the  right  foot  charges  to  the  right. 

No.  19.  Same  as  the  last,  except  when  the  right  foot  charges  di- 
agonally forward,  the  wand  is  made  to  point  diagonally  backwards 
over  the  left  shoulder,  and  vice  versa. 

No.  20.     Same  as  the  last,  except  when  the  right  foot  charges 


PHYSICAL  CULTURE. 


751 


extended  in 


diagonally  forward,  the  wand  is  made  to  point  diagonally  backward 
over  the  right  shoulder,  and  when  the  left  foot  charges  diagonally  for- 
ward, the  wand  is  made  to  point  diagonally  backward,  over  the  left 
shoulder. 

No.  21.  Same  as  the  last,  except  the  feet  charge  diagonally  back- 
ward. As  the  left  foot  charges  thus,  the  wand  is  made;  to  point  diag- 
onally forward,  on  the  right  side,  and  vice  versa.     {Fif^.  12). 

No.  22.  Same  as  the  last,  excejjt  when  the  left  foot  charges  diag- 
onally backward,  the  wand  is  made  to  point  diagonally  forward  on 
the  left  side,  and  when  the  right  foot  charges  diagonally  backward,  the 
wand  points  diagonally  forwartl,  on  the  right  side. 

No.  23.  Same  as  the  last,  except  when  the  left  foot  charges  diag- 
onally backward,  the  wand  points  diagonally  backward  on  the  sam^ 


Figure  IL 


Figure  12. 


side.  And  when  the  right  foot  charges  diagonally  backward,  the 
wand  points  diagonally  backward,  on  the  same  side. 

No.  24.  Same  as  the  last,  except  when  the  left  foot  charges  diag- 
onally backward,  on  its  own  side,  the  wand  points  diagonally  back- 
ward on  the  right  side,  and  vice  versa. 

It  must  not  be  forgotten  that  in  all  these  compound  exercises,  in- 
volving the  action  of  the  arms  and  legs,  the  wand  is  always  held  at 
an  angle  of  forty-five  degrees  above  the  horizontal ;  and  that  in  every 
case  in  passing  from  one  charge  to  another,  the  wand  is  brought  to 
the  position  represented  in  Fig:  8.  Without  this  it  would  be  im- 
possible to  keep  time  to  the  music.  Let  the  steps  be  as  long  as 
possible. 

No.  25.  Wand  horizontal  over  the  head,  as  seen  in  Fig-.  3.  As  in 
almost  all  the  wand  exercises,  be  careful  not  to  bend  the  elbows. 
Turn  the  wand  round  so  that  the  right  hand  comes  exactly  in  front, 
and  the  left  hand  exactly  behind.  Bring  the  left  in  frc*nt  and  the  right 
behind ;  so  change  twenty  times. 

No.  26.     Hold  the  wand  horizontal  over  the  head,  with  the  right 


752 


PHYSICAL  CULTURE. 


hand  in  front  and  the  left  one  behind.  Make,  by  the  side  of  the  body, 
the  motion  seen  in  paddling  a  canoe.  Each  time  carry  the  wand 
so  far  back  that  it  shall  be  perpendicular.  Do  this  ten  tnnes  on  the 
right  aide;  then  ten  times  on  the  left;  then  alternately  ten  times. 
Each  time,  as  the  wand  is  brought  over  the  head,  it  must  be  made 
horizontal,  with  one  hand  exactly  in  front,  and  the  other  behind,  ttiul 
as  it  is  brought  behind  the  body,  it  must  be  made  perpendicular. 

No.  27.     Charge  diagonally  forward  with  the   right  foot ;  wand 
in  the  same  direction.     Left  foot  diagonally  forward  ;  wand  tbo  same. 

Left  foot  diagonally  backward ; 
wand  the  same.  Right  foc-t  dia^'- 
onally  backward  ;  wund  the  name. 
Having  thus  gone  all  aroue^d,  be- 
gin again  with  the  left  foot  and 
go  round  the  other  way  in  like 
manner. 

No.  28.  With  both  hands  take 
hold  at  the  end  of  the  wand.  Hold 
it  horizontal  in  front.  Carry  it  di- 
rectly backward  without,  bending 
the  arms,  as  seen  in  Fig.  13.  (I 
see  the  artist  has  tipped  the  figure 
so  far  that  the  centre  of  gravity  is  lost). 

No.  29.  Heels  together.  Wand  directly  in  front,  resting  on  the 
floor,  ami  perpendicular.  Arm  straight.  Step  the  right  foot  forward  to 
*he  wand,  and  back  to  the  other  foot,  five  times.  Left  foot  the  samr, 
No.  30.  Step  the  right  foot  backward  as  far  as  you  can  reach 
(Fiff.  14),  and  bring  it  back  to  the  other  foot,  ten  times.  Same  with 
the  left  foot. 

No.  31.     Carry  the  right  foot  forward  to  the  wand.     Returning,  do 


Figure  13. 


Figure  14. 


Figure  16. 


not  stop  by  the  other  foot,  but  carry  it  backward  as  far  as  you  can 
reach.  Now  forward  to  the  wand  again.  Make  this  long  sweep  ten 
times.     Left  foot  the  same. 

No.  32.     Seizing  the  upper  end  of  the  wand  with  both  hands,  as 
seen  in  Fig.  15,  carry  the  right  foot  forward  to  the  wand,  and  the  left 


PIIT8ICAL  nULTURR. 


753 


foot  back  as  far  as  you  can  reach.  Change  them  at  a  single  jump, 
and  HO  continue  ten  times. 

No.  33.  Hold  the  wand  in  the  position  seen  in  Fig:  9,  on  the  right 
Hide,  with  the  right  hand  at  the  lower  end,  and  the  left  hand  at  the 
u|)|)er.  Change  it  to  the  left  side,  with  the  left  hand  at  the  lower  end, 
iiiid  the  right  hand  at  the  upper;  so  change  from  aide  to  side,  ten 
tiliH'rt. 

Nu.  34.  Begin  the  same  as  in  the  last,  except  the  wand  is  held  on 
the  back  of  the  right  shoulder  instead  of  the  front.  Carry  it  now  to 
the  back  of  the  left,  and  so  alternate  ten  times. 

No.  35.  Beginning  at  the  front  of  the  right  shoulder,  as  in  No.  32, 
ciirry  it  to  the  front  of  the  left  shoulder.  Then  to  the  back  of  the  left 
.shoulder,  and  now  to  the  back  of  the  right  shoulder.  Go  thus  around 
the  body  five  timey. 

No.  3G.  Begin  at  the  front  of  the  left  shoulder,  and  go  around  the 
body  the  other  way  five  times. 


Figure  16. 


Figure  17. 


No.  37.  Hold  the  wand  on  the  front  of  the  right  shoulder.  Carry 
it  to  the  back  of  the  left  shoulder.  Back  again  to  the  front  of  the 
right  shoulder.     Repeat  ten  times. 

No.  38.  Begin  at  the  front  of  the  left  shoulder,  and  alternate  with 
the  back  of  the  right  shoulder. 

No.  39.  Again  putting  the  wand  in  front,  on  the  floor,  perpendicu- 
lar, with  the  right  hand  seizing  the  upper  extremity,  and  the  arm 
straight,  step  the  right  foot  forward  to  the  wand.  Bring  it  back  to  the 
other  foot.  Now  step  sideways  to  the  right  as  far  as  you  can  reach. 
Bring  it  back  to  the  other  foot  again;  now  step  backward  a^;  far  as 
you  ean  reach.  Bring  it  back  to  the  other  foot.  Still  using  the  right 
foot,  step  sideways  to  the  left  as  far  as  you  can  reach,  passing  it  by 
the  left  leg  behind  (Fig'  16),  now  back  to  the  other  foot  again.  Pass 
it  to  the  left  again,  in  front  of  the  left  leg  (i%.  17),  and  bring  it  back 
to  the  other  foot.     Continue  this  round  five  times. 

95 


'^iii 


i 


754 


PHYSICAL  CULTURE. 


No.  40.  Same  with  the  left  arm  and  leg,  five  times.  In  all  this  the 
wand  must  not  lose  its  perpendicularity. 

No  41.  Stand  upright,  with  the  the  heels  together,  seize  the  wand 
at  its  middle,  with  the  right  hand,  and  hold  the  arm  horizontal  in 
front  —  wand  perpendicular.  Keeping  the  arm  in  the  horizontal  place, 
whirl  it  round  the  body,  making  a'complete  circle,  but  do  not  stir  the 
feet.     Same  with  the  left  hand,  ten  times. 

No.  42.  Grasp  the  middle  of  the  wand  with  both  hands,  and  whirl 
as  in  the  last,  as  far  as  you  can,  ten  times. 

No.  43.  Same  as  the  last,  except  the  wand  is  held  horizontal,  in- 
stead of  perpendicular. 

No.  44.  Seizing  the  wand  as  seen  in  Fig.  18,  step  backward  and 
forward  over  it  with  the  right  and  left  foot,  ten  times. 


Figure  18. 


Figure  19. 


No.  45.  Stand  upright,  heels  together,  grasp  the  wand  at  the  ex- 
treme ends  and  i.old  it  behind  the  body,  keeping  the  arms  straight. 
The  right  hand  high  up,  and  the  left  hand  low  down.  Now  swine 
the  left  hand  high  up,  and  the  right  low  down,  and  so  continue  tr 
change  the  relative  positions  of  the  end  of  the  wand,  without  bendins; 
the  elbow,  ten  times. 

No.  46.  Charge  the  right  foot  diagonally  forward,  as  seen  in  Fig, 
19,  five  times.  Now  the  left  foot  with  the  left  hand  raised  high,  five 
times.     Alternate  five  times. 

No.  47.  Same  as  the  last,  except  that  when  charging  with  the  right 
foot,  you  raise  the  left  hand  high,  and  vice  versa. 

The  wand  exercises  from  this  point  are  performed  in  couples,  and 
while  marching. 

No.  48.  Marching  as  represented  in  Fig.  20,  leap  sideways  as  far 
fis  possible,  first  one  foot,  and  then  the  other,  without  losing  your 
relation  to  each  other. 

No.  49.  Putting  the  two  wands  together,  and  holding  them  as  rep- 
resented in  Fig.  21,  leap  sideways  as  before,  being  sure  to  keep  the 


ind  at  the  ex- 
[arms  straight. 
Now  swine 
JO  continue  tr 
ithout  bendini 


PHYSICAL  CULTURE. 


755 


shoulders  back,  and  so  leaping  together,  that  the  two  will  move  as  one 
person.  Be  sure  to  keep  the  arms  quite  perpendicular  over  the  si.oulders. 


Figure  20.  Figure  21. 

No.  50.  One  person  walking  directly  behind  the  other,  take  hold  of 
the  extreme  ends  of  the  wands,  and  then  allow  the  hands  to  rest  on 
the  shoulders.     Marching  in  this  way,  at  the  word  of  command,  "  Up," 


Figure  23. 


Figure  22.    ' 

I  raise  the  wands  as  high  as  you  can,  and  as  the  right  foot  goes  forward 
;  thrust  the  right  hand  as  far  forward  as  possible,  the  left  one  at  the  same 
1  time  being  pushed  as  far  back  as  possible  {Fiff.  22),  and  as  the  left  foot 
comes  forwcd,  reverse  the  hands. 


756 


PHTSICAL  CULTUBE. 


No.  51.  Same  as  t.hft  \»nt.  PVAPnf  +he  right  hand  goes  forward  with 
the  left  foot,  and  the  left  hand  with  the  right  loot.  In  all  these  you 
must  not  bend  the  elbows,  except  when  you  are  told  to  bend  them. 

No.  52.  Still  keeping  your  arms  perpendicular,  carry  both  of  your 
hands  forward  as  far  as  you  can  reach  with  your  right  foot,  and  as  you 
step  your  left  foot  forward,  carry  both  hands  as  far  back  as  you  can 
reach,  and  thus  continue  for  ten  steps. 

No.  53.  Same  as  the  last,  except  that  the  hands  go  forward  with 
the  left  foot,  and  backward  when  the  right  foot  goes  forward. 


Figure  24. 


Figure  26. 


No.  54.  Bring  the  hands  to  the  shoulders,  and  as  the  right  foot 
steps  forward,  raise  the  right  hands  as  high  as  you  can  reach.  When 
the  left  foot  goes  forward  raise  the  left  hands,  and  bring  down  the 
right  hands,  and  so  continue  to  altern«ite  ten  times. 

No.  55.  Same  as  the  last,  except  the  right  hands  go  up  as  the  left 
feet  go  forward,  and  the  left  hands  with  the  right  feet. 

No.  56.  The  two  hands  go  up  simultaneously  with  the  stepping 
forward  of  the  right  feet,  and  come  down  as  the  left  feet  go  forward. 

No.  57.  Same  as  the  last,  except  the  hands  go  up  as  the  left  feet 
go  forward,  and  down  as  the  right  feet  go  forward.  Be  sure  in  the 
last  four  exercises  that  the  arras  go  up  and  down  quite  vertically. 

No.  58.  Put  the  two  wands  together,  and  take  hold  of  them  with 
one  hand,  as  represented  in  Fig:  23,  and  marching  side  by  side,  leap 
sideways  right  and  left,  keeping  the  wand  as  high  as  you  can  reach. 

No.  59.     Partners  change  sides  and  repeat  the  same. 

No.  60.  Carrying  the  wand  as  in  Fig:  23,  as  you  step  forward  with 
the  right  foot,  bring  the  wand  down  so  as  to  strike  your  right  leg  with 
the  hand,  and  then  as  your  left  foot  goes  forward,  carry  the  wand  back 
to  its  vertical  position,  and  so  continue  ten  times. 


No.  61.  Change  sides  with  your  partner,  and  do  the  same  again, 
only  bringing  your  wand  down  as  the  left  foot  goes  forward,  and  rais- 
ing it  as  the  right  foot  goes  forward. 

No.  62.  Cross  the  hands  on  the  two  wands  placed  side  by  side, 
but  instead  of  holding  them  over  the  head,  as  in  Fig.  21,  let  them 
hang  down  in  front,  and  carrying  them  thus,  leap  from  side  to  side. 

No.  63.  Walking  one  in  front  of  the  other,  and  extending  the  arms 
horizontally,  being  careful  not  to  bend  the  elbows,  carry  the  rij^ht  for- 
ward as  far  as  possible  with  the  right  foot,  as  represented  in  Fig.  24, 
and  simultaneously  with  this,  carry  the  left  foot  backward  as  far  as 
possible.  When  the  left  foot  comes  forward,  let  the  left  hand  come 
forward  too,  and  thus  alternate. 

No.  64.  Same  as  the  last,  except  that  the  right  hand  comes  for- 
ward with  the  left  foot,  and  vice  versa. 

No.  6o.  The  same,  simultaneously  with  the  right  foot  and  with 
the  left  foot. 

Be  careful  in  the  performance  of  the  last  four,  that  you  keep  the 
arms  exactly  horizontal  from  first  to  last. 

No.  66.  Walking  one  in  front  of  the  other,  with  the  wands  hang- 
ing in  the  hands  on  either  side,  carry  one  up  as  high  as  you  can 
reach,  as  in.  Fig.  25,  and  then  as  the  other  foot  goes  forward,  carry 
up  the  other  while  the  first  is  brought  down. 

No.  67.  Same  as  last,  except  the  right  arms  goes  up  as  the  left 
foot  goes  forward,  and  vice  versa. 

No.  68.  Simultaneously  up,  with  the  right  foot  forward,  ten  times, 
and  the  same  with  the  left  foot. 

It  is  perhaps  unnecessary  to  repeat  that  every  motion  with  the 
wands  is  to  be  done  to  music.  In  making  the  changes  from  one 
exercise  to  another,  this  rule  must  not  be  forgotten. 

It  must  not  be  forgotten  that  the  feet,  iu  every  exercise,  are  to  be 
kept  at  right  angles  with  each  other. 


Gymnastic    "rown. 

T';  «ii.,%si  burthens  on  the  head  results  in  an  erect  spine  and  an  elas- 
tic g,,  Observiii,'^  persons  who  have  visited  Switzerland,  Italy,  or 
the  Gull  States,  have  observed  a  thousand  verifications  of  thi^ 
physiological  law. 

Cognizant  of  the  value  » *' t!  is  feature  of  gymnaftic  training,  I  have 

employed,  for  this  purpose,  -.vithin  the  last  twelve  years,  various  sorts 

of  weights,  but  have  recently  invented  an  iron  crown,  which  I  think 

completely  satisfactory.     The  accompanying  cut  gives  a  good  idea  of 

its  general  form.     I  have  them  made  to  weigh  from  three  to  one  hun- 

'■'id  pounds.     The  crown  is  so  padded  within,  it  rests  pleasantly  on 

■    e.tire  top  of  the  head,  and  yet  so  arranged  that  it  requires  skill 

'linue  it.     It  is  beautifully  painted,  and  otherwise  ornamented. 


« 


758 


PHYSICAL  CULTURE. 


The  following  suggestions  are  important  in  wearing  the  crown  : 
Wear  it  five  to  fifteen  minutes,  morning  and  evening     Hold  the  body 

erect,  hips  and  shoulders  thrown  far 
back,  and  the  crown  rather  on  the  front 
of  the  head,  as  shown  in  the  cut. 
Walking  up  and  down  stairs  while 
wearing  the  crown  is  good,  if  the  low- 
er extremities  are  not  too  much  fa- 
tigued by  it.  When  walking  through 
the  hall  or  parlors,  turn  the  toes,  first, 
inward  us  far  as  possible  ;  second,  out- 
ward ;  third,  walk  on  the  tips  of  the 
toes ;  fourth,  on  the  heels ;  fifth  on  the 
right  heel  and  left  toe  ;  sixth,  on  the  loft 
heel  and  right  toe  ;  seventh,  walk  with- 
out bending  the  knees;  eighth,  bend 
the  knees,  so  that  you  are  nearly  sit- 
ting on  the  heels  while  walking  ;  ninth, 
walk  with  the  right  leg  bent  at  the 
knee,  rising  at  each  step  on  the  straight 
left  leg  ;  tenth,  walk  with  the  left  leg  bent,  rising  at  each  step  on  the 
straight  right  leg. 

With  these  ten  diflferent  modes  of  walking,  the  various  muscles  of 
the  back  will  receive  the  most  invigorating  exercise. 

All  persons,  of  both  sexes  and  of  every  age,  who  have  round  should- 
ers or  weak  backs,  are  rapidly  improved  by  the  use  of  the  gymnastic 
crown. 


The  Pangfymnastikon. 

The  Germanic  natioi.:.lity  has  been  redeemed  from  political  and 
social  degredation  by  gymnastics.  I  coifld  mention  a  score  of  emi- 
nent German  writers  and  patriots  who  freely  admit  that  the  physical 
invigoration  of  the  German  people,  through  the  universal  practice  of 
gymnastics,  was  the  foundation  of  the  subsequent  moral  revolution. 
The  soul  is  so  interwoven  with  and  dependent  upon  the  body, 
that  when  the  body  is  sick  the  soul  must  suffer  with  it.  If  the  foun- 
dation give  way,  the  superstruction  must  soon  fall  ;  and  while  the  ex- 
istence of  a  good  foundation  does  not  necessitate  a  superstruction,  the 
latter  cannot  exist  without  the  former. 

Gluttony,  drunkenness,  licentiousness,  and  other  vices  so  under- 
mined the  German  constitution,  that  adventurers  and  tyrants  found 
Germa  y  an  easy  prey.  Gutsmuth,  Jahn,  Eiselen,  Opiess,  and  their 
fellow-workers  turned  back  the  tide  of  physical  degeneration  and 
death.  Inspired  with  the  noblest  patriotic  instincts,  they  gave  their 
lives  to  the  introduction  of  gymnastics  as  an  integral  part  of  the  na* 


us  muscles  of 


PHYSICAL  CULTURE. 


759 


tional  education.  They  clearly  saw  in  a  physical  redemption,  the 
foundation  of  a  political  redemption.  The  great  German  heart  turns 
to-day  toward  these  great  gymnastic  reformers  as  the  falvation  of 
their  noble  nationality. 

It  may  be  justly  claimed  that  among  all  the  great  and  good  patriots 
who  have  devoted  themselves  to  this  momentous  task,  the  great  Schre- 
ber  of  Leipsic  was  the  most  eminent.  He  was  a  voluminous  author, 
and  the  most  remarkable  of  his  productions  was  the  Ptuig-i/ntnastikotL 
He  was  in  the  habit  of  speaking  of  this  invention  and  tlie  book  describ- 
ing it  as  the  most  important  of  his  contributions  to  the  cause  of  physical 
culture. 

That  work  I  have  translated,  and  reproduced  the  108  cuts  complete. 
The  entire  work  with  the  cuts  is  published  in  my  work  known  as  the 
"  New  C4ymnasrics,"  published  by  Ticknor  &c  Fields,  Boston. 

I  will  here  say,  that  whoever  desires  to  put  up,  for  home  use,  a 
Pjingymnastikon,  after  Scb'-'-  ber's  design  (and  without  doubt  it  is  the 
best  means  for  home  trauiing  ever  devised),  can  obtain  detailed  de- 
scriptions of  this  apparatus,  by  sending  a  request  to  that  ertect  to  Dr. 
Dio  Lewis,  Box  12,  Boston,  with  a  stamp  to  pay  the  return  postage. 
With  a  complete  illustrative  cut,  and  •'ull  descriptions  in  text,  there 
will  be  no  difficulty  in  understanding  the  invention. 


School-Desks  and  Seats. 

A  RADICAL  change  m  school  furniture  is  needed.     The  seats  and 
desks  now  used  compel  an  attitude  which  results  in  a  stooping  form. 


Kiffure  1. 


Figure  2. 


The  other  day  I  stood  an  hour  in  the  street  and  saw  more  than  five 
hundred  persons  pass,  not  one  of  which  was  erect.     Bending  over  the 


760 


PHYSICAL  CULTURE. 


desks  in  otir  schools  would  make  us  crooked  if  we  were  made  of 
spring-steel.  ^  The  desk  tops  should  be  so  arranged  that  it  can  be 
raised  nearly  to  the  perpendicular  before  the  face  of  the  pupil,  and  the 
book  h<^'d  in  such  a  position  which  compels  him  to  sit  with  head  and 
shoulders  well  drawn  back. 

Fig.  1  exhibits  a  fruitful  source  of  stooping  shoulders. 

Fig.  2  shows  a  better  desk  and  the  improved  position  of  the  pupiL 

Fig.  3  is  a  model  desk.     The  top  can  be  raised  to  any  desired 


Figure  3. 


Figure  4. 


height,  or  let  down  to  nearly  the  horizontal  for  writing  exercises.  On 
the  desk  top  will  be  seen  a  bar  which  supports  the  book.  This  can 
be  moved  at  pleasure  and  has  a  pair  of  fingers  which  will  hold  the 
book  in  any  position. 

Fig.  4  shows  two  support-bars,  an  arrangement  which  must  prove 
most  convenient  to  students  of  the  languages,  and  to  those  who  have 
occasion  to  consult  a  dictionary  while  reading.  The  seat  is  easily  ad- 
justed to  any  desiied  height. 

The  new  Book-holder,  patented  Dec.  9,  1862,  is  destined  to  play  an 
important  part  in  the  prevention  of  the  round-shoulder  deformity,  and 
its  certainty  to  produce  erect  forms  will  be  seen  upon  an  examination 
of  the  cut  It  may  be  used  upon  the  ordinary  desk,  and  is  made  to 
hold  one,  two  or  three  books  in  a  much  better  position  than  by  the 
desk.  It  is  exceedingly  light  and  pretty.  The  inclination  can  easily 
be  altered  by  raising  the  hook  attached  to  the  strap.  The  fingers,  im- 
perfectly shown,  keep  the  book  open,  and  thus  dispenses  with  the  use 
of  the  hands.  There  is  no  chance  in  its  use  to  sit  stooping  without 
bringing  the  face  in  direct  contact  with  the  book.  When  we  remem- 
ber how  many  years  children  are  engaged  over  their  books,  the  great 
importance  of  this  invention  will  be  appreciated.  It  is  cheap,  and  not 
liable  to  get  out  of  order.  Those  wishing  to  procure  such  a  holder 
can  send  to  Dr.  Warren,  Bostoa 


mum 


PHYSICAL  CULTURE. 


761 


e  made  of 
b  it  can  be 
pil,  and  the 
h  head  and 


f  the  pupil 
any  desired 


ereises.  On 
k.  This  can 
will  hold  the 

I  must  prove 
3se  who  have 
t  is  easily  ad- 

ed  to  play  an 
eforrnity,  and 
I  examination 
id  is  made  to 
1  than  by  the 
ion  can  easily 
le  fingers,  im- 
3  with  the  use 
oping  without 
;n  we  remem- 
oks,  the  great 
sheap,  and  not 
such  a  holder 


History  of  gymnastics  in  the  United  States. 

I  DO  not  purpose  a  general  history  of  the  Physical  Culture  Move- 
ment in  this  country.  I  shall  speak  of  only  one  feature.  I  refer  to 
the  efforts  to  introduce  physical  education  into  young  ladies'  semi- 
naries. A  consciousness  of  its  need  was  deeply  felt.  Thoughtful  ed- 
ucators know  that  education  meant  a  preparation  for  the  duties  of 
life ;  and  they  saw  the  graduates  of  these  institutions,  pass  from  the 
school  into  hopeless  invalidism,  not  in  rare  instances,  but  as  a  rule.  As 
the  phrase  goes,  their  ^^  education  was  finished,"  but  the//  too  were 
finished.     Their  spines  were  unable  to  support  their  learned  heads. 

Anxious  fathers  and  mothers  besought  school  manag(!rs  to  give 
their  daughters'  bodies  a  chance  for  life.  Willing  to  respond,  they 
announced,  "  Physical  culture  receives,  in  our  institution,  careful  at- 
tention," etc.  Generally  they  had  no  conception  of  what  was  meant 
by  physical  culture,  and  of  course  accomplished  nothing.  The  girls 
under  their  charge  who  needed  two  or  three  hours  of  daily  unre- 
strained, romping,  laughing,  and  vigorous  muscle  training,  were  made  to 
walk  in  solemn  procession  through  the  school  grounds  under  a  picket 
g^zhrd  of  maiden  ladies,  on  proper  days,  and  once  or  twice  a  week 
they  were  conducted  through  a  series  of  dull  calisthenic  arm-motions, 
under  corsets  and  long  dresses.  No  wonder  they  "  got  through"  with 
pale  faces,  drooping  shoulders,  and  ruined  health. 

I  hazzard  nothing  in  saying  that  the  physical  training  given  in  ninety- 
nine  hundredths  of  the  female  seminaries  in  the  country  has  no 
value.  How  much  benefit  would  be  derived  from  musical  training  in 
these  same  schools  if  they  employed  a  person  who  had  no  comprehen- 
sion of  harmony  ;  or  of  mathematics,  who  had  never  learned  the 
multiplication  table ;  or  of  reading  and  spelling,  who  did  not  know  the 
alphabet?  Physical  education  must  be  placed  on  the  same  basis  as 
moral  and  intellectual  training,  and  competent  teachers  employed ; 
otherwise  it  will  as  certainly  fail  as  would  the  efforts  to  introduce 
pianno  music,  without  a  teacher  who  knew  how  the  touch  the  keys  so 
as  to  bring  forth  harmonious  sounds. 

Parents  and  teachers  are  beginning  to  understand  this.  Patrons  of 
schools  now  loudly  demand  tliat  a  three  years  course  they  give  their 
daughters  shall  improve,  shall  educate,  instead  of  spoil  their  bodies. 
A  true  change  has  begun.  The  graduates  of  the  Normal  Institute  for 
Physical  Education  are  in  eager  demand. 

Only  two  years  ago,  the  principal  of  one  of  the  most  celebrated 
ladies'  seminaries  in  the  country  wrote  me  a  letter,  of  which  the  follow- 
ing is  an  extract:  "  I  wish  you  would  indicate  the  day  on  which  yoa 
can  give  me  an  hour  or  two  with  the  least  inconvenience  to  youiselt 
I  am  determined  to  introduce  your  entire  system,  and  as  I  know  noth- 
ing of  it,  you  must  give  me  a  good  lesson."  He  thought  it  was  a 
science  which  could  be  learned  in  two  hours.  Two  years  have 
passed  away,  and  the  same  institution  employs  a  lady  teacher,  thor- 
96 


762 


PHYSICAL  CULTURE. 


oughly  trained,  from  my  school,  at  an  expense  of  $650  per  year.  Un. 
der  her  management  all  the  young  ladies  of  the  institution  devote  more 
than  an  hour  daily  to  thorough  bodily  training.  What  is  now  wanted 
is  Ten  thousand  teachers.  Young  men  and  women  can  enter  no  pro- 
fession  more  favorable,  useful,  and  profitable.  Those  who  would  pro- 
pare  for  this  important  work,  should  come  to  Boston,  either  on  the 
second  of  January  or  the  fifth  of  July,  and  enter  the  Normal  Institute 
from  which  they  can,  with  average  capacity,  graduate  in  ten  weck.s, 
prepared  to  enter  a  noble  and  remunerative  profession. 

I  cannot  close  this  brief  consideration  of  the  history  of  our  efforts  to 
introduce  gymnastics  into  ladies'  seminaries,  without  alluding  to  one 
or  two  successful  attempts. 

Rev.  George  Gannett,  Pemberton  Square,  Boston,  has  a  first-class 
seminary  for  young  ladies.  He  has  recently  added  a  largo  hall  to  his 
already  extensive  establishment,  with  almost  sole  reference  to  physi- 
cal training;  and  he  is  pushing  the  work  with  commendable  zeal. 
During  more  than  two  years  I  have  had  charge  of  this  important  de- 
partment in  Mr.  Gannett's  institution,  and  can  say  that  his  earnest- 
ness is  constantly  increasing. 

The  Maplewood  Institute  at  Pittsfield,  Mass.,  under  the  charge  of 
Rev.  Mr.  Spear,  is  carrying  on  the  same  work  with  energy. 

The  fine  private  school  located  at  West  Newton,  Mass.,  under  the 
management  of  N.  T.  Allen,  Esq.,  is  thoroughly  alive  in  this  vital  de- 
partment. During  more  than  two  years  I  have  had  supervision  of 
physical  education  in  Mr.  Allen's  school. 

Graduates  of  the  Normal  School  for  physical  education  are  en- 
gaged in  many  of  the  first  young  ladies'  seminary  in  the  country. 
The  friends  of  a  true  education  have  occasion  to  rejoice  and  take 
courage. 


PRESCRIPTIONS. -RECIPES. 


TriESE  prescriptions  are  numbered,  and  referred  to  by  corresponding 
numbers  in  the  treatment  of  the  various  diseases.  This  arrangement 
saves  the  troul)le  of  writing  out  each  prescription  every  time  it  is 
wanted  under  the  several  disorders.  When  there  are  sev(!rai  recipes, 
each  of  which  is  suitable  in  a  certain  stage  of  a  comphiint,  this  plan 
affords  the  means  of  referring  to  them  all  in  a  little  space,  by  simply 
giving  their  numbers.  The  doses  named  are  always  for  groivn  per- 
sons, unless  it  is  otherwise  stated. 

Great  pains  have  been  taken  in  preparing  these  prescriptions.  A 
considerable  portion  of  them  are  the  favorite  recipes  of  the  most  dis- 
tinguisli(d  pliysicians,  the  world  over. 

The  classification  of  these  recipes  under  separate  heads,  is  necessa- 
rily very  imperfect,  and  has  been  attempted  only  to  jnake  it  more 
easy  for  me  to  refer  to  them  while  writing  the  book.  The  classifica- 
tion could  only  be  applied  to  a  part  of  them,  however ;  the  rest  are 
indiscriminately  mixed.  , 

» 

Pukes.     Emetics. 

1.  Pulverized  Ipecac,  1  scruple ;  pulverized  cayenne,  10  grains ;  water,  2 
ounces.     Mix.     To  be  taken  at  a  draught. 

2.  Pulverized  Lobelia,  1  oz. ;  pulv.  blood  root,  ^  oz. ;  pulv.  seneka,  1  scru- 
ple ;  pulv.  ipecac,  6  drams ;  pulv.  cayenne,  4  scruples.  Mix.  An  excellent 
emetic  in  all  cases  where  one  is  required.  Dose.  —  One-half  teaspoonful  ia 
warm  water,  and  repeat  every  fifteen  minutes  three  or  four  times. 

3.  Wi7ie  of  Antimony,  1  dram ;  wine  of  ipecac,  1  oz.     Mix. 

4.  Tartar  Emetic,  1  grain  ;  pulverized  ipecac,  1  scruple.  Mix.  To  be 
taken  in  a  wine-glassful  of  swe(!tened  water. 


Purges.     Cathartics. 

5.  Precipitated  Sulphur,  15  grains;  magnesia,  1  scruple.  Mix.  To  be 
taken  each  night  at  bedtime,  for  costiveness  and  bleeding  piles. 

6.  Confection  of  Senna,  2  ozs. ;  cream  of  tartar,  1  oz. ;  sulphur,  1  oz.  j 
iyrup  of  ginger  enough  to  make  a  stiff  paste.  Mix.  A  piece  as  large  as  a 
nutmeg  is  to  be  taken  as  often  as  necessary  to  keep  the  bowels  open.  One  of 
the  very  beat  remedies  for  piles. 


nil  3-      ^  , 
>   *>    'Ui 


764 


PRESCRIPTIONS.  —  RECIPES. 


7.  Jiocheik  Saltt,  2  drams ;  bi-carbonate  of  soda,  2  scruples ;  water,  ^ 
pint.  Mix.  To  this  mixture  add  3d  grains  of  tartaric  acid,  and  take  the 
whole  fotw.nng.    This  is  the  recipe  for  Seidlitz  powders. 

8.  Calcined  Magnesia,  1  dram;  water,  2  ozs.  Mix.  To  be  taken  at  a 
draught. 

9.  Sulphate  of  Magnesia,  (epsom  salts),  2  drams ;  freshly  roasted  coffee 
in  coarse  powder,  2  scruples ;  hot  water,  4  ozs.  Mix  and  boil  for  three  minute:), 
and  strain.  This  may  be  sweetened,  and  taken  every  morning  for  habitual  cos- 
tiveness,  or  repeated  once  in  three  hours,  if  an  immediate  effect  is  desired. 

10.  Castor  Oil,  1  oz. ;  the  yolk  of  one  egg ;  put  together,  and  add,  simplti 
syrup,  ^  oz. ;  peppermint  water,  2  ozs.  Mix.  To  be  taken  at  a  draught,  after 
being  well  stirred  or  shaken. 

11.  Sulphur,  1  dram;  cream  of  tartar,  2  drams.  Mix.  To  be  taken  in 
syrup  or  molasses. 

12.  Rhubarb,  10  grains ;  calcined  magnesia,  ^  dram.  Mix.  To  be  taken 
in  syrup  or  molasses. 

13.  Powdered  Senna,  ^  dram  ;  powdered  jalap,  10  grains  ;  powdered  cloves, 
10  grains ;  Mix.     To  be  taken  in  sweetened  water. 

14.  Powdered  Jalap,  10  grains;  cream  of  tartar,  2  drams.  Mix.  To  be 
taken  in  syrup  or  molitsses. 

15.  Fluid  Extract  of  Senna  and  Jalap,  2  drums;  infusion  of  cloves,  2 
ozs.     Mix.     To  be  taken  at  a  draught. 

16.  Castor  Oil,  1  dessert  spoonful ;  oil  of  turpentine,  1  dessert  spocnful. 
Mix. 

17.  Castor  Oil,  1  dessert  spoonful :  magnesia,  1  dessert  spoonful.  Rub 
together  into  a  paste.  By  this  combination,  the  taste  of  the  oil  is  almost  en- 
tirely concealed,  and  children  will  take  it  without  opposition. 

18.  Sulphate  of  Magnesia,  1  oz. ;  cream  of  tartar,  1  oz. ;  pure  water, 
1  pint.    .Mix.     A  wine-glo^ssful  occasionally. 

19.  Compound  Extract  of  Colocgnth,  ^  dram ;  blue  pill,  8  grains.  Mix, 
and  divide  into  8  }nlls. 

20.  Epsom  Salts,  2  ozs. ;  tartar  emetic,  1  gvain ;  spearmint  water,  1  pint. 
Mix. 

21.  Senna,  3  drams ;  salts,  |  dram  ;  manna,  j^  dram  ;  fennel  seed,  1  dram ; 
boiling  water,  ^  pint.  Macerate  for  one  hour  in  a  covered  vessel,  and  strain. 
Take  a  teacupful  once  in  four  hours,  till  it  operates. 

22.  Aloes,  2  scruples  ;  carbonate  of  pota^sa,  15  grains  ;  decoction  of  barley, 
\  pint.     Mix,  and  rub  together. 

23. 
Mix. 

Mix.     One  dessert  spoonful, 


Sulphur,     1  teaspoonful ;  cream  of  tartar,  10  grains ;  saltpetre,  5  grains. 
To  be  taken  at  a  dose. 


24.  Manna,     2  drams ;  fennel  water,  1  oz 
as  a  cathartic  for  an  infant. 

25.  Compound  Infusion  of  Senna,  4  ozs. ;  caraway  water,  2  ozs. ;  tartrate 
of  potassa,  2  drams ;  manna,  1  dram.  Mix.  A  tablespoonful  for  a  child,  to 
relieve  costiveness. 

26.  Calcined  Magnesia,  1  scruple  ;  pulverized  rhubarb,  1  scruple ;  pulver- 
ized ipecac,  1  grain.     Mix.     Give  one-fourth  of  this  daily. 


>e  taken  at  a 


)  be  taken  ir 


To  be  taken 


ssert  spocnt'ul. 


27.  Epnotn  Salts,  2  drams ;  dissolve  in  pure  water,  1  oz.  Then  add  sweet 
gpirits  of  nitre,  2  dramti ;  laudanum,  10  drops.  Dose.— -A  teaspountul,  to  be 
repeated  according  to  circumstances. 

28.  Pulverized  Rhubarb,  1  scruple  ;  leptandrin,  10  grs. ;  calcined  magnesia, 
2  scruples  ;  pulverized  cinnamon,  10  grains.  Mix.  Three  or  four  grains  ever/ 
tliird  hour,  to  a  child  of  six  months. 

2!>.  Compound  Ertract  of  Cofocynth,  ^  dram  ;  extract  of  jalap,  15  grains. 
Mix.  Make  12  pills.  Two  or  three  pills  will  produce  active  operation  of  tlia 
bowels. 

30.  Pulverized  Senna,  2  drams ;  bicarbonate  of  potassa,  2  ozs. ;  pulver* 
{zed  cayenne,  10  grains ;  pulverized  jalap,  1  dram.  Mix.  Divide  into  18 
parts.     One  part  for  an  adult  every  four  hours  till  it  operates. 

31.  Pulverized  Cfamboge,  12  grs. ;  pulv.  scammony,  12gra. ;  claterium,  2 
grs. ;  croton  oil,  8  drops;  ext.  of  stramonium,  3  grs.  Mix.  Make  12  pills. 
One  pill  is  a  dose,  repeated  every  hour  until  it  operates. 

32.  Pulverized  Scammony,  1 2  grs. ;  pulv.  gamboge,  1 2  grs. ;  pulv.  colocynth, 
8  grs. ;  castile  soap,  4  grs. ;  oil  of  anise,  5  drops.  Mix.  Make  12  pills.  One 
pill,  repeated  every  three  hours  till  it  operates. 

33.  Pulverized  Scammony,  6  grs. ;  croton  oil,  4  drops  ;  pulv.  loaf  sugar,  1 S 
teaapoonfuls.  Rub  well  together  in  a  mortar.  Give  one  teaspoonful  every 
hour  or  two,  to  a  child  7  years  old,  till  it  operates. 

34.  Leptandrin,  1  dram ;  jiodophyllin,  1  scruple ;  scutillarine,  2  drams ; 
pulv.  cayenne,  1  scruple  ;  pulv.  loaf  sugar,  4  ozs.  Rub  together  for  some  time 
in  a  mortar.     Dose  for  an  adult,  -^  of  the  above. 

3 ").  Pulverized  Rhubarb,  2  scruples  ;  bicarbonate  of  potassa,  1  scruple  ;  ext. 
of  nux  vomica,  5  grs.     Mix.     Make  20  pills.     One  pill  twice  a  day. 

36.  Leptandrin,  1  dram ;  podophyllin,  1  scruple ;  apocynin,  1  scruple ; 
ext.  nux  vomica,  G  grs. ;  castile  soap,  I  dram.  Make  30  pills.  One  pill  every 
night. 

37.  Sweet  Tinct.  of  Rhubarb,  4  ozs. ;  bicarbonate  of  soda,  2  drams.  Mix- 
From  a  teaspoonful  to  a  tablespoonful,  as  occasion  may  require. 

38.  Pulverized  Rhubarb,  2  ozs. ;  bicarbonate  of  potassa,  1  oz.  Mix.  Of 
this  take  enough  to  produce  one  movement  of  the  bowels  per  day. 

39.  Leptandrin,  30  grs.;  podophyllin,  10  grs.;  pi.lv.  cayenne,  10  grs.;  ext. 
nux  vomica,  6  grs.;  quinine,  12  grs.  Mix.  Make  24  pills.  One,  two,  or 
three  times  a  day. 

40.  Podophyllin,  15  grs. ;  leptandrin,  2  scruples  ;  cream  of  tartar,  5  scru' 
pies.     Mix.     Divide  into  10  powders.     One  is  a  dose. 

41.  Comp.  Powder  of  Jalap,  1  oz.;  cream  of  tartar,  1  oz.  Mix.  Ono  te* 
spoonful  is  a  dose,  to  be  taken  in  sweetened  water. 

42.  Pulverized  Charcoal,  \\  drams;  pulverized  rhubarb,  2  scruples;  pul- 
verized ipecac,  6  grains ;  extract  of  hyoscyaraus,  12  grs.  Mix.  Divide  into 
12  portions.     Give  one  every  three  or  four  hours, 

43.  Pulverized  Blood-root,  1  dram  ;  pulv.  rhubarb,  1  dram ;  castile  soap,  2 
scruples.  Mix,  and  divide  into  32  pills.  Take  one  morning  and  night.  Ex- 
cellent for  costiveness. 


766 


rHESCRIPTlONS  -  UKC'Il'ES. 


44.  Jiorhelle,  14  drams;  nuif^nesia,  11  ilrams ;  jiowdcred  charcoal,  8  (Irums. 
Mix,  Dose. — A  heaping  teaspooniul  in  dyspepsia  and  costivencsu,  with  foul 
breath,  etc. 

45.  Pulverized  Mlinkirb,  8  prs. ;  pulv.  guaiacnm,  8  grs. ;  galbanuni,  2  gra. ; 
pulv.  ipecjic,  2  grs.  Mix.  Maiic  8  ])ills.  Take  one  to  two  pills  night  and 
morning.     For  a  weak  Htomach,  and  u  biliouH  condition. 

Tonic   and  Cathartic. 

46.  Podophi/llin,  4  grs.;  loptandrin,  8  grs,;  quinine,  8  gra. ;  ext.  nux  vom- 
ica, 2  gra.    Mix.    Make  10  i)ills.    One,  two,  or  three  pills,  at  bed  time,  accord 
ing  to  the  requirements  of  the  cjise. 

47.  Sulphate  of  Iron,  1  8cru})le  ;  pulverized  aloes,  2  scruples.  Mix,  and 
make  into  20  pills.  One  pill  twice  a  day.  An  excellent  remedy,  in  chlorosis, 
when  the  bowels  are  confined. 

48.  Carbonate  of  Iron,  1  dram ;  pulverized  rhubarb,  ^  dram ;  pulver- 
ized aloes,  ^  dram ;  extract  of  hops,  ^  dram.  Mix.  Make  30  pills.  One  pill 
three  times  a  day. 

49.  Fluid  Extract  of  Senna,  1  dram ;  compound  fluid  extract  of  gentian, 
^  dram  ;  fluid  extract  of  ginger,  ^  dram ;  aromatic  spirits  of  ammonia,  I  dram. 
Mix.     To  be  taken  in  a  wine-glassful  of  sweetened  water. 

50o  Aromatic  Syrup  of  H/mbarb,  1  oz. ;  tincture  of  Colombo,  1  oz.  Mix. 
Dose.  —  Two  teaspoonfuls  three  times  a  day. 

51.  Compound  Infusion  of  Gentian,  6  ozs. ;  epsom  salts,  4  drams ;  diluted 
sulphuric  acid,  16  drops.     Mix.     A  table  spoonful  every  six  hours. 

52.  Blue   Pill,   10  grs.;   pulv.  gum   arable,  5    grs.;    magnesia,  1    dram 
white  sugar,  5  grs. ;  comp.  infusion  of  gentian,  1  ^  ozs. ;  water,  1  ^  ozs. ;  tiiict, 
of  ginger,  1 J  ozs.     Mix.     From  a  teaspoonful  to  a  tablespoonful  to  be  taken 
night  and  morning. 

53.  Pulverized  Peruvian  Dark,  1  oz. ;  pulv.  rhubarb,  J  dram  ;  p''lv.  muri- 
ate of  ammonia,  1  dram.  Mix.  Divide  into  eight  powders.  Take  one  three 
times  a  day. 

54.  Oxide  of  Zinc,  2  drams;  magnes.,  ^  oz. ;  quinine,  1  scruple.  Mix. 
Divide  into  32  powders.     Take  one  four  times  a  day, 

65.  Aloes,  1  oz. ;  gentian,  1  oz. ;  orange  peel,  1  oz. ;  juniper  berries,  1  oz, ; 
aniseed,  bruised,  1  oz, ;  gin,  1  pint.  Mix.  Macerate  two  weeks,  and  strain. 
Dote.  —  A  tablespoonful.     Good  for  bilious  habits. 

Oarminative  Physic. 

66.  Manna,  1  oz. ;  aniseed,  bruised,  1  dram ;  boiling  water,  J  pint.  Mix- 
Let  the  mixture  stand  for  half  an  hour,  then  strain,  and  add  three  drams  of 
carbonate  of  magnesia  so  as  to  make  a  perfect  mixture.  Take  a  wine-glass 
fiiU  every  two  or  three  hours,  till  it  operates.  For  the  drum-head  state  of  the 
bowels. 


57.  Thoroughwort,  2  ozs. ;  ginger  and  cloves,  each,  \  oz. ;  ext,  dandelion, 
4  ozs.;  water,  1^  pints.  Boil  to  one-third,  and  add  sugar,  1^  pounds,  and 
brandy,  J  pint.    An  excellent  cordial  cathartic  to  act  upon  the  liver. 


ruKscim'TioNs.  —  kkcipks. 


767 


Tonics. 

!')H.  Chatnnmile  Flowers,  \  oz. ;  cold  wattT,  I  pint.  Macorat*!  for  one  hour 
uiid  Htrain.     A  wiiic-gliussfiil  to  Xw.  taken  sovt.'ral  tiint's  a  diiy. 

AO.  Sulphate  of  Qiitnine,  lo  grains  ;  dilutctl  ^siilpliuric  acid,  lo  drops ; 
cotiipound  tinctui't'  of  uirdani.,  3  drain.s  ;  linctiirc  of  hops,  li  drams  ;  compound, 
infusion  of  rosos,  ('»  ozs.  Mix.  A  tcaspoouful  two  or  tlin-c  timcsi  u  day,  ia 
calorosis. 

fiO.  Diluted  Sulphuric  Acid,  2  di'ams  ;  syruj)  of  orungn  peel,  2  ozs. ;  c>inn»« 
mon  water,  1  o/..  Mix.  A  teaspounful  or  two  in  a  wiiie<glas8  of  water  two 
jr  liirce  times  u  day. 

61.  Carbonate  of  Iron,  1  dram  ;  extract  of  gentian,  1  dram.  Mix.  Make 
30  pills.     One  pill  two  or  three  times  u  day. 

62.  Sulphate  of  Quinine,  12  grains;  aromatic  sulphuric  acid,  24  drops; 
syrup,  1  oz. ;  peppennint  water,  1  oz.  Mix.  In  intermittent  fever,  take  one 
tJiblesi)oonful  once  in  three  hours.  Ordinarily,  one  teaapoonful  is  a  suificient 
dose. 

63.  Compound  Infusion  of  Gentian^  8  ozs. ;  uitro-muriatic  acid,  30  drops. 
Mix.     Take  one  tablcspoonful  three  times  a  day. 

64.  Bicarbonate  of  Soda,  ^  oz. ;  compound  infusion  of  gentian,  4  ozs.| 
tincture  of  Colombo,  1  oz. ;  syrup  of  orange  peel,  J  oz.  Mix.  Take  a  table- 
spoonful  three  times  a  day. 

65.  Sulphate  of  Quinine,  1  scruple  ;  alcohol,  4  nzs. ;  sulphuric  acid,  fl 
drops  j  Madeira  wine,  1  quart.     Mix.     Two  wine-glassfuls  a  day. 

66.  Rasped  Quassia,  2  dnims  ;  cold  water,  I  pint.  Macerate  twelve  hours, 
and  strain. 

67.  Quinine,  1  scruple ;  alcohol,  4  ozs. ;  sul[)huric  acid,  5  drops.  Mix. 
Take  a  teaspoonful  three  times  a  day. 

68.  Arseniate  (f  Iron,  3  grains ;  extract  of  gentian,  2  drams ;  pulver- 
ized liquorice,  1  dram.  Mix.  Make  20  pills.  Take  one  pill  three  times  a 
day.  If  the  eye-lids  become  inflamed,  discontinue  for  a  few  days,  and  then 
begin  again. 

69.  Soji  Water,  3  ozs. ;  quinine,  10  grains  ;  diluted  sulphuric  acid,  10  drops ; 
simple  syrup,  1  oz.     Mix.     A  teaspoonful  every  two  or  three  hours. 

70.  Quinine,  10  grains ;  diluted  sulphuric  acid,  10  drops ;  white  sugar, 
4  drams  ;  cinnamon  water,  4  ozs. ;  tincture  of  kino,  2  drams.  Mix.  One  tea* 
spoonful  every  three  hours. 

71.  Tartrate  of  Iron,  40  grains  ;  soft  water,  2  ozs. ;  syrup  of  ginger,  ^  oz. 
Mix.    20  to  40  drops  every  three  hours. 

72.  Potassio-tart.  Iron,  4  scruples  ;  quinine,  4  scruples  ;  alcoholic  ext.  of 
black  cohosh,  4  scruples.     Mix.     Make  48  pills. 

73.  Hose  Water,  6  ozs. ;  syrup  of  orange  peel,  1  oz. ;  muriated  tinct.  of 
iron,  1  oz.  Mix.  For  an  adult,  one  teaspoonful  in  a  wine-glass  of  water 
after  each  meal. 

74.  Precipitated  Carbonate  of  Iron,  30  drama }  ext.  of  conium,  15  drams  i 


768 


PRESCRIPTIONS.  —  RECIPES. 


^yrup  of  balsam  of  To)u,  6  ozs. ;  oil  of  cinnamon,  12  drops  ;  oil  of  lemon,  12 
drops  ;  alcohol.  9  ozs. ;  water,  1  pint ;  brandy,  }  pint ;  loaf  sugar,  4  ozs.  Mix. 
Give  from  one  to  three  tablespoonfuls  three  or  four  times     day,  in  insanity. 

75.  Citrate  of  Lon,  1  drani ;  sulphate  of  quinine,  1  scruple  ;  ext.  of  nux 
vomica,  8  grs.     Mix.     Make  32  pills.     One  pill  three  times  a  day. 

7G.  Nitric  Acidy  1  dram ;  hydrochloric  acid,  J  dram  ;  comp.  infusioa  of 
gentian,  1^^  ozs.     Mix.     One  teaspoonful  in  water  is  a  dose. 

77.  Sulph.  Quinine,  1  dram ;  tartaric  acid,  6  gr.s. ;  water,  1  drop.  Mix. 
Make  30  pills.     Dose.  —  One  p'h,  to  be  repeated  as  often  as  needed. 

78.  Diluted  Nitric  Acid,  I  drams ;  diluted  muriatic  acid,  4  drams ;  syrup 
of  orange  peel,  1  dram;  wat'3r,  1^  ozs.  Mix.  One  teaspoonful  in  a  wine 
glass  of  water,  taken  before  meals. 

General  and  Nerve  Tonics. 

79.  Valerianate  of  Quinine,  \  dram ;  ext.  of  black  cohosh,  1  dram ;  ext, 
of  ladies  slipper,  2  drams.  Mix.  Make  60  pills.  Take  one  pill,  every  one, 
two,  three,  or  four  hours,  according  to  the  urgency  of  the  case. 

80.  Iron  hy  Hydrogen,  24  grs. ;  su]|>hate  of  morphia,  1  gr. ;  ext.  of  nux 
vomica,  5  grs.    Mix.    Make  24  pills.     For  an  adult,  one  pill  three  times  a  day. 

81.  Ext.  of  Scullcap,  2  drams  ;  ext.  of  chamomile,  2  drams  ;  ext.  of  boneset, 
1  dram  ;  quinine,  1  dram  ;  pulv.  cayenne,  1  scruj^'e  ;  oil  of  valerian,  ^  dram. 
Beat  well  together  and  make  i)0  pills.  For  an  adult,  one  pill  every  two  or 
three  hours. 

82.  White  Vitrio\  1  dram ;  ext.  of  nux  vomica,  8  grs.  Mix.  Make  32 
pills.     One  pill  three  times  a  day. 

8?.  Strychnia,  2  grs. ;  ext.  of  aconite,  16  grs. ;  ext.  of  hyoscyamus,  16  grs.; 
quinine,  ^  dram.     Mix.     Make  32  pills.     One  pill  three  times  a  day. 

84.  Citrate  of  Iron,  1  dram  ;  trisnitrate  of  bismuth,  1  dram  ;  sulphate  of 
quinia,  1  scruple :  ext.  of  nux  vomica,  6  grs.  Mix.  Make  32  pills.  Take 
one  pill  three  times  a  day. 

Nerve  Tonics  and  Antispasmodics. 

85.  Strychnine,  2  grs. ;  ext.  belladonna,  5  grs. ;  alcoholic  extract  of  hlacl 
cohosh,  2  scruples.     Mix.     Make  40  pills.     One  pill  four  times  a  day. 

86.  Strychnine,  2  grs. ;  diluted  phosphoric  acid,  1  oz. ;  pcnpermint  water, 
8  pints.  Dissolve  the  strychn  le  in  the  acid  ;  then  add  the  peppermint  whIh'. 
A  taijiospoonful  to  be  taken  three  times  a  d'ly,  in  palsy,  dyspepsia,  ncuralgiii, 
and  in  most  states  of  the  nervous  system  rt'<iuiring  tone.  Also  in  fever  and 
ague. 

87.  m^h  Cranberry  Bark,  1  oz. ;  skunk  cabbage  root,  J  oz, ;  sctillcap, 
J-  oz. ;  cardamom  stjeds,  2  drams  ;  pulv.  cayenne,  2  drams.  Put  these  !o  a  pint 
of  wine,  shake  well  every  day  for  three  or  four  days.  A  tablespoonful  four 
times  a  day. 

88.  Distilled  Water,  2  ozs. ;  valerianic  a<!id,  1  oz. ;  subcarbonale  of  am- 
monia t-'nough  to  ncutrali/e  the  acid ;  then  add  alcoholic  ext.  of  valerian,  2 
iicruplf«.    A  teaspoonful  three  times  a  day.     For  Neuralgia. 


».i,*jii, 


'f*r;\!!'>;*i!" 


of  lemon,  12 
4  oza.     Mix. 
insanity. 

;  ext.  of  mix 
.  infusioa  of 


drop.    Mix. 
sd. 

Irams ;  syrup 
il  in  a  wine 


B 


I  dram;  ext 
ill,  every  one, 

1  ext.  of  nux 
B  times  a  day. 

St.  of  boneset, 
irian,  ^  dram,  i 
every  two  or 

X.     Make  32 

imus,  16  grs.; 
lay. 

;  sulphate  of 
piUs.    Take 


tract  of  Nad 
day. 

lermint  water, 
)ennint  water, 
sia,  nouralgiii, 
»  in  fever  and 


oz. ;   scullcnp, 
tlioe  to  a  i>int    I 
i;si)Oonrul  lour 


>onato  of  am- 
of  valerian,  2 


PRESCRIPTIONS.  —  RECIPES. 


769 


89.  Ext.  of  Valerian,  12  grs.;  ext  of  hyoscyamus,  12  gr?. ;  oxide  of 
sine,  21  grs.     Mix.    Make  12  pills.    One  pill  twice  a  day. 

90.  Sulphate  of  Morphia,  2  grs. ;  cyanide  of  potassium,  4  grs. ;  ext.  of 
valerian,  4  grs.     Make  24  pills.     One  pill  three  times  a  day. 

91.  JSxt.  of  Hyoscyamus,  ^  dram;  sulphate  of  morphia,  3  grs.;  strych- 
nine, 2  grs. ;  pulv.  cayenne,  ^  dram  ;  sulphate  of  zinc,  15  grs.  Make  30  pills. 
Take  one  four  times  a  day.     Excellent  in  neuralgia. 

92.  Eri.  of  Hyoscyamus,  ^  dram ;  valerianate  of  zinc,  1  scruple.  Mix. 
Make  30  pills.     Take  one,  two  or  three  times  a  dry,  for  neuralgia  of  the  face. 

93.  Ext.  of  Hyoscyamus,  J  dram ;  valerianate  of  iron,  1  dram.  Mix. 
Make  30  pills.     Give  from  one  to  three  a  day.     F  >r  neuralgia,  in  its  various 

forms. 

94.  Tin:',  of  Black  Cohosh,  2  ozs.;  tinct.  of  skullcap,  2  ozs.  Mix.  One 
tea^poonful  from  two  to  five  times  a  day. 

95.  Alcoholic  Ext.  of  St.  Ignatius's  Bean,  30  grs. ;  pulv.  gum  arable,  10 
grs.     Make  into  40  pills.     Take  one  pill  three  limes  a  day. 

96.  Simple  Syrup,  1  oz. ;  prussic  acid,  1  drop.  Mix.  A  teaspoonful  morn- 
ing and  evening.  If  no  dizziness  or  sickness  is  produced  within  forty-eight 
hours,  repeat  the  dose  three  times  a  day.  This  is  tor  a  child  six  months 
old ;  a** ;  one  drop  more  of  the  acid  for  each  additional  year  of  the  child's  age. 

97.  Comp.  Pill  of  Galbnnum,  1  dram  ;  comp.  pill  of  valerian,  1  dram.  Mix. 
Divide  into  40  pills.     One  oi  two  pilis  three  times  a  day. 

98.  Sulphate  of  Zinc,  1  dram  ;  cyinp.  gulbanum  pill,  J  dram ;  ext.  of 
fycscyamus,  1  scruple.  Mix.  Make  32  pilL.  One  pill  three  times  a  day. 
For  St.  Vitus's  dunce. 

99.  D  oscorein,  12  grs.;  pulv.  camphor,  4  grs.;  pulv.  cayenne,  12  grs.; 
white  sugai,  1  scruple.  Mix.  Divide  into  four  powders.  Give  one  every  15 
minutes. 

100.  Ext.  of  High  Cranberry  Bark,  1  scruple;  cypripedin,  1  scruple; 
aletridin,  1  scruple ;  pulv.  cayenne,  1  scruple.  Mix.  Make  20  pills.  Take 
one  pill  an  how  after  each  meal. 

Alteratives  and  Tonics. 

101.  Iodide  of  Potassium,  1  oz. ;  cojnpound  infusion  of  gentian,  or  infusion 
of  quassia^  6  ozs.  Dose.  —  A  tables|KX)nful,  for  secondary  and  tertiary  syphi- 
lis, and  oth'jr  complaints.     A  teaspoonful  tor  a  child. 

102.  Iodide  of  Iron,  A  dram  ;  compound  tincture  of  nlombo,  1  oz. ;  pure 
water,  7  oz:<.     Mix.     A  tiiblespoonful  three  times  a  day. 

'03.  Syrup  of  Iodide  of  Iron,  1  oz.  Thirty  drops  three  times  a  day,  in 
water.  An  excellpnt  remedy  in  chlorosis,  and  all  other  low  states  of  the  blood 
connected  with  .scrofula. 

Expectorants  and  Cough  Preparations. 

104.  Tartar  Emetic,  1  grain ;  boiling  water,  10  drams.  Mix.  Take  one 
tcaspoonfu' every  two  hours.  . 

97 


=L) 


ill 


,'t:' 


770 


PRESCRIPTIONS  —  RECIPES 


105.  Infusion  of  Senega,  4  ozs. ;  syrup  of  ipecac,  1  dram  ;  syrup  of  squills, 
3  drams  ;  tartar  emetic,  1^  grains.     Mix.     A  tea^spoonful  every  ten  minutes. 

106.  Tincture  of  IjobeUa,  J  oz. ;  syrup  of  squills,  .V  oz.  Mix.  Twenty 
droi)s  four  or  five  times  a  day  for  a  child  two  years  old. 

107.  Peppermint  Water,  G  ozs. ;  epsom  salts,  1  oz. ;  tartar  emetic,  1  grain, 
Mix.     Two  tables{)oonfuls  every  four  hours. 

108.  Hydrocyanic  Acid,  25  drops ;  wine  of  ipecac,  2  drams ;  syrup  of 
tolii,  1  oz. ;  soft  water,  ;}  ozs.  Mix.  A  teaspooiiful  four  or  live  times  a  da,y. 
An  excellent  remedy  in  hooping  cough. 

109.  Tinct.  Blood-root,  1  oz. ;  laudanum,  2  drams  ;  wine  of  ipecac,  4  drams ; 
syrup  of  tolu,  2  ozs.     Mix      Dose  from  30  to  60  dro])s  four  times  a  day. 

110.  Tinct.  Blood-root,  1  oz. ;  sulphate  of  morpliia,  \\  grains;  tinct.  digi- 
talis, \  oz. ;  wine  of  antimony,  i  oz. ;  oil  of  wintergreen,  10  drops.  Mix.  Dose 
from  20  to  40  drops  twice  or  three  times  a  day.  J^xcellent  for  a  hard,  dry 
cough. 

111.  Tinct.  of  Lobelia,  ^  oz. ;  tinct.  of  blood-root,  2  ozs.  -,  oil  of  spearmint, 
}j  dram  ;  molasses,  5  ozs.     Take  one-half  a  teaspoonful  as  often  as  needed. 

112.  Syrup  of  Tolu,  1  oz. ;  syrup  of  squills,  ^  oz. ;  wine  of  ipecac,  2  f.rs.; 
paragoric,  3  drs. ;  mucilage  of  gum  arabic,  Ij-  ozs.  Mix.  Take  a  teaspoonful 
^occasionally. 

1 13.  Tinct.  Blood  Root,  2  drams  ;  syrup  of  tolu,  1  oz. ;  mucilage  of  gum 
arabic,  3  ozs. ;  diluted  hydrocyanic  acid,  40  drops  ;  sulphate  of  morphia,  2  grs. 
Mix.     Dose,  from  one  to  two  teaspoonfuls. 

GarminartiTes. 

114.  Bruised  Cloves,  2  drams ;  boiling  water,  1  pint.  Macerate  for  two 
hours  in  a  covered  vessel,  and  strain.  A  wine-glassful  to  be  taken  occasion- 
ally. 

115.  Comp.  Tinct.  of  Gardamonij  2  ozs.;  comp.  tinct.  of  lavender,  2  ozs.; 
comp.  tinct.  of  gentian,  2  ozs.  Mix.  One  teaspoonful  at  a  time,  as  occasion 
may  require.  ^ 

Narcotics  and  Anodynes. 

116.  Extract  of  Jfyoscyamus,  1  scruple  ;  gum  camphor,  1  scruple  ;  Dover'si 
powder,  1  scruple.  Mix,  and  make  into  20  pills.  Dose.  —  One  twice  a  day, 
for  painful  menstruation. 

117.  Powdered  Camphor,  12  grains;  powdered  castile  soap,  12  grains; 
powdered  opium,  12  grains ;  syrup,  2  scruples.  Mix.  Make  into  12  pills. 
Take  one  every  hour  till  the  effects  of  opium  are  experienced. 

118.  Laudanum,  ^  oz. ;  wine  of  ipecac,  J  oz. ;  spirits  of  nitric  aether,  J  oz. 
Mix.     One  teaspoonful  every  hour,  till  narcotic  effects  are  observed. 

119.  Camphor,  2  drams  ;  chloroform,  1  dram  ;  the  yolk  of  an  egg.  Mix, 
and  rub  together  ;  and  tiien  add,  tinclure  of  opium,  1  oz. ;  aromatic  spirits  of 
ammonia,  1  oz.  Mix  well.  Take  one  teaspoonful  every  hour  until  it  proves 
anodyne. 

120.  Camph  '  ^  dram ;  extract  of  opium,  6  grains ;  muc>lage  of  gum 
arabic^  2  scruples.     Make  10  pills. 


121.  Chloroform,  2  ounces;  compound  sulphuric  ether,  2  ozs. ;  Inudanum, 
2  ozs. ;  tinct.  cayenne,  H  ozs. ;  hydrocyanic  acid,  diluted,  ^  oz.  Mix.  Dose. 
—  Haifa  teaspoonlul  every  three  hours  till  anodyne  effects  are  experienced. 

122.  JUxt.  of  Belladonna,  10  grs. ;  hydrocyanii^  acid,  40  drops;  tinct, 
coiombo,  1  oz. ;  simple  syrup,  1  oz. ;  soft  water,  2  ozs.  Mix.  One  teaspoonful 
three  or  four  times  a  day.  Excellent  in  gastralgia  .and  irritable  dyspepsia. 
Also  in  iisthma. 

123.  £!xt.  of  Belladonna,  6  grs. ;  ])ulv.  ipijcac,  10  grs. ;  confection  of  roses, 
2  grs.     Mix.     Make  (i(>  pills.     Take  1  pill  twice  a  day. 

Diaphoretics   and  Sedatives. 

124.  Tinct.  of  American  Hellebore,  1  dram  ;  tinct.  of  black  cohosh,  2  ozs. 
*  Mix.     Take  one  teaspoonful  from  three  to  six  times  a  day.     I^xcellent  for 

Neuralgia. 

12.*).  Pulverized  Gum  Arabic,  1  scinple  ;  soft  water,  2  ozs. ;  sweet  spiints  of 
nitre,  ^  oz. ;  tinct.  of  verati-um  viride,  20  drops.  Mix.  Give  half  a  teaspoon- 
ful every  half  hour. 

126.  Piilv.  Blood-root,  2  dnuns ;  pulv.  golden  seal,  2  drams ;  pulv.  sumach 
berries,  2  drams ;  pulv.  b.ayberry  bark,  2  drams.  Mix.  Make  an  infusion  in 
a  pint  of  hot  water,  and  give  a  t^iblespoonful  every  half  hour.  To  produce 
perspiration. 

127.  Pulverized  Camphor,  2  grs.,  pitlv.  nitrate  of  potash,  2  grs.;  pulv. 
opium,  1  gr.  Mix.  Make  two  powders.  Take  one  on  going  to  bed,  in 
rheumatism. 

Diuretics. 

128.  Tincture  of  Digitalis,  1  oz. ;  syrup  of  squills,!  oz.  Mix.  Ten 
drops  for  a  child  7  years  old  every  four  hours. 


129.     Nitrate  of  Potassa,  2  scruples ;  water,  1  4^. 
suit 


Mix.     Flavor  to 


130.  Infusion  of  Digitalis,^  ozs.;  acetate  of  potash,  2  di  uus ;  sweet 
spirits  of  nitre,  2  drams;  cinnamon  water,  1^  ozs.  Mix.  A  tables !>oonful 
every  four  or  five  hours. 

131.  Spirits  of  Mindererus,  2  ozs.;  sweet  spirits  of  nitre,  1  oz.  Mix. 
Take  one  teaspoonful  every  three  hours. 

Refrigerants. 

132.  dream  of  Tcrrtar,  2  scruples ;  water,  1  quart.  Mix.  Flavor  to 
suit. 

133.  Bicarbonate  of  Soda,  30  grain-s;  water,  6  ozs.  Mix.  To  this  mix- 
tore  add  25  grains  of  tartaric  acid,  and  tiike  the  whole  foaming. 

Stimulants. 

134.  Muriate  of  Ammonia,  1  oz. ;  soft  water,  9  ozs.  Mix.  Take  one 
table  spoonful  three  or  four  times  a  day. 


if 


i 


IM 


772 


PRESCRIPTIONS.  —  RECIPBS. 


135.  Aromatic  Spirits  of  Ammonia,  2  drams;  ether,  1  dram;  laudaaum, 
20  drops ;  spirits  of  camphor,  1  dram.  Mix.  Half  a  teaspoonfiil  as  often  m 
required. 

Alteratives. 

136.  ProtO'iodide  of  Mercury,  10  grains  ;  extract  of  opium,  5  grains.  Mix. 
Make  20  pills.     Take  one  pill  night  and  morning. 

137.  Biniodide,  of  Mercury,  5  grains  ;  extract  of  conium,  2  scruples.  Mix. 
Make  20  pills.     Take  one  pill  night  and  morning. 

1 38.  Compound  Infusion  of  Sarsaparifla,  1  pint ;  iodide  of  potassium, 
]f  oz.     Mix.     Take  a  teaspoonful  after  each  meal. 

139.  Compound  Infusion  of  Sarsaparilla,  1  pint ;  corrosive  sublimate, 
4  grains.     Mix.     Take  a  teaspoonful  four  times  a  day. 

140.  Compound  Infusion  of  Gentian,  4  ozs. ;  iodide  of  potassium,  \  at. 
Mix.     One  teasi)oonful  after  each  meal. 

141.  Iodide  of  Arsenic,  5  grains ;  soft  water,  1  pint.  Mix.  One  tea- 
spoonful three  times  a  day. 

142.  Blue  Pill,  12  grains;  pulverized  ipecac,  3  grainij ;  extract  of  hyos- 
cyamus,  4  grains.  Mix.  Divide  into  12  parts,  one  to  be  given  every  three 
hours. 

143.  Pulverized  Blood  Root,  1  scruple ;  iodide  of  arsenic,  2  grs. ;  ex- 
tract of  cicuta,  2  scruples.  Mix.  Make  40  pills.  One  pill  three  times  a 
day. 

144.  Iodide  of  Potassium,  1  dram ;  water,  ^  oz.  Mix.  Thirty  drops 
to  a  child  7  years  old,  every  hour. 

145.  Comp.  Syrup  of  StiUingia,  1  pint;  iodide  of  potasi^ium,  1  oz.  Mix. 
A  tablespoonful  after  each  nical. 

146.  Fluid  Ext.  of  Sarsaparilla,  4  ozs.;  fluid  ext.  of  pipsissewa,  1  or,; 
water,  1  quart ;  iodide  of  potassium,  2  ozs.  Mix.  Take  a  tablespoonful  three 
times  a  day. 

1 47.  Bicarbonate  of  Potassa,  3  drams  ;  water,  4  ozs.  Mix.  Add  a  table- 
spoonful  of  the  solution  to  the  same  quantity  of  lemon  juice,  previously  mixed 
with  a  tablespoonful  of  water.     To  be  taken  foaming,  several  ilmes  a  da^ . 

148.  Blue  Pill,  ^  dram;  extract  of  henbane,  1  scruple.  Make  10  pills. 
One  pill  at  night. 

149.  Mercury  with  Chalk,  \  dram  ;  extract  of  conium,  1  scruple.  Make 
into  8  pills.     Take  one  pill  night  and  inurning. 

150.  Corrosive  Sublimate,  4  grains  ;  extract  opium,  5  grains.  Mix,  and 
make  into  20  pills.     Take  one  pill  night  and  morning. 

151.  Iodide  of  Potassium,  1  dram ;  syrup  of  sarsaparilla,  4  ozs.  Mix. 
Take  two  teaspoonfuls  three  times  a  day. 

Astringents. 

152.  Sugar  of  Lead,  2  scruples;  opium,  1  scni,  le;  conserve  of  red  roses, 
1  scruple.  Beat  into  a  mass,  which  is  to  be  divided  into  30  pills.  Take  one 
every  hour,  until  narcotic  effects  are  observed. 


n;  laudaBum, 
nl  as  often  m 


grains.    Mix. 
sruples.    Mix. 

of  potassium, 

live  sublioiate, 

jtassiam,  {  or. 

[ix.     One  tea- 

xtract  of  hyo8- 
en  every  thr^e 

ic,  2   gre. ;  ex- 
1  three  times  a 

Tliirty  drops 

im,  1  oz.    Mix. 

)9i8sewa,  1  o?.; 
espoonful  three 

Add  a  table- 
reviously  mixed 
nes  a  day. 

Make  10  pilk 
scruple.  Make 
rins.  Mix,  and 
4  0Z8.     Mix. 


ve  of  red  roses, 
ilia.    Take  one 


PRESCRIPTIONS.  —  RECIPES. 


773 


n 


153.  Dover's  Powder,  ^  dram ;  prepared  chalk,  1  scruple.  Mix,  and  divide 
into  12  equal  powders. 

154.  Chalk  Mixture,  4  ozs. ;  tinct.  of  catechu,  ^  oz. ;  laudanum,  1  dram. 
Mix.     Dose,  in  diarrhcea,  Lvro  to  four  teaspoonfuls  three  times  a  day. 

155.  Oil  of  Turpentine,  1  dram  ;  mucilage  of  gum  arabic,  1  dram ;  simple 
syrup,  ^  oz. ;  cinnamon  water,  2  ozs.     Mix.     To  be  taken  at  a  draught. 

156.  Sugar  of  Lead,  16  grains;  prepared  chalk,  1  dram;  pulverized  ipecac, 
4  grains ;  pulverized  opium,  2  grains.  Mix.  Divide  into  16  portions,  one  to 
be  given  every  three  or  four  hours.  . 

1 57.  Sugar  of  Lead,  8  grains  ;  vinegar,  8  drops ;  white  sugar,  1  dram  j 
Boft  water,  1  oz.     Mix.     A  teiispouaful  tliree  or  four  times  a  day,  until  thv-?  dis- ' 
charges  are  abatc«l. 

158.  Prepared  Chalk,  ^  dram ;  pulverized  ipecac,  3  grains.  Mix.  Make 
12  powders.     Give  one,  two  or  three  times  a  day. 

159.  Pulverized  Catechu,  2  drams ;  bruised  cinnamon,  ^  dram ;  boiling 
water,  5  ozs.  Steep  in  a  covered  vessel  for  one  hour,  and  strain.  A  teaspoonful 
every  two,  three,  or  four  hours,  according  to  age,  nature  of  tlie  case,  etc. 

160.  Soft  Water,  1  oz. ;  sugar  of  load,  5  grains;  vinegar,  6  drops;  loaf 
sugar,  3  drams.     Mix.     A  teai»poonful  every  hour  or  two. 

161.  Tinct.  of  Catechu,  ^  oz.;  laudanum,  2  drs. ;  spirits  of  camphor,  2  drs.; 
tincU  of  niyrrhae,  2  drs. ;  tinct.  of  cayenne,  2  drs.  Mix.  Dose,  from  half  a 
teaspoonful  to  a  teaspoonful,  for  diarrhoea. 

162.  oyrup  of  Orange  Peel,  1  oz. ;  acetate  of  morphia,  2  grs. ;  tinct  of 
cinnamon,  6  drs. ;  tinct.  cardamom,  2  drs.  Mix.  Dose.  —  A  teaspoonful.  A 
valuable  remedy  in  diarrhoea. 

■^  Counter-irritants. 

1 63.  Tincture  of  Spanish  Flies,  1  oz. ;  olive  oil,  2  ozs. ;  alcohol,  ^  pint. 
Mix.  To  be  applied  externally,  watching  the  effect,  so  as  not  to  produce  a 
blister. 

164.  Water  of  Ammonia,  1  dram;  olive  oil,  1  oz.    Mix.    Apply  to  the  skin. 

165.  Mustard  Poivder,  1  tablespoonful.  Mix  with  a  little  water  to  mike 
a  thick  paste.  Then  spread  upon  a  piece  of  brown  papt;r  or  cotton  cU  th, 
and  cover  its  surface  witli  a  piece  of  thin  muslin  to  prevent  the  mustard  from 
sticking  to  the  flesh.  Place  it  upon  the  sort  or  riainful  part,  and  keep  it  on 
fifteen  or  twenty  minutes,  or  till  a  good  degree  of  r      less  is  produced. 

166.  Vinegar  of  Spanish  Flies,  1  oz. ;  spirits  of  camphor,  1  oz.  Mix. 
To  be  rubbed  gently  upon  the  skin.  If  applied  freely,  and  rubbed  thoroughly 
in,  it  may  protluce  a  blister. 

167.  Yellow  Wax,  Rosin,  Lard,  each,  6  drams.  Melt  over  a  slow  fire,  and 
then  stir  in  slowly,  when  at  a  very  moderate  degree  of  warmth,  1  ^  drams  of 
pulv.  Spanish  flies,  to  make  an  ointment. 

168.  Water  of  Ammonia,  strong,  1  oz. ;  alcohol,  1  oz.  Mix.  Wet  a  piece 
of  cotton  cloth,  and  lay  it  upon  the  painful  part,  and  cover  it  with  flannel  to 
prevent  evaporation. 


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774 


PRESCRIPTIONS.  —RECIPES. 


Ointments. 

169.  Mercurial  Ointment,  1  oz. ;  extract  of  belladonna,  1  oz. ;  extract  of 
henbane,  1  oz. ;  camphor,  10  grains.     Mix.     For  external  use. 

170.  Extritct  of  Belladonna,  J  dram  ;  lard,  ^  oz.  Mix.  To  be  rubbed 
)n  the  neck  of  the  womb  in  painful  menstruation. 

171.  Prussic  Acid,  2  drams  ;  sugar  of  lead,  1  dram  ;  cocoa-nut  oil,  I  oz.j 
lard,  1  oz.     Make  an  ointment. 

172.  Neapolitan   Ointment,  2  drams  ;  extract  of  belladonna,  1  dram.    Mix. 

173.  Extract  of  Pelludouna,  15  grains;  lard,  1  oz.     Mix. 

174.  Sulphurct  of  Lime,  1  dram;  camphor,  in  powder,  1.0  grains;  lard, 
1  oz.     Make  an  ointir.ent. 

175.  Elder-Flower  Ointment,  1  oz. ;  oxide  of  zinc,  1  dram.  Make  an 
ointment. 

176.  Oxide  of  Zinc,  1  dram  ;  spermaceti  ointment,  1  oz.     Mix. 

177  Napthaline,  2  scruples ;  lard,  1  oz.  Make  an  ointment.  To  be 
epread  upon  linen,  and  applied  to  the  diseased  skin  night  and  morning. 

178.  Mild  Nitrate  of  Meroiry  Ointment,  3  drams  ;  sugar  of  lead,  16  grains; 
rose-water  ointment,  1  oz. 

179.  Laudanum,  \  dram  ;  sulphur,  \  dram  ;  oxide  of  zinc,  1  dram  ;  oil  of 
almonds,  1  oz. ;  lard,  3  ozs.     Make  an  ointment. 

180.  on  re  Oil,  4  ozs.;  white  wax,  2  drams.  Melt  these  together,  and 
then  add  honey,  2  drams  ;  croton  oil,  20  drops. 

181.  Elder-Mower  Ointment,  1  oz.  •,  pulverized  blue  vitriol,  1  scruple. 
Make  an  ointment. 

182.  Purified  Beeves^  Marrow,  or  lard,  6  drams ;  oil  of  sweet  almonds,  2 
drams  ;  pulverized  Peruvian  bark,  1  dram.     Mix. 

183.  Pulverized  Sulphate  of  Copper,  10  grs ;  extract  of  Spanish  flies,  5 
grs. ;  lard,  1  oz.     Mix.     Rub  into  the  scalp. 

184.  Iodide  of  Lead,  1  dram ;  lard,  2  ozs.  Mix.  To  be  rubbed  on  the 
surface. 

185.  Iodide  of  Potassium,  1  dram ;  lard,  2  ozs.     Mix. 

186.  Basilicon  Ointment,  1  oz. ;  red  precipitate,  1  dram.     Mix. 

187.  Iodide  of  Potassium,  ^  dram ;  lard,  1  oz.     Mix. 

188.  Veratria,  4  grs. ;  lard,  5  drams.     Mix. 

189.  Tobacco  Leaves  (fresh  and  sliced),  10  ozs.;  diluted  acetic  acid,  4  pintaj 
basilicon  ointment,  13  ozs.  Boil  the  tobacco  in  the  acid,  strain,  and  evaponite 
the  decoction  to  six  ounces.  Add  this  to  the  basilicon  ointment,  heated,  and 
stir  till  cold.     For  gathered  breasts. 

Liniments. 

190.  Sweet  Oil,  1  oz. ;  strong  water  of  ammonia,  1  o«.  Mix.  To  be 
rubbed  on  with  a  piece  of  flannel. 


PRESCR'  PTIONS.  —  RECIPES. 


775 


191.  Lime    Water,  2  ozs. ;  flax  seed  oil,  2  ozs.     Mix.     Apply  outwardly. 

192.  Olive  Oil,  1  oz. ;  solution  of  potassa,  2  drams ;  strong  mercurial 
ointment,  1  dra"n.     Mix. 

193.  Oliv;  Oil,  4  ozs. ;  oil  of  amber,  2  drams  ;  oil  of  rosemary,  2  drama. 
Mix. 

194.  Spirits  of  Turpentine,  1  oz. ;  linseed  oil,  1  oz. ;  lime  water,  1  oz. 
Mix.     For  ext(,'rrial  u<it. 

195.  Oil  of  Hemlock,  2  drams;  oil  of  origanum,  1  dram;  camphor,  1  dram; 
opium,  1  dram  •;  iilcoliol,  4  ozs.     Mix. 

196.  Soap  Liniment,  2  o^.s. ;  chloroform,  1  dram.     Mix. 

197.  Tincf.  of  Aconite-root,  ^  oz.;  o|>ium  liniment,  J  oz.  Mix.  For  neu 
ralgia,  etc.     Apply  a  tea-spoonfnl  to  the  painful  part. 

198.  White  Sonp,  12  o7s.  ;  camphor,  G  ozs. ;  oil  of  rosemary,  1^  ozs. ;  alco- 
hol, 4  pints  ;  opium,  3  ozs.  Mix  and  filter.  An  excellent  liniment,  acting 
at  times  like  a  charm  in  the  removal  of  local  pains. 

199.  Sulphuric  Acid,  1  dram ;  spirits  of  turpentine,  1  dram  ;  olive  oil, 
3  drams.  Mix  the  oil  and  spirits  of  turpentine  flrsi,  then  gradually  add  the 
■sulphuric  acid.  A  valuable  liniment  for  chilblains.  To  be  rubbed  on  two  or 
three  times  a  day. 

Washes.  Lotions,  Gargles,  etc. 

200  Bruised  White  Oak  Bark,  1  oz. ;  water,  1  \  \ym\s.  Boil  down  to  a 
pint,  and  strain.     To  be  used  as  a  wash. 

201.  Borat"  \>f  Soda  or  Borax,  2  drams ;  water,  4  ozs.  Mix.  To  be  used 
as  a  lotion. 

202.  Alum,  2  drams  ;  water,  4  ozs.     Mix.     To  be  used  as  a  lotion. 

203.  Tannin,  1  scruple  ;  water,  4  ozs.     Mix.     For  external  use. 

204.  Bihorate  of  Soda,  \  oz. ;  rose  'vater,  6  ozs. ;  sulphate  of  morphia, 
6  grains.     Mix.     To  be  used  as  a  wash  in  itching  of  the  female  privities. 

205.  <yhlorinated  Soda,  1  oz.;  water,  12  ozs.  Mix.  Rinse  the  mouth  with 
it  two  ov  three  times  a  day,  but  do  not  swallow. 

207.  Hose  Water,  5  ozs  • ;  sugar  of  lead,  8  grains  ;  sulphate  of  zinc,  8  grs. 
Mix. 

208.  Rose  Water,  4^  -azs. ;  nitrate  of  silver,  2  grains.     Mix. 

209.  Sulphate  of  Zinc,  8  g;ains;  t^^innin,  1  scruple;  water, 5  ozs.     Mix. 

210.  Chloride  of  Zinc,  6  grains  ;  soft  water,  2  ozs.     Mix. 

211.  Nitrate  of  Silver,  10  grains ;  soft  water,  1  oz.     Mix. 

212.  Corrosive  Sublimate,  5  grains;  soft  water,  1  pint.     Mix. 

213.  Alcohol,  1  pint;  soft  soap  of  potash,  1  pint.  Dissolve  and  filter,  then 
add  oil  of  citron,  1  oz.  Mix.  It  will  answer 'a  good  purpose  if  the  oil  of 
citron  be  omitted.  ' 

214.  Nitrate  of  Silver,  2  scruples  ;  nitric  acid,  12  drops  ;  soft  water,  1  oz. 
Mix.     Apply  with  a  piece  of  lint  tied  to  the  end  of  a  stick. 


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776 


PRESCRIPTIONS.  —  RECIPES. 


215.  Copperas,  1  oz. ;  soft  water,  1  pint.     Mix. 

216.  Alcohol,  1^  ozs. ;  rose  water,  4  ozs.     Mix. 

217.  Corrosive  Sublimate,  6  grains ;  spirits  of  rosemary,  1  oz. ;  alcohol, 
1  oz. ;  emulsion  of  bitter  almonds,  6  ozs.     Mix. 

218.  Solution  of  Sugar  of  Lead,  12  drops ;  laudanum,  1  dram ;  water,  4  ozs. 
Mix.     To  be  applied  externally  only. 

219.  Nitrate  of  Silver,  1^  drams  ;  soft  water,  1  oz.     Mix. 

220.  White  Vitriol,  1  dram  ;  rose  water,  3  ozs.     Mix.     Apply  outwardly. 

221.  Hydrocyanic  Acid,  4  drams;  sugar  of  lead,  15  grains;  alcohol,  4 
drams  ;  water,  7  ozs.     Mix.     Apply  externally. 

222.  Corrosive  Sublimate,  5  grains  ;  almond  mixture,  ^  pint.  Mix.  Apply 
externally. 

223.  Rose  Water,  4  ozs. ;  pulverized  borax,  J  oz. ;  sulphate  of  morphine^ 
6  grains.     Mix.     To  be  applied  to  the  parts  many  times  a  day. 

224.  Sugar  of  Lead,  2  drams ;  laudanum,  1  dram ;  soft  water,  |  pint 
Mix.     For  external  use. 

225.  Corrosive  Sublimate,  5  grains ;  cologne,  2  ozs. ;  soft  water,  6  ozs. 
Mix.     For  external  use  only. 

226.  Acid  Nitrate  of  Mercury,  1  dram ;  soft  water,  4  ozs.  Mix.  Apply 
every  second  day. 

227.  Sugar  of  Lead,  3  grains ;  soft  water,  1  oz.  Mix.  As  a  wash  in 
inflammation  of  the  mouth  in  infants. 

228.  Mucilage  of  Gum  Arabic,  1  oz. ;  syrup  of  orange  peel,  J  oz. ;  chloride 
of  lime,  15  grains.     Mix. 

229.  Decoction  of  Peruvian  Bark,  3  ozs. ;  syrup  of  orange  peel,  1  oz. ; 
chloride  of  soda,  1  oz.     Mix. 

230.  Creosote,  4  drops ;  mucilage  of  gum  arable,  J  oz. ;  camphor  water, 
8  ozs.     Mix. 

231.  Vinegar,  1  dram ;  alcohol,  3  drams  ;  simple  syrup,  1  oz. ;  water,  3  ozs. 
Mix. 

232.  White  Oak  Bark,  1  oz. ;  water,  1  pint.  Boil  away  one  quarter,  and 
strain ;  then  add  alum,  1  scruple.  Apply  to  the  parts  with  a  soft  spoage,  or 
dossil  of  lint,  several  times  a  day. 

233.  Hydrochloric  Acid,  J  dram;  honey,  1  oz. ;  rose  water,  1  oz.  Mix, 
Apply  three  or  four  times  a  day. 

234.  Sulphate  of  Copper,  ^  dram ;  soft  water,  1  oz.  Mix.  To  be  ap" 
plied  twice  a  day  to  the  ulcers  in  gangrene  of  the  mouth. 

235.  White  Vitriol,  1  dram  ;  soft  water,  2  drams.  Mix.  Then  add  honey, 
2  drams  ;  tincture  of  myrrh,  2  drams.  To  be  applied  twice  a  day  to  the  ulcers 
in  gangrene  of  the  mouth. 

236.  Creosote,  1  dram ;  alcohol,  1  dram.  Mix.  To  be  applied,  vAth  a 
camel's  hair  pencil,  to  the  gangrenous  ulcers  of  the  mouth  after  running  a 
lancet  through  the  sloughs. 

237.  Acid  Nitrate  of  Mercury,  ^  dram  ;  soft  water,  1  oz.  Mix.  To  be  in- 
iected  into  the  throat  with  the  shower  syringe,  or  applied  to  ulcers  with  a  pencil 


PBESCRIPTIONS. — RBCIPX8. 


777 


Mix.    For  external 


Tincture  of  Arnica,  ^  oz. ;  cold  water,  4  ozs.    Mix.     For  external 


Blood-root,  2  ozs. ;   solution  chloride  of  Soda,  2  ozs. ;   tinct. 
Mix. 


998.    Sm$    Water,  4  ozs. ;  sugar  of  lead,  2  drams.     Mix.     For  extenml 

uqe. 

239.    Eote  Water,  2  ozs. ;  sugar  of  lead,  1  scruple. 
use. 

240. 
use. 

241.  Tinct. 
henbane,  2  ozs. 

242.  Bucket  of  Warm  Water ;  cayenne  pepper,  pulverized,  1  tablespoonful ; 
ground  mustard,  2  tablespoonfuls.     Mix.     As  a  foot  bath  in  suppression,  etc. 

243.  Chlorate  of  Potash,  J  oz. ;  strong  hydrochloric  acid,  40  drops  ;  water, 
1  pint.  Mix.  An  excellent  wash  for  chronic  fetid  ulcers,  —  soon  converting  a 
foul  ulcer  to  a  healthy-looking  one.     A  good  gargle. 

244.  Powdered  Golden  Seal,  1  dram ;  powdered  cranesbill,  1  dram  ;  pow- 
dered witch-hazel  bark,  1  dram.  Mix.  Pour  upon  these  half  a  pint  of  boiling 
water.  Let  them  stand  till  cold.  To  swab  an  ulcerated  throat  in  scarlet  fever, 
and  for  other  purposes. 

245.  Pulv.  Cayenne,  1  dram ;  salt,  1  dram  ;  boiling  water,  1  gill.  Mix,  and 
let  them  stand  fifteen  minutes.  Then  add  one  gill  of  vinegar.  Let  them  stand 
an  hour,  and  strain.  Put  a  teaspoonful  in  a  child's  mouth  once  an  hour,  in  ma- 
lignant scarlet  fever. 


Injections. 

246.  Castor  Oil,  1  gill ;  pulv.  cayenne,  10  grs. ;  molasses,  1  gill ;  table 
salt,  1  teaspoonful ;  warm  water,  1  pint.     Mix. 

247.  Senna  Leaves,  2  drams.  Steep  in  a  pint  of  water.  Then  add  one 
ounce  of  epsom  salts,  and  strain.  A  quarter  of  this  may  also  be  taken  as  a 
brisk  purge. 

248.  Castor  Oil,  2  ozs. ;  tinct.  prickly  ash  bark,  J  oz. ;  comp.  tinct.  of 
Virginia  snake  root,  2  drams ;  infusion  of  boneset  and  senna,  equal  parts,  ^  pint. 
Mix. 

249.  Castor  Oil,  1  oz. ;  salts  of  tartar,  ^  oz. ;  warm  water,  1  pint.     Mix. 

250.  Epsom  Salts,  1  oz. ;  senna  leaves,  ^  oz. ;  pulv.  cayenne,  10  grs.; 
boiling  water,  1  pint.  Let  the  water  stand  upon  the  senna  and  cayenne  15 
minutes.     Then  pour  it  oiF,  and  add  the  salts. 

251.  Thoroughwort,  1  oz. ;  senna,  1  oz. ;  lobelia,  ^  dram ;  cayenne,  10 
grs. ;  epsom  salts,  1  table-spoonful ;  molasses,  ^  pint ;  boiling  water,  1  pint. 
Make  a  strong  decoction  of  the  herbs,  and  then  add  the  salt  and  molasses. 

252.  Wine  of  Ipecac,  1  oz. ;  spirits  of  turpentine,  1  oz. ;  castor  oil,  1  oz.; 
molasses,  J  pint ;  warm  water,  ^  pint.     Mix. 

253.  Flax  Seed  Tfea,  ^pint;  laudanum,  40  drops.     Mix. 

254.  Nitrate  of  Silver  Crystals,  10  grains ;  corrosive  sublimate,  5  grs.  i 
sugar  of  lead,  1^  drams ;  white  vitriol,  1^  drams;  soft  water,  6  ounces.  Mix. 
An  injection  for  certain  forms  of  whites,  etc. 

255.  Bruised  Galls,  ^  oz.  ,*  two  large  poppy  heads ;  water,  1  pint  Boil  a 
quarter  of  an  hour,  and  strain.     For  piles. 

98 


l-M 


778 


PRESC'UirTIONS  —  UECIPES. 


256.  Common  Suit,  1  oz. ;  chamomile  flowers,  ^  oz. ;  pulv.  aloes,  1  dram. 
Boil  the  chamomile  and  aloes  five  minutes,  in  one  pint  of  water,  then  strain,  and 
add  the  salt. 

Hair  Oils,  Washes,  etc. 

257.  Cologne,  2  ozs. ;  tincture  of  Sj)anish  flies,  2  drams  ;  oil  of  rosemary, 
10  drops;  oil  of  lavender,  10  dro])s.  Mix.  Apply  cjiutiously.  If  sorenerts 
of  the  scalp  is  produced,  omit  for  a  short  time. 

258.  Castor  Oil,  2 J  pounds;  strongest  alcohol,  2 J  pints;  '.iv.  Spanish 
flies,  J  oz. ;  oil  of  bur^amot,  2^  ozs. ;  otto  of  roses,  20  drops.  Mix.  liet  thorn 
Btand  for  a  few  days,  and  filter.  A  superior  i)reparation  for  keeping  the  hair 
from  falling,  and  to  prevent  dandruff". 

259.  Tinct.  Benzoin,  miiip.,  2  drams  ;  tinct.  Spanish  flies,  2  drams  ;  cistor 
oil,  6  ozs. ;  oil  burgamot,  1  dram;  oil  of  cassia  or  verbena,  lo  drops;  strong 
alcohol,  1)J  ozs.     Mix.     As  a  hair  wash,  better  even  than  tlie  above. 

260.  Slaked  Lime,  2  drams ;  bicarbonate  of  soda,  3  drams  ;  lard,  2  ozs. 
Mix. 

261.  Slaked  Lime,  1  oz. ;  bicarbonate  of  potassa,  2  ozs. ;  charcoal  in  pow- 
der, 1  dram.  Mix.  Apply  to  the  parts,  and  wash  ort'  when  dry.  Keep  in 
well  stopped  bottles. 

262.  Slewed  Lime,  4  ozs.;  orris  powder,  IJ  ozs.  Mix.  Apply  to  the 
parts,  and  wash  off"  when  dry. 

263.  Spanish  White,  ^  pound ;  litharge,  ^  pound ;  slaked  lime,  ^  pound. 
Mix.  Pulverize  in  a  mortar.  To  be  kept  dry.  When  used,  mix  with  water 
to  a  paste  the  thickness  of  cream.  Spread  on  the  hair  and  lay  over  it  a  wet 
cloth  over  night. 

264.  Sulphur,  1  oz. ;  sugar  of  lead,  1  oz. ;  rose  water,  4  ozs.  Mix.  A[>- 
ply  to  the  hair. 

265.  Nitrate  of  Silver,  1  dram ;  nitric  acid,  1  dram ;  soft  water,  1  pint ; 
sap  green,  3  drams ;  pulverized  gum  arable,  1  dram.    Mix.    Keep  well  corked. 

266.  Hydrosulphuret  of  Ammonia,  1  oz. ;  liquor  potassa,  3  drams ;  soft 
water,  1  oz.  Mix.  Apply  this  with  a  tooth  brush  15  or  20  minutes.  Then 
brush  the  hair  over  with  the  following :  —  nitrate  of  silver,  I  dram ;  soft  water, 
2  ozs. ;  using  a  clean  comb  to  separate  the  hair. 

Miscellaneous. 


Wine  of  Spurred  Rye,  2  ozs.     Dose.  —  One  teaspoonful  three  times 
For  profuse  menstruation  from  a  relaxed  state  of  the  womb. 


267. 
a  day. 

268.  Sulphate  of  Iron,  1  dram;  sub-carbonate  of  potash,  1  dram.  Mix, 
and  make  into  38  pills.  One  pill  twice  a  day,  and  gradually  increasing  to  four 
a  day,  in  chlorosis. 

269.  Sulphate  of  Iron,  1  dram ;  extract  of  hops,  15  grains ;  extract  of 
poppies,  15  grains ;  oil  of  cinnamon,  15  drops.  Mix,  and  make  into  24  pills. 
One  pill  two  or  three  times  a  day. 

270.  Oxide  of  Zinc,  2  drams ;  ezt  of  cicuta,  2  scruples.  Mix.  Make 
48  pills. 


PRESCRIPTIONS.  —  RECIPES. 


779 


Mix.    Make 


271.  Pulverized  Savin,  1  scruple;  sulpliate  of  copper,  1  scruple.  To  bo 
sprinkled  on  veiiereul  lumps  or  tumors,  called  condylomutu,  on  the  i'emule  geni' 
tills,  or  elsewhere. 

272.  lialsam  of  Copaiva,  1  oz. ;  oil  of  cubebs,  2  drams ;  laudanum,  1 
dram  ;  mucilaj^e  of  gum  arable,  2  ozs, ;  swet;t  spirits  of  nitre,  \  oz. ;  compound 
spirits  of  lavender,  .'{  drams  ;  camphor  water,  4  ozs. ;  white  sujjiir,  2  drams  ; 
oil  of  partridge-berry,  a  drops.  .Slix.  Take  a  table-spoonful  tliree  or  four 
timiis  a  day.     For  gonorrlui-a. 

27.'3.  liahttin  of  Cnpaira,  1  oz. ;  pidverized  onbebs,  2  ozs.  ;  essence  of  pefv 
permitit,  •'{()  drops.     Make  a  thick  paste,  like  doiigli. 

27 1.  Pulverized  Borax,  1  oz. ;  pulverized  white  sugar,  1  oz.  Mix.  A  little 
to  be  dissolved  on  the  tongue. 

27.>.     Pulverized  Borax,  J  o?,. ;  honey,  4  ozs.     Mix. 

276.  Ifi/ilrochloric  Arid,  1  drain  ;  honey,  1  oz.  Mix.  For  touching  large 
curdy  palciies  in  -oie  mouth  of  ciiildren. 

277.  Pulverized  Ipecac,  3  grains  ;  precipitated  sulphur,  2  scruples  ;  extract 
of  hyo/cyainus,  (>  grains.  Mix.  Drvide  into  12  parts.  One  to  be  taken  every 
three  or  four  hours. 

278.  Pulverized  Belladonna-root,  5  grains  ,  compound  ipecac,  jiowder,  10 
grains  ;  precipitated  sulphur,  J,  dram  ;  white  sugar,  2  scruples.  Mix.  Make 
20  i)owd«M's.     One  every  three  hours  to  a  child  two  years  old. 

279.  Pulverized  Alum,  2.5  grains  ;  extract  of  cicuta,  1 2  grains  ;  syrup  of 
red  poppies,  2  drams  ;  spearmint  water,  3  ozs.  Mix.  A  dessert-s[»oonful  every 
six  hours  for  a  child  two  or  three  years  old. 

280.  Camphor,  1  dram  ;  sulphuric  ether,  1  oz.  IMix.  Ten  drops  every 
half  hour. 

281.  Pulverized  Rhubarb,  1  scruple ;  mercury  with  chalk,  10  grains ; 
aromatic  powder,  5  grains.  Mix.  Divide  into  10  powders.  One  every  four 
or  five  hours. 

282.  Pulv.  Blood-root,  i  to  1  oz, ;  chloride  of  zinc,  J  to  2  ozs. ;  water, 
2  ozs.     Add  enough  wheat  Hour  to  make  a  paste  as  thick  as  molasses. 

283.  Sal.    Volatile,  ^  dram  ;  camphor  water,  1  oz.     Mix. 

284.  Tinct.  of  Nux  Vomica,  \  oz. ;  tinct.  aconite,  2  drams ;  volatile  tinct. 
of  guaiacum,  2  drams.     Mix.     Thirty  drops  every  three  hours. 

285.  Tinct.  af  Black  Cohosh,  2  ozs, ;  tinct.  of  digitalis,  2  drams.  Mix. 
One  teaspoonful  from  two  to  five  times  a  day. 

28fi.  Barberry  Bark,  1  oz. ;  pipsissewa  herb,  2  ozs. ;  wild  cherry  bark,  1 
oz. ;  bitter-root,  1  oz.  Mix.  Infuse  for  sevci'al  liours  in  4  pints  of  water 
One  tablespoonful  three  or  four  times  a  day. 

287.  Horse  Radish  Root,  1  oz. ;  bayberry  bark,  1  oz- ;  barberry  bark, 
1  oz. ;  wild  cherry  bark,  1  oz. ;  prickly  ash  bark,  1  oz.  Reduce  tl\e  whole  to  a 
coarse  p»-wder,  and  infuse  for  several  hours  in  4  pints  of  cider.  A.  tablespoon' 
ful  three  or  four  times  a  day. 

288.  Mercury,  95  parts;  balsam  of  storax,  48  parts  ;  diacalon  plaster,  312 
parts;  wax,  rosin,  turpentine,  each,  16  parts;  ammonia,  bdellium,  eac>>.,  5  parts; 
olibanam  and  myrrh,  each,  5  parta ;  saffiron,  3  parts ;  spirits  of  kvender,  2  parts. 
Mix,  and  spread. 


780 


PRESClilPTIONS.  —  RECIPES. 


m 


■% 


289.  Populin,  20  grs. ;  sanguinarin,  10  grs. ;  pulv.  white  sugar,  80  gra. 
Rub  well  together,  and  divide  into  16  powders.  Take  one  four  times  a  daj. 
At  the  same  time  use  prescription  73. 

290.  Ptelein,  24  grs. ;  hydrastin,  24  grs. ;  ext.  of  belladonna,  3  grs. ;  ext. 
of  nux  vomica,  2  grs.     Mix.     Make  24  pills.     Take  one  three  times  a  day. 

291.  Strychnia,  2  grti. ;  ptilv.  cantharides,  4  grs.;  pulv.  arnica  leaves, 
1  dram.     Mix.     Divide  into  32  powders.     One  to  be  taken  three  times  a  day. 

292.  Wine  of  Colchicum  Seeds,  1  oz. ;  fluid  ext.  of  dandelion,  1  oz.     Mix 
One  tcaspoonful  three  times  a  day. 

293.  Willow  Bark,  1  oz. ;  boiling  water,  1  pint.  Boil  for  ten  minutes,  and 
strain.     Dose.  —  A  wine-glass  full  once  in  three  hours. 

294.  Canada  Balsam,  1  dram  ;  Hlaked  lime,  1  dram.  Mix,  to  form  a 
paste.     An  excellent  remedy  for  tooth  ache,  when  pressed  into  ilm  cavity. 

295.  Ttn?t.  Black  Cohosh,  1  oz. ;  iodide  of  potassium.  2  drams;  syrup  of 
ipecac,  1  oz. ;  spring  v/ater,  2  ozs.  Mix.  A  tcaspoonful  tiiree  or  four  times  a 
day,  in  rheumt^tism  and  cell-dropsy. 

296.  Tinct.  jJinfk  Cohosh,  1  oz. ;  tinct.  myrrh,  6  drams ;  laudanum,  1 
dram  ;  tinct.  cayeiuie,  1  dram.  Mix.  Take  30  or  40  drops  lour  times  a  day, 
for  dropsy. 

297.  Solution  Chloride  of  Soda,  6  drops ;  water,  2  ozs.  Mix.  To  be 
taken  at  a  draught.  A  sure  remedy  for  offensive  breath  from  deranged  stom- 
ach. 

298.  Cream  of  Tartar,  ^  o*. ;  fresh  lemon  peel,  bruised,  4  ozs. ;  Loaf 
sugar,  4  ozs. ;  boiling  water,  3  pints.     Mix,  and,  after  standing  a  while,  strain. 

299.  Citric  Acid,  ^  dram  ;  bi-carbonate  of  potassa,  ^  dram ;  lemon  syrup, 

1  oz. ;  soft  water,  6  ozs. ;  epsom  salts,  1  oz.     Mix.     Two  table  spoonfuls,  to  be 
repeated  every  four  hours,  if  necessary. 

300.  Hard  Wood  Ashes,  1  quart";  common  soot,  ^  gill ;  water,  6  pint's. 
Digest,  settle,  and  lilter.  Take  one  tablespoonful  three  times  a  day,  in  acidity 
of  stomach. 

301.  Peppermint  Water,  1^  ozs;;  wine  of  colchicum-root,  ^  oz. ;  sulphate 
o>'  morphia,  1  gr. ;  magnesia,  1  scruple.  Dose.  —  One  tcaspoonful  three  or 
four  times  a  day.     Excellent  for  rheumatism. 

302.  Cream  of  Tartar,  1^   ozs. ;    sulphate   potassa,  J  oz. ;   pulv.  squills, 

2  drs. ;  tartar  emetic,  2  grs.     A  tcaspoonful  of  this  mixture  to  be  taken  four  or 
five  times  a  day,  in  dro])sy. 

303.  Pulv.  Alum,  ^  dram ;  white  precipitate,  1  grain.  Rub  these  well  to- 
gether, and  place  the  powder  in  a  bottle ;  then  add  1  ^  drams  of  glycerine. 
Shake  the  bottle  until  the  mixture  is  of  the  consistence  of  cream,  and  repeat  the 
shaking  whenever  it  is  about  to  be  applied  to  the  skin.  For  external  use  in 
erysipelas. 

804.  Copaiva,  5  drams ;  yolk  of  one  egg ;  gum  of  extract  of  opium,  one 
grain ;  water  7  ounces.  Mix.  To  be  used  as  an  injection  several  times  a  day  in 
gonorrhoea. 

305.  Tannin,  3  grains  ;  ext.  belladonna,  |  grain  ;  ext  coniura,  2  V  grains ; 
infusion  of  senna,  3  ozs. ;  fennel  water  and  syrup  of  marshmallow,  each  1  }j  oz». 
liix.  A  tablespoonful  to  be  taken  every  two  hours,  in  chronic  bronchitis,  and 
otiier  complaints. 


I  minutes,  nnd 


PRR8CRIPTI0NS.— RRCIPR8. 


781 


306.  Glycerine,  1  drain ;  tannin,  1  dram.  Dissolve  the  tannin  in  the  f^ly- 
cerine.     Excellent  for  sore  nipples,  and  for  chaps  and  excoriations  generally. 

307.  Collodion,  1  oz. ;  Venice  turpentine,  ^  oz. ;  castor  oil,  2  drams.  Mix. 
To  be  applied  outwardly,  for  chilblains  and  chaps.  For  cancer,  manganic  acid. 
Not  as  painful  as  other  caustics. 

308.  Sulphate  of  Coftper,  2  grains;  wine  of  opium,  1  dram;  soft  water  2 
drams.  Mix.  Apply  freely  with  a  soft  camel  hair  brush,  three  times  a  day,  for 
purulent  ophthalmia. 

309.  Pure  Acetic  Acid,  2  drnms ;  soft  water  3  ozs. ;  simple  syrup,  3  drams. 
Mix.  A  tcaspoonful  is  to  be  taken  every  three  hours,  in  scarlet  fever,  at  the 
!<ame  time  using  sheet  baths  with  tepid  water. 

310.  Compound  tincture  of  Peruvian  Hark,  4  ozs. ;  citrate  of  iron  44  grains ; 
citric  acid,  20  grains.  Dissolve  the  citric  acid  in  the  tincture,  and  then  the 
citrate  of  iron.     After  a  few  days,  filter.     Dose,  one  to  two  teaspoonfuls. 

311.  No.  1.  Gallic  acid,  10  grains;  dissolve  in  alcohol,  2  drams;  water,  6 
drama.  No.  2.  Crystals  of  Nitrate  of  Silver,  J  dram ;  water  J  oz.  Dissolve 
and  add  strong  liquor  of  ammonia,  till  it  becomes  clear  ;  then  add  powdered  gum 
ambic,  and  dilute,  if  necessary,  to  6  drams.  This  will  color  black  ;  to  color 
brown,  reduce  it.  An  excellent  hair-dye.  Use  the  common  directions,  where 
there  is  a  No.  1  and  No.  2. 

312.  Epsom  Salts,  2  drams  ;  magnesia,  1  scruple ;  syrup  of  ginger,  1  dram  ; 
spearmint  water,  11  drams.  Mix.  To  be  taken  at  a  draught.  This  will  \w 
r(!tuined  by  the  stomach,  when  most  other  things  are  rejected. 

313.  Diluted  Nitro- Muriatic  Acid,  2  drams  ;  sweet  spirits  of  nitre,  2  drams ; 
simple  syrup,  h  oz.,  water  7  J  ozs.  Mix.  Two  tablespoonfuls  are  to  be  taken 
thrive  times  a  day.     E.xcellent   in  dyspepsia,  with  nasty  tongue,  and  inactive 

liver. 

314.  Hose  Leaves,  1  scruple;  boiling  water,  8  ozs.;  diluted  nitric  acid,  2^ 
Jrums.     Mix.     After  standing  half  an  hour,  strain,  and  use  as  a  wash  for  ul<«rs. 

315.  White  Vitriol,  1  dram  ;  water,  1  pint.     Mix.     To  be  used  as  a  wash  for 

ulcers,  etc. 

316.  Citrate  of  Iron  and  Strychnine,  1  dram ;  syrup  of  orange  peel,  2  ozs. ; 
soft  water,  ^  pint.  Mix.  Give  one  teaspoonful  three  times  a  day  in  neuralgia, 
and  in  other  cases  in  which  a  nerve  tonic  is  needed. 

317.  Aloes  and  Soap  Pill,  10  grains.  Divide  into  two  pills  ;  or,  compound 
pill  of  aloes,  10  grs.    Divide  into  two  pills. 

318.  Compmtnd  Colocynth  PHI,  2  J  scruples  ;  castilc  soap,  9  grs. ;  oil  of  aniae^ 
2  drops.     Mix,  and  make  12  pills.     Two  to  be  taken  at  bed-time. 

319.  Compound  tincture  of  Senna,  2  drams;  epsom  .salts  2  drams  ;  diluted 
sulphuric  acid,  8  drops  ;  spirits  of  nitric  ether,  J  dram  ;  infusion  of  rhubarb,  10 
drams.     Mix.     To  be  taken  at  a  draught. 

320.  Sulphate  of  Iron,  2  grs. ;  epsom  salts,  2  scruples  ;  diluted  sulphuric  acid, 
10  drops ;  compound  tincture,  1  dram  ;  .syrup  of  poppies,  1  \  drams ;  pimento 
water,  9  drams.     To  be  taken  at  a  draught  twice  a  day. 

321.  Pulverized  Rhubarb,  12  grains ;  carbonate  of  magnesia,  10  grains  ;  arO" 
matic  spirit  of  ammonia  J  dram ;  syrup  of  ginger,  1  dram ;  spearmint  water,  10 
drams.     Mix.     To  be  taken  at  a  draught. 

322.  Comp.  infusion  Senna,  5  drams;  infusior.  rhubarb,  5  drams;  comp 


(•  I 


783 


PRESCRIPTIONS.— RKCIPKS. 


tincture  panlamom,  J  dram  ;  syrup,  1^  drama.    Mix.   To  be  taken  at  a  draught, 
by  dyspeptic  )>ers<>iis. 

32.'».  Carlxmafe  of  Soda,  10  prs. ;  aromatic  spirit  of  ammonia,  \  dram  ;  tinc- 
ture ol"  ornnjre  peel,  1  driuu  ;  syrup  of'oranfj*'  peel,  1  dram  ;  <'onipound  infusion 
of  geiilian,  JO  drams.     Mix.     To  be  taken  at  a  draught  twice  a  day. 

<VJ.l.  Trtsjii Irate  of  /sis»in//i,  1  dram;  romp,  frajiieantli  pow<ler,  2  drams; 
oom|)ouri(l  lineture  eardanioni.  \  ounce;  tincture  of  f/it.;j:er.  \  ounce;  spearmint 
water,  7  ounces.   Mix.   Two  labl«'sp(K)ntuls  to  be  taken  twice  a  day,  in  dyspepsia. 

.321.      Tn'sni'ddfr  of  /iisniut/u  it  fjrs.  ;  bicarbonate  of  sotia,  (!  grains;  piilxcr- 
ized  cayenne,  I  jrrain.     Mix,     This  (pnuitiiy  to  Ijo  taken  twice  a  day  in  <lyspi  p 
»a,  with  acidity  of  the  stomach. 

'J25.  Soliillon  of  Acclafe  of  Ammonia,  \  ounce  ;  tincture  of  oran;ie  peel,  1 
dram ;  syrup  of  orange  peel,  1  dram  ;  tincture  of  <'ayenne,  20  dro(>s  :  comp.  infu- 
sion of  orange  peel,  (>  dr  ins.  Mix.  The  whole  to  be  taken  to  relieve  head- 
ache, after  intoxication. 

326.  Matfiicsiiu  J;")  grains;  solution  of  potassn»,  1/)  drops  ;  comp.  tincture  of 
senna,  1  dram  :  »'on.p.  infusion  of  senrui,  (!  drams  ;  syrup  of  ginger,  1  dram ; 
comp.  iniiision  of  orange  peel,  \  ounce.  Mix.  TaJien  at  a  draught,  tus  an 
aperient,  in  sick  and  billions  headaches, 

327.  Aromatic  Spiri'f  of  Ammomn,  1  dram  ;  tincture  of  columbo,  1  dram  ; 
infusion  of  columbo,  10  drams  ;  syrup  of  poppies,  1  dram.  Mix.  To  be  tak("i> 
ttt  n  draught,  three  times  a  day. 

328.  Diluted  Snlphima  Acid,  15  drops  ;  diluted  hydrochloric  aciu,  10  dropn , 
tincture  of  orange  i)ei'K  1  dram;  ccmip.  infusion  of  gentian,  (5  drams;  syrup  ot 
poppies,  1  dram.  To  be  taken  at  u  draught,  thi-ee  times  h  day,  half  an  hour 
before  meids. 

329.  Diluted  Nitric  Acid,  12  drops  ;  diluted  hydrochloric  acid,  8  drops;  in- 
fusion of  cascarl:a,  11  drams;  i?yrup  of  poppies,  1  dram.  Mix.  To  be  taken 
at  a  dniught,  twice  a  day. 

330.  Jilue  Pill,  4  gr,s. ;  comp.  pill  of  rhubarb,  4  grs. ;  ext.  hyo.scyamus,  2  grs. 
Mix.     Make  two  pills ;  one  pill  to  be  taken  at  night. 

331.  Ext.  //y'Mcyrr/rt?(,i(,  2 ^  grs, ;  pulv.  camphor,  2)^  grs.  Mix.  Make  tv.-'> 
piilfi ;  one  to  be  taken  when  the  pain  is  most  severe,  in  nervous  headache, 

332.  Comp.  Trafjacanth  Pmvder,  8  grs. ;  oil  of  lemon,  3  drops ;  camphor 
water,  11  drams;  (>omp.  tinct.  cirU*duniom,  J  dram  ;  tinct.  hyoscyamus,  .J  dranr 
chloroform,  \h  <lrops.     Mix. 

333.  Tinct,  Hyoscijumns,  \  dmm ;  aromatic  spirit  of  amr-ofiia,  \  dram  ;  synip 
of  orange  peel,  ^  drum  ;  peppermint  water,  10  drams.  Mix.  In  nervous  and 
hysterical  cases. 

334.  Soap  Liniment,  2J  ozs, ;  liquor  ammonia,  \  di. ;  laudanum,  i^  oz.  Mix 
Make  a  lininiont. 

335.  Comp.  Pill  of  Colocynth,  7  grs, ;  ext.  of  colchicum,  2  grs. ;  o'\  of  ciini 
way,  1  drop,     Mi\,  and  make  two  pills.     To  bt^  taken  at  bod-time  in  rhcumuiic 
headaches. 

336.  Chloride  of  Zinc,  6  ozs, ;  pulv,  bloo<lro'<t,  2  ozs. ;  myrtle  wax,  I  o/  . 
water  of  «xtriu-t  of  opiuiu,  (>  dramH  ;  uxtravi.  of  cunium,  6  dranu.  Mix,  and 
make  an  ointment. 


PRESCRIPTIONS —UKCIPES. 


783 


S37.  Iodide  uf  Lead,  \  scrupli; ;  glycerine,  1  drain;  spermaceti  ointment,  2 
ozr..    Make  an  ointment. 

;{.'iS.  Rh^dmrb  Pidr.,  ^  oz. ;  spcarinint  hcih,  piilv.  \  oz. ;  nulv,  eascarilla,  \ 
(I/..;  piilv.  liiviiilionale  of  polassa.  .^  oz. ;  piilv.  wild  clicrry  lia  "a,  .',  oz. ;  .Mix, 
iiiid  pour  on  out"  qiiurl  of  iiol  water.  Let  liiis  stand  till  told,  and  add  half  a 
pint  of  bi-andy.     Dose  lialf  a  wineglassful. 

.'5311.  Ext.  licllddonua,  f>  {.'rains  ;  pulv.  iperac.  10  ;^rains  ;  confection  of  roses, 
2  jrrain*.     JMix.     Make  .'JO  pills,  one  pill  to  Ix-  taken  twice  a  day. 

.'MO.  JJioscorcin,  1 2  {xrains ;  ])ulv.  ca:n|)hor,  i  <2;rains ;  pnl v.  cayenne,  1 2  prain.s ; 
white  sugar,  1  scniitle.  Mix.  Divide  into  tour  powders.  Ciive  one  every  fifteen 
minutes. 

.'iH.  Leptandriiu  12  ^'rains  ;  geranium,  12  grains  ;  mj.icin,  12  grains.  Mix. 
Divide  into  twelve  powders,  of  wliich  one  may  be  given  three  or  four  times  a 
(lay. 

312.  Quinine,  },  dram;  pulv.  catechu,  1  dram  ;  pulv,  opium,  15  grains.  Mix. 
Make  32  pills.     Give  one  pill  three  times  u  day. 

343.  Compound  Syrup  of  Rhulxirb  and  Potassa,  4  ozs. ;  tincture  of  prickly 
a<h  berries,  I  oz. ;  essence  of  peppermint,  1  dram  ;  paregoric,  4  drums.  Mix. 
A  lablespoonful  shouhl  be  given  every  hour  until  it  operates  gently  on  the 
bowels. 

344.  Puh\  Camphor,  j^  dram  ;  pulv.  opium,  Ifi  grains  ;  pulv.  cayenne,  \  dram. 
Mix.     Make  10  pills  ;  one  every  hour,  in  cholera. 

345.  Rhubarb,  4  ozs. ;  black  cohosh  root,  2  ozs. ;  wild  ehorry  bark,  2  ozs. ; 
giTanium,  2  ozs.,  coarsely  powder  them,  and  mix.  Add  two  pints  of  brandy 
and  two  pints  of  water.  Let  the  mixture  stand  five  or  six  days,  stirring  often, 
and  then  strain.  Add  fotir  pints  of  water  to  the  dregs,  boil  slowly  to  two  pints, 
rtniin,  and  a<ld  to  this  Uie  previous  tincture.  Sweeten  with  loaf  sugar.  Take 
a  tablespotmful  every  one,  two,  or  three  hours. 

34'>.  Be(h  Hoot,  1  oz. ;  geranium,  I  oz. ;  blackberry  root,  1  oz. ;  wild  cherry 
bark,  1  oz.  ;  cinnamon,  1  oz,  Powder  the  whole,  and  add  to  them  1  i  pints 
brandy,  and  1  ^  pints  water.  Let  them  stand  s  veral  dayS;  stirring  frequently. 
Add  sweetening  if  preferred.  Dose.  One  or  two  teaspoonfuls  t"very  two  or 
three  hours. 

347.  Rnspbernf  Leaves,  1  oz. ;  geranium,  1  oz. ;  blackberry  rw.j,  1  oz. ;  lep- 
taiulra  root,  I  oz.  Mix,  and  nuike  three  pints  of  strong  decoction.  Dose.  A 
♦eii.«poonful  every  hour.     Suitable  for  a  gargle. 

348.  Su(/ar  of  Ljcad,  24  grains ;  vinegar.  1  dram  ;  syrup  of  poppies,  1 
oz. ;  rosM  water,  3  ozs. ;  soft  water,  4  ozs.  Mix.  Dose,  one  or  two  table- 
!=|Hxmfuls 

349.  Pjaasio-tnrtrate  of  iron,  ^  oz. ;  syrup  of  orange  peel,  1  oz.  ;  water,  t 
oz,     Mix.     Take  two  teaspoonfuls  three  times  a  day. 

350.  Geranium,  golden  seal,  marshmallow,  wilil  indigo  root,  rosemary,  each 
half  an  ounce.  Mix,  and  make  mie  pint  of  strong  infusion.  After  straining, 
will  two  drams  powdered  borax,  and  one  gill  of  honey.  An  excellent  astringent 
gargle. 

351.  Dover's  Powder,  \5  grains:  leptandrin,  5  grains.  Mix.  Divide  into 
ten  powders.     One  every  three  hours,  for  a  child. 


784 


PBESCKIPTIONS— Ri:CII'ES. 


35^.  Dover's  Pmoder,  15  grains  ,  calomel,  5  grains.  Mix.  Divide  into  ten 
powders.     Give  one  every  three  hours  to  a  child  in  croup. 

353.  Hydrochlorntf.  of  ammonia,  \  oz. ;  diluted  acetic  acid,  \  oz, :  alcohol,  \ 
oz. ;  camphorated  mixture,  15  oz.«.  Mix.  A  good  scattering  wash  for  hydro- 
cele, etc. 

351.  Chloride  of  soda,  nitrate  of  potash,  and  hydrochlorate  of  ammonia, 
equal  parts,  and  water  enough  to  dissolv*  *^esu.  Mix.  An  excellsnt  freeaing 
mixture. 


Divide  into  ten 


CONCLUSION  OF 


HOMCEOPATHIC    REMEDIES. 


ORGANS  OF  CIRCULATION. 


Thb  heart,  its  appendages  and  valves;  the  pericaidium,  or  membrane 
tliat  covers  the  heart ;  the  nerves  that  are  distributed  to  the  organ,  as 
well  as  tlie  arteries  and  veins, 

lion. 


are  embraced  in  the  organs  of  circula- 


L 


Inflammation  of  the  Heart.  —  Endocarditis. 

When  a  sharp  pain  is  sometimes  felt  in  the  region  of  the  fifth  rib,  with 
quick  pulse,  Hushed  face,  and  hurried  respiration,  there  are  indications  of 
Endocarditis.  Aconite  in  the  usual  dose  niiiy  he  given  every  hour  until 
the  frequency  of  the  pulse  is  diininished ;  Vend,  vin'de,  if  Aconite 
fails  to  reduce  the  ])ul.so  in  twcntv-four  hours.  If  (ho  disease  has 
boon  brought  on  I)v  .i  shock  oi  injiny,  Anii'ra;  if  from  excessive 
griof,  T'jnnlui ;  if  from  cold,  Ai'scnicuta;  if  it  is  the  se(|Uol  of  in- 
llauunutory  rh(!umalism,  Pulsatilla;  if  the  disoaso  terminates  in 
dropsy  of  the  pericardium  or  chest.  Apis  mellijica.  Let  the  diet  be 
simple,  and  easy  of  digestion. 

Inflammation  of  the  Pericardium. — Pericarditis. 

Acute  Inflammation  of  tlio  pericardium  is  denoted  by  symptoms 
much  the  same  as  those  attendant  on  Endocarditis,  and  may  be  brought 
on  by  a  cold,  a  sudden  check  ol'  perspiniiion,  or  simultaneously  with  a 
sudden  attack  of  inflammatory  rheumatism.  Aconite  repeated  every  hour. 
Pnhatilla  or  Dryoma  may  follow  in  the  usual  dose,  and  be  repeated 
every  hour  until  a  change  occurs.  Tim  jjoricardium,  l)ciug  a  serous 
nieiid)rano,  is  liable  to  u  profuse  collection  of  scrum  alxxit  the  heart. 
Apis  mellijica  in  the  usual  dose  every  two  hours  will  bo  likely  to  give 
relief;  Anncijnuin  and  Ilellehnrus  nig.  are  also  reuuMlics  that  maybe 
cm|)loyed  in  curing  this  troul)le.  If  the  heart  i)alpitates  severely, 
give  Pulsatilla  or  i)ifjifalis.  Diet  simple  and  nutritious,  and  free 
tVom  any  exciting  stimulants. 

Chronic  Inflninniniioii  of  the  Perlcardiinn  has  similar  symptoms, 
but  not  so  severe.  It  often  attends  Uw.  gout,  and  is  treated  with  the 
same  remedies.  Colchicum  \:i  a  valuable  remetly,  and  may  be  given 
throe  times  a  day,  in  usual  doses.     Sulphuv  is  often  useful. 

Chronic  Pericarditis  may  sometimes  be  cured  by  Calcarea  or  Lycoj^o- 
dium.  Aurum  muriaticum  and  ISpigelia  are  called  into  re(][utsition  when 

. 786 


>€    I' 


\i     <s 


^      •  .1  * 


1 

I 

, 

■  jl 

■   ,'l 

I 

■i 

% 

'^ 

i'V 

1 

786 


ORGANS  OF  CJIRCULATION 


there  is  irregularity  of  the  heart's  action,  Arsenicum  when  there  is  a  burn- 
ing sensation  accompanying  the  pain.  Diet,  if  the  stomach  will  bear  it, 
may  be  quite  generous. 

Dilatation  of  the  Oavities  of  the  Heart. 

This  trouble  is  manifest  from  a  more  perceptible  action  of  the  heart, 
than  is  normal ;  its  motion  bein<;  more  violent.  Lache»is  when  there  is  a 
(lis|)osition  to  sigh  ;  Belladonna  if  there  is  a  tendency  of  blood  to  the  head ; 
Digitalis  if  there  is  ii  quick,  full  pulse  ;  or  Vcrnt.  tu'rido;  Aconite  \i 
there  is  fever  ;  PaUatilla  if  there  is  rhoiunati.siii  t)f  the  joints  at  the 
same  time. 


Imperfect  Action  of  the  Valves  of  the  Hearb. 

A  difficulty  such  as  this  is  not  denoted  by  any  one  set  of  symptoms ; 
but  it  may  give  rise  to  various  sufferings,  such  as  fainting,  rush  of  blood 
to  the  head,  apoplexy,  and  convulsions.  Fainting  requires  Pid»atilla^ 
China,  Bryonia,  and  Ithus.  Rush  of  blood  to  the  head,  Belladonna  ;  apo- 
plexy. Aconite,  Belladmna,  and  cold  application  to  the  head ;  convulsions 
require  Cliamomilla,  Belladonna,  HyoBcyamus,  and  Digitalis.  Whichever 
remedy  is  selected  may  be  given  every  half-hour  until  relief  is  obtained, 
or  change.  Spasmodic  pains  about  the  heart  from  bome  sudden 
exciteniont,  Gelsemium, 

Aneurism  of  the  Aorta. 

This  is  a  rupture  of  some  of  the  coats  of  the  great  artery,  and  which 
80  weakens  the  rest  that  they  looo  their  tenacity,  and  bulge  out  so  as 
to  impair  its  function.  It  often  is  very  painful,  and  pulsates  in  u 
frightful  manner.  Aconite^  Bryonia,  Digitalis^  Zinc,  Lachesia,  and 
Rhus  tox.  are  remedies  that  may  bo  consulted.  Either  will  reliev  , 
under  certain  conditions.  The  usual  dose  may  be  repeated  every  two 
hours. 

Inflamination  of  the  Arteries  may  bo  relieved  by  the  persistent  use 
of  Aconite,  and  inflammation  of  the  veins  by  Phoupkorus,  Ilamaw- 
lis,  or  Rhus  tox.  Arteritis  and  Phlebitis  are  both  formidable  diseases, 
and  require  the  attendance  or  care  of  a  physician. 


"1 


DISEASES  OF  THE  URINARY  ORGANS. 


The  urinary  apparatus  includes  tlie  bladder  and  kidneys,  and  their 
appendages,  all  of  which  are  subject  to  infiainmation. 

Inflammatioii  of  the  Bladder.  —  Cystitis. 

When  urination  becomes  painful  and  difficult,  and  the  orifice  of  the 
bladder  seems  to  l)o  insufficient  for  voiding  the  urine,  we  have  indi- 
cations of  inflammation  of  the  bladder;  and  also  when  there  is 
frequent  inclination  to  urinate,  with  ability  to  pass  but  little  at  a 
time.  Aconite  may  be  given  at  first  if  fever  attend  the  difficulty; 
Belladonna  might  follow  Aconite  if  there  should  be  any  congestion  ; 
Cantharis,  however,  is  one  of  th(!  best  remedies,  if  there  is  tenes- 
mus or  straining.  Cannabis  saliva,  also,  is  a  good  nuneily,  and 
with  old  peo})lo  Arsenicum  is  often  beiielicial.  It  is  well  to  drink 
mucilaginous  drinks,  and  subsist  mostly  on  gruel,  until  the  severe 
symptoms  subside.  All  this  trouble  may  pass  from  the  acute  to  the 
chronic  form  of  the  disease,  and  be  an  entailed  dilHculiy.  The  best 
way  to  prevent  it  is  to  have  the  lirst  acute  stage  well  attended  to. 
The  frequent  desire  to  urinate,  which  we  sometimes  find  in  aged 
persons,  may  bo  due  to  chronic  inflammation  of  the  neck  of  the 
bladder.  /Sulphur,  given  every  niglit,  may  mitigate  the  disease 
materially ;  and  so  also  a  decided  beiu^fit  njay  be  gained  from  the 
use  of  Conium  rnuculaium.  The  same  diet  found  beneficial  for  the 
acuto  form  of  this  disease  will  be  found  beneficial  for  the  chronic. 

Strangury. 

This  affection  consists  in  being  unable  to  void  the  urine,  and  is 
believed  to  be  the  result  of  inflammation  of  the  neck  of  the  bladder, 
or  some  mechanical  pressure  ui)on  the  urethra.  It  often  proves  to 
be  quite  painful,  and  attended  with  fever.  Aconite  may  bo  given 
every  hour  when  the  skin  is  hot,  dry.  and  feverish,  oi  ^Spirits  of 
Camphor  in  drop  doses  every  twenty  minutes  until  relieved.  Ilyos- 
cyamus,  if  the  stoppage  appears  t(»  be  unattended  with  fever; 
Uantharis,  if  there  is  an  inettectual  urging  to  urinate ;  and  Can- 
nabis, also,  when  there  is  inal>ility  to  evacuate  the  bladder.  Doso 
and  udmlnistration,  four  globules  every  hour. 

787 


if, 


788 


DISEASES  OF  THE   URINABT  OBOiWSr 


'■(>  ■■  ,•■■. 


ili 


1  -fi 


T'>*j:^i|v'" 


Stone. 

When  one  is  voiding  urine,  and  some  obstacle  to  its  passage  suddenly 
interferes,  and  the  stream  is  cut  short,  we  ma}'  infer  that  a  stone  lias  inter* 
posed  at  the  orifice  of  the  bladder.  The  symptoms  are  like  those  of 
strangury.  Oftentimes  there  is  pain  in  passing  urine,  inclination  to  pass  it 
often,  and  straining  to  keep  tlie  stream  flowing.  Against  the  ill  effects  of 
stone  in  the  bladder,  Cantharis  or  Cannabis  are  among  the  prominent 
remedies.  Lycopodiuniy  Cakarea,  and  Phosphorus  are  also  good  remedies. 
The  two  remedies  first  named  niuy  be  given  in  drop  doses  every  hour,  and 
the  three  lost  only  tliree  times  u  day.  The  patient  should  driuk  soil  water, 
and  live  upon  a  moderate  non-mcdi 'final  diet,  avoiding  malt  and  distilled 
liquors  as  a  beverage. 

This  is  indicated  by  violent,  cutting,  intermittent  pains  in  the  region  of 
one  or  the  other  hip  and  kidney,  extending  down  the  ureter  to  the  groin 
cc  down  the  thigh,  frequent  but  scanty  urine,  fever,  and  nausea.  The  most 
iseful  remedies,  in  tlm  order  of  their  importance,  are  Uva  ursi,  Belladonna, 
Chamomilla,  and  NUrum,  repeated  often. 

Retention  of  Urine. 

This  difHculty  results  from  fever  or  some  local  irritation,  and  consists 
simply  in  disinclinatiun  to  evacuate  the  bladder,  not  from  inability  on  ac- 
count of  inflammation,  or  some  obstruction,  but  because  tliere  is  an  irre- 
sistibly pronencss  to  retain  the  urinary  secretion,  either  from  nervous 
weakness  or  spasm  of  tiie  neck  of  tlie  l)lad(ler.  The  remedies  found  most 
nseAil  are  Cina,  iSpif/clia,  Jl;/osc,i^amus,  Belladonna,  and  Rhus  tax.  Kitlier 
of  these  may  be  given  and  repeated  until  the  patient  is  relieved.  Ihfoscy" 
amus  and  Gina  are  preferable.     With  old  people,  Arsenicum  or  Secale. 

Suppression  of  Urine. 

In  some  fevers  the  kidneys  do  not  perform  tiieir  ofliee,  and  tlie  urinar}' 
secretion  is  suppressed  and  tlirown  back  upon  the  system  ;  and,  as  a  conse- 
quence, the  blood  fails  of  being  defecated,  and  the  result,  in  a  sliort  time, 
must  prove  quite  disastrous.  A  dose  of  Sulphur  may  sometimes  overcome 
tliis  ditliculty,  and  set  tlie  organs  of  secretion  at  work.  Baptisia,  Nitrum, 
PulnaJilla,  Bryonia,  Rhus,  Cautharin,  and  any  of  the  remedies  that  act 
spedtically  upon  the  renal  region,  will  be  lilcely  to  afford  relief.  Tlie 
n'nu'dies  may  be  repeated  every  two  hours,  and  the  diet  should  be  muci- 
iuginous  drinks. 

Incontinence  of  Urine. 

Some  persons  cannot  help  urinating  at  once  as  soon  as  the  ])ladder  fills. 
Their  incontinence  becomes  uianifeHt  when  no  opportunity  oilers  for  im- 
mediate resort  to  the  water-closet,  and  in  many  instances  l)econie.s  painfully 
mortifjang.  and  rendi'rs  the  victim  an  olyect  of  8\  inpatliy.  Munmrius 
vious  may  be  given  in  tha  usual  <lose.  three  times  a  day.  If,  aft(>r  a  trial 
of  a  few  (lays,  the  patient  is  not  improved,  give  Opium,  China,  Calcarea, 
Causticum,  and  Svdphur  in  the  same  way. 

Wettinfif  tlie  Bed.  —  Nocturnal  Enuresis. 

Childrcin  addicted  to  this  habit  from  some  diseased  condition  maj'  be  cured 
by  <laily  doses  of  Sulphur,  or  Carbo  animalis,  or  perhaps  Silicea,  or  Caustic^'tn. 


But  some  children  get  the  habit  and  become  confirmed  in  it  from  no  phys* 
ical  cause  whatever ;  and,  if  no  measures  are  taken  to  reform  them,  tiiey 
will  grow  up  under  the  impression  tiiat  they  cannot  help  it.  The  best 
way  to  treat  such  is  to  impress  upon  them  that  they  can  and  must  banish 
the  habit.  Let  them  be  impressed  even  to  shame  and  a  threat  of  chastise- 
ment if  they  keep  up  the  practice  ;  and,  in  most  cases,  this  is  all  that  if 
necessary. 

Diabetes.  —  Immoderate  Floio  of  Sweet  Urine. 

Tliero  is  no  disoase  that  resists  more  stubbornly  the  action  of  remedicfl 
than  Diabetes.  It  consists  in  a  copious  secretion  of  sweet  urine,  tiiut  con- 
f;  'lis  many  jfrains  of  solid  material  passing  away  from  the  tissue:)  every 
twenty-four  hours.  This  disease  will  emaciate  a  fleshy  subject  in  six  weeks, 
and  jfive  him  a  pale  and  sickly  look.  The  disease  has  been  ])aliiated,  hut 
never  cured  pi-rnianently  that  we  find  any  record  of;  and  yaX.  Phuaphorlc 
add,  <fiven  three  times  a  day,  has  diminisiied  the  amount  of  the  seeretion 
iVotn  twelve  to*  two  (piarts  in  twenty-i'our  hours  ;  and  a))partutly  this 
remedy,  with  Nitrate  of  uraniu/it,  has  ellecteil  tem|)orary  cure.!.  Muri- 
atic- a".id.  Sulphur,  and  Kali  carb.  have  also  been  cstconied  a.s 
valuable  remedies,  all  of  which  may  be  given  in  th<3  usual  doses,  three 
times  a  day. 

Bloody  Urine. 

As  gravel  is  believed  to  be  one  of  the  causes  of  this  difficulty,  and  in- 
flammation of  the  bladder  is  believed  to  be  another,  the  same  remedies 
ai>plicable  to  the  one  will  serve  for  the  other.  Arsenicum  may,  however,  be 
added  to  the  remedies,  particularly  if  there  is  any  burning  at  the  neck 
of  the  bladder  and  tenesmus. 

Inflammation  of  the  Sidneys. 

When  there  is  pain  in  the  back,  and  increased  flow  of  urine,  and  a  desire 
to  urinate  frequently,  and  sometimes  severe  pain  in  the  hip  and  side, 
nausea,  vomiting,  and  fever,  there  is  undoubtedly  inflammation  of  Ibc 
kidneys.  In  the  treatment  of  this  painful  ditliculty,  we  find  ^'  'ica 
the  best  remedy  if  the  inflammation  has  been  j)roduccd  by  a  mechan- 
ical injury.  If  from  a  cold,  Jihns  tax.  or  JV^ux  vomica.  If  there  is 
much  fever.  Aconite;  chilliness  down  the  spine,  JMhidoitua.  When 
there  is  obstinate  vomiting.  Bismuth.  The  patient  should  lie  in  bed, 
and  not  try  to  exercise  much  till  the  inflammation  passes  off.  The 
medicine  should  be  given  every  hour  or  two  hours,  according  to  the 
Hcverity  of  the  inflammation. 


'  >ffl 


>r'-, 


i        ' 


6^ '      **     J.  s. 


M 


DISEASES  OF  THE  ORGANS  OF  GENERATIOIT. 


Tm?  organs  of  generation  in  the  male  are  the  penis,  testes,  and  tlioir 
Appendages.  Those  of  the  female  are  the  vulva,  vagina,  womb,  ovaries, 
and  their  appendages. 

Inflammation  of  the  Urethra. 

The  urethra  is  the  common  passage  through  which  the  urine  passes  from 
the  bladder,  and  the  semen  from  tlie  testes.  AVhen  it  becomes  intiaraed 
from  cold,  or  as  the  sequel  of  some  acute  disease,  Pulsatilla,  Cannabis, 
Mercurius  viv.,or  Sulphur  may  cure  the  dillioulty  by  being  given  every  two 
or  three  hours.  One  remedy  only  must  be  given  ;  if  this  fails,  try  another; 
but  if  the  disease  is  the  result  of  impure  connection,  and  is  the  ( Jonorrhrea 
(or  Clap),  give  Cantharia,  and  afterwards  Catuiahitt.  If  there  is  painful 
smarting,  give  these  remedies  every  hour  in  alternation  until  the  disciiargo 
ceases.  Give  Pulsatilla,  also,  every  hour,  if  the  other  remedies  fail,  aud  use 
a  solution  of  Ilamamdis  in  water  as  an  injection. 


Syphilis. 

Nearly  allied  to  (lonorrhoca  is  Syphilis  ;  only  tl- .  latter  is  a  more  formi- 
dable result  of  impure  connection,  wliich  inoculat  the  blood,  it  becomes 
manifest  in  discliarge  from  tlie  urethra,  chancres,  uboes,  etc.  When  there 
is  a  purulent  discharge  from  tlie  uretlira,  Mercurius  viv.  may  bo  given  per- 
sistently for  several  days,  and  this  may  arrest  the  further  progr<>ss  of  the 
disease ;  but  sliould  it  not,  and  ciiaiicrcs  make  their  appearance  on  the 
prepuce  or  foresliiii,  or  on  the  glans,  burn  them  witli  Nitric  acid,  full 
strength  of  the  stores,  aud  tlinn  give  Mercurius  corrosivua  every  six  hours 
for  several  days;  dressing  tiie  sores  with  lint  wet  with  cold  water  ami 
Cah'uihda.  If  the  cliancrcs  heal,  it  is  well  and  good  •  if  th»!y  do  not.  give 
Mercurius  indalus  tlirce  times  a  day.  Let  the  patient  avoid  drinking  uiiy 
intoxicating  beverage  whatever,  and  abstain  from  all  niediciual  articles  of 
diet. 

Inflammation  of  the  Testicles. 

Sometimes  a  suppression  of  Gonorrhoja  will  cause  inflammation  and 
swelling  of  the  testicles.  Both  may  bo  implicated,  and  become  exceedingly 
painful  and  enormously  swollen.     For  the  first  stage  before  the  swelling, 

790 


DISEASES  OF  THE  ORGANS  OF  GENERATION. 


791 


Aconite  may  be  given  erary  two  hours  to  reduce  tlie  general  febrile  condi- 
tion of  the  system.  Afterwards  Arnica  may  be  given  to  remove  the  sore- 
ness, and  Pulsatilla  to  remove  the  swelling.  Either  of  these  remedies 
may  be  given  every  day,  three  times,  until  the  object  for  which  they  are 
given  is  accomplisiied.  Let  the  patient  lie  in  bed,  and  apply  warm  com- 
presses to  tht  part.  Let  Him  subsist  upon  a  spare  diet,  and  drink  no 
exciting  drinks.  Let  him  wait  with  patience  for  a  subsidence  of  the 
swelling  and  inflammation. 

Dropsy  of  the  Scrotum.  —  Hydrocele. 

Sometimes  inflammation  of  the  testes  will  result  in  Hydrocele,  and  the 
scrotum  will  become  tilled  with  water,  ffelleboriis  nifj.,  Apia  mel.,  and 
Arsenicum  are  remcdips  that  have  been  employed  to  cure  the  difficulty ; 
but  sometimes  remedies  prove  unavailin<2;,  and  tijo  water  has  to  bo  drawn 
off  by  a  trochar,  in  which  event  consult  an  experienced  surifeon.  But 
try  the  remedies  first,  and  give  each  named  in  succession  (provided  the 
first  or  second  does  not  prove  effectual),  every  three  hours  during  the  day. 


Inflammation  of  the  Yulva. 

This  may  occur  from  acrid  Leucorrhoeu,  or  cold,  or  from  Gonor- 
rhoea ;  and,  from  whatever  cause,  it  recpiircs  the  application  of  warm 
water  and  compresses,  and  a  dose  of  Aconite  or  Belladonna  every 
hour  until  relieved. 


Inflammation  of  the  Vagina. 

The  vagina  is  lined  by  a  mucous  membrane,  which  sometimes  becomes 
inflamed ;  and  when  from  a  cold,  producing  an  ordinary  catarrh,  give 
Nux  vomica  or  Sulphur,  night  and  morning,  until  better.  If  from 
chronic  irritation  of  the  membrane  tiiere  is  a  Leuchorrhoeal  discharge 
from  the  vagina,  give  Sepia  night  and  morning.  If  this  fails,  give  Calci- 
rea  carb.  ;  and,  if  this  fiiils,  give  Sulphur  in  the  same  way.  Leucorrlioea 
may  be  occasioned  by  falling  of  tlie  womb,  which  irritates  the  mucous 
membrane  of  the  vagina,  in  which  event  Sepia  or  Nux  may  be  given 
every  night,  with  full  prospect  of  a  cure. 


Inflammation  of  the  Wombi 

This  painful  malady  is  often  the  result  of  protracted  labor,  and  is 
known  by  great  thirst,  pain  over  the  region  of  the  womb,  and  great  ten- 
derness of  the  touch.  Arsenicum,  given  every  three  hours  at  first,  and 
followed  by  Belladonna,  generally  j)roves  successful ;  but  Bryonia  and 
Rhus  tax.  or  Verat.  viride  may  be  resorted  to,  and  repeated  every 
three  hours,  if  found  necessary.  Inflaniiuation  of  the  womb  is  a 
painful  difficulty  and  u  dangerous  one,  and  should  bo  treated  with 
great  care.  Warm  bran  poultices,  if  the  patient  can  bear  them,  may 
l)e  applied  while  giving  the  remedies. 


Et' 


'h:u 


If  w 


J.-, 


■1 


792 


DMIA8I8  or  THB  OBOAMS  Ut   OOESATIOM. 


Falling  of  the  Womb. 

The  womb  is  said  to  rail,  when  from  debility,  or  a  relaxed  condition  of 
its  ligaments,  it  sinks  down  into  the  vagina ;  and  this  is  indicated  by  pain 
in  the  back,  and  a  dragging  sensation  over  the  hips,  and  bearing-down 
pains.  These  are  often  attended  with  headaches  and  other  derangements, 
which  must  be  considered.  Nux  vomica,  every  night,  is  one  of  the  most 
valuable  remedies  for  prolapsus  uteri.  Sulphur  sometimes  does  well.  Sepia 
every  morning  has  often  cured  and  relieved  the  headache,  nausea,  and 
other  concomitant  symptoms.  Calcarea  has  relieved  when  the  pain  is 
most  j)rominent  about  the  hips ;  Ljnatia,  when  the  difficulty  has  been 
brought  on  by  grief.  Patients  of  this  description  should  not  drink  coflee 
or  strong  green  tea.  Blaok  tea,  cocoa,  and  milk  may  be  allowed,  with  a 
moderately  generous  diet. 

Inflammation  of  the  Ovarieto 

This  difficulty  is  denoted  by  sharp  pains,  eitlior  in  the  right  or  lell  side, 
or  both,  just  fnint  of  the  upper  edge  of  the  hip-bone.  It  sometimes  is  very 
painful,  and  requires  rest  and  the  best  treatment  and  nursing  to  subdue  it. 
Conium,  in  daily  doses,  has  relieved  some  ;  so  has  Pulsatilla,  Belladonna, 
and  Ignatia.  Some  remedies  relieve  for  a  time,  such  as  Bryonia  and  lihut 
tox.  Belladonna  will  cure  when  the  inflammation  is  attencK  1  with  head- 
ache and  considerable  neuralgic  pain  in  the  region  of  tl  i2;lands  ;  if 
much  fever  attends  the  aflfection,  give  Aconite  three  or  four  iiines  a  day. 
Now,  as  all  these  affections  disturb  the  nervous  system,  and  give  rise  to 
various  forms  of  nervous  complaints,  such  remedies  as  Pulsatilla,  Igna- 
tia^ Hyoscyamus,  Nux  vomica,  Moschus,  and  Caulophyllin  will  be  con- 
stintl}'  needed,  and  stimulants  need  to  bo  taken  with  great  cuution. 
Cold  comnre.sses  in  acute  attacks. 

Ulceration  of  the  Womb. 

Any  thing  that  irritates  the  mouth  of  the  womb  may  occasion,  first,  in- 
flammation of  the  OS  tincae,  and  then  ulceration.  Frequent  miscarriages 
will  so  weaken  the  organ,  and  especially  its  ligaments,  as  to  admit  of  its 
being  easily  misplaced,  or  turned  backwards  or  forwai-ds.  These  misplace- 
nents  are  often  the  cause  of  ulcerations,  and  almost  always  the  source  of 
weakening  Leucorrhoea.  The  medical  treatment  of  this  difficulty  is  of 
the  first  importance.  Sulphur  every  night  may  commence  the  treatment. 
If,  after  ;8ing  the  Sulphur  for  a  week,  the  purulent  discharge  becomes  less, 
and  there  is  less  pain  and  soreness  in  the  region,  and  still  considerable  pain 
remaining  in  the  back,  give  Nux  vomica  every  night  for  a  week.  If  these 
two  remedies  fail  of  bringing  about  a  cure,  then  drop  twenty  drops  of  the 
tincture  of  Calendula  (Marygold  flowers)  in  half  a  tumbler  of  water,  and 
inject  it  into  the  vagina  every  day,  and  at  the  same  time  take  a  dose  of 
Sepia  every  morning.  Continue  this  treatment  as  long  as  useful.  Calct^ 
rea,  taken  every  night,  sometimes  has  a  good  effect.  Local  applications 
tc  thn  ulcers  are  sometimes  made,  but  this  is  the  business  of  the  sur^on. 


LenoorrhcBE.  —  Whitea, 

When  the  mucous  membrane  lining  the  womb  and  vagina  becomes  in> 
tated  or  inflamed,  it  undergoes  solution,  and  there  is  a  white  discharge. 
This  is  of  frequent  occurrence,  and  in  some  instances  is  sucii  n  diain  upon 
the  system  as  to  weaken  the  function  and  tone  of  the  nutritive  organs. 
Any  treatmer*'  that  will  strengthen  the  wholo  system  will  generally  euro 
the  derangement.  China,  Ferrum,  and  Aurum  are  i-onii'diea  that  may  be 
employed,  either  of  which,  in  daily  doses,  will  prove  suflfirient.  In  tliP 
mean  time,  let  the  patient  refrain  from  over-exertion.  A  more  aggra- 
vated form  of  Leucorrhoea  attends  falling  of  the  wonih,  and  tliis  perhaps  is 
the  cause  of  the  difficulty.  The  remedies  which  will  best  meet  this  rliffi- 
culty  are  S^ia  and  Calcarea  carh.  ;  the  former  may  be  given  every  morn- 
ing, and  the  latter  every  evening  ;  or  perhaps  Nux  vomica  may  be  given 
in  the  evening,  and  Calcarea  in  the  morning.  If  there  is  sick  headache 
attending  this  form  of  Leucorrhasa,  Sepia  is  still  the  remedy.  If  other 
biliary  derangements,  Nux  vomica  is  equally  applicable.  Ladies  afllicted 
with  any  of  tliese  uterine  difficulties  must  not  drink  strong  tea  or  cotfee ; 
but  mild  black  tea,  cocoa,  and  milk  should  be  the  chief  beverages,  and,  if 
the  appetite  permit,  a  moderately  generous,  but  non-medicinal  diet  may  be 
iddea. 


100 


If  t{,^ 


•s'.. 


I J  'i' ; 


r:  I 


.k 


i] 


u  1: 


'  Mi  .'i 


DISEASES  OF  THE  SKIN. 


Boils.  —  Furunculi 


Thesb  are  smallv  circumscribed,  and  painful  tumors,  which  begin  in  the 
form  of  a  pimple,  and  then  grow  until  they  acquire  tlie  size  of  acorns. 
They  are  several  days  in  coming  to  maturity ;  and  sometimes  their  pain- 
fulness  excites  fever  and  chilliness,  loss  of  appetite,  and  other  dcrango- 
ments.  When  suppurating,  the  pain  in  them  is  intense  and  pulsating  just 
before  the  crisis.  As  soon  as  they  break,  the  pain  diminishes,  and  very 
soon  the  injury  is  repaired.  Aconite  may  be  given  two  or  three  times  a 
day  to  subdue  any  fever  that  may  be  present.  Belladonna  also  will  re- 
move the  pain  of  congestion  ;  and  this  may  be  given  several  times  during 
the  day.  Arnica  tincture  may  be  applied  externally  to  remove  the  sore- 
ness, and  with  great  advantage  it  may  be  taken  internally  ;  and  in  the 
same  way  Hamamelia  Virginica  may  be  employed.  Wet  a  compress,  and 
apply  directly  over  the  boils,  and  renew  several  times  a  day,  and  the  pair, 
will  be  very  greatly  diminished.  Poultices,  in  case  of  very  large  boils, 
may  prove  of  service,  —  bread  and  milk,  or  flaxseed  ;  and,  when  employed, 
give  at  the  same  time  Ilcpar  aulph.,  four  globules,  and  repeat  twice 
a  day.     Arsenicum  often  prevents  their  recurrence. 

Oarbiinole.  —  Antfirax. 

The  difference  between  a  boil  and  a  carbuncle  is  this :  a  boil  is  circum- 
scribed, but  a  carbuncle  travels,  or  moves  along  the  subcutaneous  tissue  ; 
and,  when  it  breaks,  it  seems  to  have  several  openings  instead  of  one  as  in 
the  case  of  the  boil.  Anthrax  is  a  troublesome  disorder  :  sometimes  it  is 
attended  with  active  inflammatory  fever,  and  sometimes  with  low  fever. 
It  is  far  more  common  among  old  than  young  people,  and  sometimes 
very  difficult  of  cure.  A  carbuncle  upon  the  back  of  the  neck,  accom- 
panied by  fever,  requires  Aconite  during  the  time  of  its  development,  and 
afterwards  Hepar  sulphur.  The  effect  of  this  latter  remedy  is  to  hasten 
suppuration.  Phospliorus  is  also  employed  to  promote  the  same  end. 
Bread  and  milk  poultices  may  be  employed  ;  and  a  dressing  of  adhesive 
plaster,  with  apertures  for  the  pus  to  discharge,  mav  be  applied  after  the 
poultice.  The  sore  should  be  dressed  every  day  ;  and,  if  very  painful,  com- 
presses wet  with  HamamelU  voaj  be  resorted  to.    To  remove  great  sore- 

794 


DISEASES  OF  THK  SKIN. 


796 


ness,  Arnica  may  be  used  in  the  same  way.  Sometimes  in  aged  people  a 
carbuncle  becomes  gangrenous ;  and  then  Araenioum  should  be  employed, 
a  dose  every  three  hours.  When  the  discaso,  or  carbuncle,  comes  on  the 
hack,  either  to  the  right  or  lefl  of  the  spine,  it  is  liable  to  mike  its  way 
downwards  ;  and,  in  order  to  prevent  its  doinj;  so  to  any  extent,  compresses 
bound  tightly  beneath  may  ke(3p  them  wlioro  tlioy  bi'sin.  In  all  cases 
when  there  is  active  fever  acconipanyiiiji  carbuncle.  Aconite  may  be 
iKiCessary  ;  for,  so  long  as  there  is  great  arterial  exc;iteiniMit,  it  will  tend  to- 
wards the  carbuncle  and  greatly  auj^inent  itn  severity,  if  low  fever,  or  a 
lassitude  and  stupor,  attends  the  discrasia,  give  ^ryo/i/a,  and  repeat  every 
three  hours ;  or  perhaps  Jihua  tox. ;  Arsenicum,  if'  the  pus  is  of  an  olfen- 
sive  smell.  Carbuncles  are  supposed  to  orJL^inatu  from  low  conditions  of 
the  ciiculation,  and  therefore  a  generous  tliet  is  su'j:;:('ste(l.  Avoid 
medicinal  food  and  condiments,  except  salt.  Animal  food  is  most  com- 
mended for  a  diet. 

Abscesses. 

Abscesses  generally  form  in  the  subcutaneous  tissue,  but  manifest  tliem- 
selves  through  the  skin.  Generally  there  is  some  protuberance  or  swelling 
upon  the  surface;  sometimes  there  is  none.  Frecjuently  there  will  be 
some  redness,  to  indicate  that  an  inHammatory  process  is  going  on  ;  and, 
at  other  times,  there  will  be  no  indication  of  tlie  kind.  An  abscess,  then, 
is  simply  a  circumscribed  collection  of  pus,  formed  from  broken-down  tissues 
or  blood  corpuscles.  They  are  subject  to  medical  treatment.  OulcareUy 
tor  abscesses  in  scrofulous  persons,  may  bo  given  every  day,  and  espe- 
cially in  cases  of  ficrofulou:?  children.  Abscesses  uj)on  the  arms  or  hands 
may  be  cured  by  .t.ie  use  of  Puhatilla  or  Nux.  Abscesses  on  the  face 
require  Bryonia  and  Calcarea  ;  abscesses  from  the  bone  require  Silicea. 
Abscesses  should  be  relieved  of  their  p'ls  by  the  lancet  as  soon  as  suffi- 
ciently ripe.  They  may  be  washed  with  Calendula  tincture.  Persons 
prone  to  suffer  from  abscesses  should  subsist  upon  a  spare  diet,  and  should 
avoid  rich  gravies  or  great  quantities  of  butter.  Bread,  potatoes,  beana 
and  peas,  beef  and  mutton,  may  constitute  about  the  range  of  diet ;  and 
oof}(3e,  ale,  cider,  and  distilled  spirits  must  not  be  touched. 


Corns. 

The  feet  appear  to  be  the  only  locality  affected  by  corns  ;  and  they 
occur,  frequently  upon  the  toes.  Acorn  is  simply  hardened  cuticle  or 
skin,  rendered  so  by  some  pressure  or  irritation  upon  the  surface,  such  as 
a  tight  boot  or  shoe.  Those  who  subject  the  I'eet  to  such  treatment  must 
suffer  the  consequences.  The  best  treatment  for  a  sore  corn  is  to  shave 
off'  the  hard  skin,  and  apply  the  tincture  of  Arnica,  or  perhaps  the 
tmcturo  of  CausticAun.  It  is  said,  however,  thiit  Graphites,  Silicea, 
/Sulphur,  and  Antimonium  crud.  are  remedies  that  may  bo  taken 
internally  to  cure  corns.  Either  of  the  remedies  may  be  taken  in 
daily  doses.  A  corn-salve  is  sometimes  applied,  made  of  pine  pitch 
or  diachylon.  Any  plaster  that  will  protect  the  tender  and  irritated 
spot  from  the  pressure  of  the  boot  will  be  found  useful. 


Uloerst 

Ulcers  »re  included  among  skin-afFections,  because  they  break  the 
continuii5  of  tlie  skin,  and  manifest  themselves  upon  the  surface.  An 
ulcer  is  form  i  r;enera!ly  by  the  disorganizing  influence  of  itiHammation, 
which  atteots  tiio  membranes  and  skin.  Ulcerati(m  of  the  soft,  puns,  jiml 
ulceration  of  the  stomach  and  intestines,  are  of  frequent  occnrrenci.' ; 
and  an  ulcer  is  slow  to  heal,  and  constantly  discharges  j)ns.  Ulcers  ^^\' 
the  legs,  toes,  feet,  hand,^,,  and  arms,  are  met  with  extensively.  Liict'is 
of  tlie  lo\v<;r  extremities,  or  legs  and  feet,  can  be  cured  by  a  ilaily 
doiiV!  of  S'dicea  or  of  Salphti'.  Uk^ers  of  the  upi»er  extremities,  or  the 
arms  and  iiand.s,  can  be  cured  by  daily  doses  of  Calcarai  and  GrnpluUH. 
Ulcers  of  the  soft  parts  require  Phoispluinm  or  China.  Ulceration  itt  the 
stomach  requires  (Joniiun  or  Pkmph'tras.  Ulceration  of  the  bowchi 
recjuiros  ^lr.st'?u'(nt/rt.  Each  of  these  remedies  may  be  given  in  daily  doses, 
and  continued  as  long  as  observation  teaches  their  utility.  Ulcerations 
are  supposed  to  result  from  lou-  states  of  the  blood  ;  and,  therefore, 
stimulants  nmst  be  em|''-.>yed  to  tone  up  th<>  system.  A  generous  jlict  is 
generally  to  be  commended.  There  is  no  use  in  trying  to  heal  over  the 
surface  of  an  ulcer  ;  {it\\  in  so  doing,  it  may  work  out  deeper  mischief  in 
the  economy.  The  only  sate  way  is  'o  build  up  the  most  healthy  state 
of  the  system,  and  let  tiie  ulcer  dischaige  itself,  and  heal  from  the  I  ottoin. 
l*ers()ii.s  Mibjcct  to  ulcers  are  evidtnitiy  scrofulous,  or  the  victims  of 
Homo  otln'r  (aint.  If  jscrrofnlous,  Arsenwuni,  Silicea,  or  Calcarea 
may  benefit  (he  coixlition.  Ulcers  arise  also  frotn  hen-edit ary  syph- 
ilitic taint.  MercnriuH  vio.,  Me./r,nrii(s  ioddfiis,  and  Jlercuriut. 
corr.  aro  compolt^nt  to  cradic-atc  this  taint  from  the  constitution;  so 
is  llepar  fudph.  or  Nitric  acid.  If  llic  ulcers  arise  from  this  taint, 
alcoliolic  stimulants  must  be  avf)idc(l,  and  the  most  generous  meat 
dit^t  ?uust  t:il\e  their  plac<*.  Whatever  be  the  predisposirig  cause  of 
ulceration  known  in  a  family,  it  should  l>e  carefnllv  watched. 


Chilblains. 

Frosted  feet,  as  this  complain^  is  termed,  occurs  niostiv  in  cold  weatlx  r. 
find  most  frequently  in  persons  susceptible  from  .some  constitutional  taint. 
It  has  been  observed  that  chilblains  will  iissnme  the  character  of  painte! 
fores  in  those  known  to  be  of  o  ■croiulous  habit.  The  teet  being  very 
susceptible  to  cold,  become  cl^ihcd,  and  afterwards  the  !ieels,  and  some- 
times the  toes,  becomes  painfully  tcndcu',  Cruton  liy.  <n'  Arsenicum, 
in  the  usuiil  dose,  may  be  administered  twii'o  a  day,  when  there  is 
bun'inir  heat  and  swelling:  Nu.c  vomica,  in  the  same  way,  when 
attended  with  rheumatic  pains.  l*almtillo  i.s  a  better  remedy  lor 
femalen  of  delicate  constitution,  and  subject  to  colds.  When  the 
chdb'.ains  assume  a  bluish  appearance,  Phosphorus  and  Sulj)htir 
may  be  given;  either  of  which,  in  the  usual  doh-  ,  may  l)o  given 
twice  a  day.     Externally,   the  tincture  of  Aruicd  may  be  applied 


-„ 


to  remove  soreness.  Tincture  of  Cantharis,  if  there  is  an  incli- 
niition  to  blister;  Rhus  tox.,  if  they  are  red  and  inflamed.  A 
solution  of  glue,  in  warm  water,  has  been  found  a  good  palliative 
as  a  foot-bath. 

Whitlow. 

This  is  an  inflammation  and  suppuration  around  the  nails  of  the  Knirers ; 
Botnetimes  siijrht,  and  at  other  times  exceedingly  painfiil.  Hepar  sulphur, 
taken  iMt<!rniilly,  will  hustoii  to  a  crisis;  Graphites  or  Mercurius  is 
•iuiDotinu's  uhoaI  for  the  siiiuc  purpose;  ISilicea  will  hasten  huj>- 
pnralinu  and  a  cure.  Rhus  or  Lachesh,  if  the  system  is  in  a  low 
condition.  Either  remedy  may  be  administered  twice  in  twenty- 
four  hours. 


Itch.  —  ScabiQS. 

This  cutaneous  eruption  consists  of  small  pimples,  or  pustules,  wiiicli 
make  their  appearance  in  clusters  upon  the  skin,  and  itcli  and  burn  con- 
tinually. Tliey  are  believed  to  result  from  the  acarus,  or  itch-mite,  cm- 
betldeu  in  the  cuticle.  These  |)iinples  usually  break  out  between  the 
lingers,  on  the  liamls  and  wrists,  ami  over  the  lioilv.  Sulphur  has  uver 
bocu  found  a  salutaiv  reuuMly,  taken  intornally,  and  applied  !is  an 
ointnuMit  daily.  In  many  <'ascs,  (Ja/carea,  Jlepar Hnlph.,  Jlercnriits, 
and  JUiiis  have  been  lound  useful.  For  what  is  lenncd  the  Prairie 
licli,  which  is  veiy  stubborn,  Mercuriun  viv.,  taken  internally,  and 
an  ointment  of  the  red  oxide  o/merruri/,  used  with  care,  externally, 
has  proved  ellectual.  Sidphnr  ointment  has  been  in  freiuu'al  use, 
and  is  of  great  service  if  used  sparingly  and  with  caution. 


Itching  of  the  Skin.  —  Prurigo. 

Sometimes  there  will  be  intense  itchiui^of  the  skin,  without  any  appar* 
ent  eruption.  Scratchini^  or  rubbinj^  does  not  relieve  ;  every  attempt  to 
relieve  in  this  way  aggravates  the  difficulty.  There  is  no  disease  of  the 
skin  ap[)arently  uu)re  superficial,  nor  yet  mure  annoying.  As  there  is 
i.o  prominent  symptom  but  itching,  we  would  naturally  snppose  that  some 
single  remedy  would  antidote  it.  But  not  so.  In  bilious  temperaments, 
Mcrcuvius  is  the  best  remedy.  In  sanguine  temperanu'nts,  Nux  VDinioa, 
<ir  perhaps  SaJphur.  Ii\  the  lUTVdus,  Puhntillit^  /(jnnlid,  iScpia,  (Jalca- 
rea,  and  Ooniuin.  The  remedy  selected  to  ujeet  the  ease  may  be  given 
twice  a  day  until  relieved,  unh.'ss  there  is  found  a  necessity  for  change. 


Ringworm .  — Ilerpes  Circinnatus. 

This  troublesome  disorder  usually  manifests  itself  upon  the  face,  and 
is  at  first  a  small  circular  eruption  that  enlarges  in  the  form  of  a  ring. 
The  cause  is  believed  to  be  a  minute  itch-mite,  which  lives  in  the  skin, 


798 


DISEASES  OF  THE  SKIN, 


t     I 

■-     I 


and  commits  its  circuitous  mischief.  Sometimes  only  one  ring  appears  ; 
at  other  times  there  are  several,  each  enlarging  its  area  until  the  face 
becomes  nearly  covered.  A  frequent  cause  of  their  appearing  is  by  being 
sh-aved  with  a  razor  that  communicates  the  infection.  A  strong  tiiicturo 
of  ITi/oscyamus,  applied  to  the  surface,  will  generally  extinguisli  tlu-ni ; 
hut  there  must  be  some  constitutional  predisposition  that  favors  them  ;  aiu' 
tlii-reforo  internal  I'lniedies  must  bo  employed.  In  case  of  syplii'ltic 
taint,  daily  doses  of  Mercurius  viv.  will  Ih'  required.  In  those  of  stra- 
mous  constitutions,  Calcarea,  Arsenicum,  and  tS'cpia.  In  thosv  coii^tiiii- 
tionally  inclini'd  to  erysi[)olas,  lihus  tax.,  Didcainam,  IL'par  Kiiljihur,  jiikI 
Bryonia  will  be  found  of  use.  Two  or  three  dosi-s  o!' the  iL'tiiidy  st-K-itod 
may  ba  administered  every  day  ;  and,  at  the  same  titne,  the  JlijoncijaiauM 
liniturc  may  Im!  aiiplicd  cxtcniMlIy.  Tliis  trnatniont  has  been  found 
crticacious  in  most  eases.  A  dihitc  tincture  of  Cdnfharis,  ap|)lied 
locally,  is  a  spccitic. 

Hives. 

Small  red  blotches  upon  the  skin,  that  burn,  itch,  and  sting,  are  usually 
called  hives.  They  are  believed  to  result  from  some  derangement  ot 
nutrition,  caused  by  certain  articles  of  diet.  But  little  danger  attends  the 
difficulty,  unless,  by  exposure  to  cold,  the  eruption  is  made  to  recede,  nnd 
it  lalls  upon  the  bowels:  this  sometimes,  in  eliildren,  results  in  diarrlKca. 
Pulsatilla  may  be  given  in  the  usual  dose,  three  or  four  times  a  day.  In 
young  cliiklreii,  who  may  be  teethitig,  tliamoinilla  will  be  ibund  usetul. 
If  there  is  any  nausea,  give  Jir>/nni(i  or  //x'nif..  an<l  the  d-'rang  incnt 
will  be  corrected  very  soon.      Crotnn  tiij.  is  a  line  general  speeilie. 

Varicose  Veins. 

The  external  veins  upon  the  lowt^r  limbs  sometimes  become  congested 
and  enlarged,  and  are  termed  "  varicose."  Inflammation  someiiine^; 
attends  this  difficulty,  and  terminates  in  varicose  idcers.  The  best  remedy 
known  for  simple  varicose  veins  is  Hamamelis  Virg.  Pnlmtilla  is  bt- 
ieved  to  be  useful,  and  also  Lacheus.  Either  of  these  remedies  may  be 
administered  three  times  a  day.  The  Hamamelis  may  be  applied  externally 
when  administered  internally.  For  varicose  ulcers,  Arnica  may  be  givei> 
in  the  inflammatory  stage,  aw^l  Hepar  Bulph.  after:  when  ulceration  takt  > 
place,  Arsenicum  and  Carbo  vegetabilis  may  be  called  into  use.  A  do.^ 
every  day  will  hasten  a  cure. 

Felons. 

Felons  commence  at  the  bone,  beneath  the  periosteum,  or  membrane 
that  surrounds  it.  They  are  very  painful,  and  most  commonly  make 
their  appearance  on  the  fingers  or  thumbs ;  at  first  a  prickling  sensation 
is  ex})erienced,  as  from  a  splinter,  and  then  a  sensation  of  heat  attend<d 
with  intense  ))ain,  depriving  the  sufferer  of  rest  or  sleep.  The  skin  he- 
comes  changed  in  color  at  the  surface,  and  there  is  painful  throbbing  and 
swelling.  The  most  speedy  cure  for  a  felon  is  to  thrust  in  the  lancet  t(i 
the  bone,  and  give  vent  to  the  matter  beneath  the  membrane  ;  and,  after- 
wards, an  applicatioo  of  warm  flaxseed  poultiotis  will  keep  the  sore  dis- 


DISEASES  OF  THE  SKIN. 


799 


chai-ging.  Previous  to  lancing,  resort  has  sometimes  been  had  to  soak- 
ing the  part  in  hot  water  to  which  Ammojiia  has  been  added,  to 
ripen.,  and  prepare  the  way  for  the  matter  to  come  to  the  surface.  Ilepar 
snlph.,  taken  internally,  exerts  a  bcneflcial  influence  in  hastening  suppura- 
tion. After  a  resort  to  the  lancvt  is  had,  Silicea  is  a  valuiible  remedy  to 
hasten  a  cure.  For  the  constitutional  distuibanee  which  felons  excite, 
Aconile  may  be  given  to  reduce  arterial  excitement ;  Arnica,  to  remove 
Korencss  ;  Nux  vomica,  to  allay  an  irritable  condition  of  the  stomacli ;  and 
tSulphnr,  to  fortify  the  nystera  against  the  recurrence  of  the  difllculty.  It 
is  always  well  to  keep  the  hand  at  rest  until  the  pain  and  inflammation 
has  subsided. 


Tetter.    Salt  Rheum.  —  Herpes. 

Tetter  is  an  inflammatory  disease  of  the  skin,  which,  for  the  most  part, 
appears  upon  exposed  surfaces, -- the  hands  and  face,  —  though  some- 
times it  cou\os  on  the  arms  and  legs.  It  is  a  reel,  scaly,  or  burning  erup- 
tion, very  stubborn  in  its  character,  and  painful.  It  sometimes  becomes 
complicated  with  constitutional  erysipelas,  and  causes  swelling  and  infiltra- 
tion of  the  cellular  tissues  around  the  eyes ;  affects  the  cars  and  nose ; 
l-'caks  out  on  the  backs  of  the  hands  and  arms,  and  in  the  hend  of 
the  elbow-joint,  causing  the  skin  to  crack  and  become  exceedingly 
sore.  Sometimes  the  Tetter  is  dry,  sometimes  humid  ;  and  at  others 
scaly.  For  dry,  burning  Tetter,  Arsenicum  is  a  valuable  remcd}'.  If 
there  is  feverish  heat  in  the  skin  generaHy,  Aconite  and  a  lotion  of 
tincture  of  Aconite  may  be  applied  externally.  When  the  skin  cracks 
and  is  dry,  it  may  bo  anointed  with  the  ghcerole  of  Aloes.  The  burn- 
ing may  be  somewhat  allayed  by  applying,  with  a  down-brush,  a  little 
riie-flour.  Sepia,  Oalciirea,  and  Dulcamara  are  also  valuable  remedies 
for  dry  Tetter.  The  remedies,  when  selected,  must  be  used  persistently, 
two  or  three  doses  a  dav-  For  humid  Tetter,  Jifms  tax.,  Conium,  and 
Sulphur  may  "be  employed.  The  Rhus  tox.  may  be  given  flrst,  and  rev 
peated  every  six  hours.  A  lotion  of  twenty  drops  of  the  tincture  in  half 
a  tumbler  of  water  may  hv  applied  externally ;  and  a  similar  preparation 
of  (  oninm  may  be  used  externally  when  this  remedy  is  administered  inter- 
nally. When  humid  Tetx.r  smarts,  and  thi'  skin  is  broken,  cold  cream 
may  also  be  applied.  Foi  I'le  scaly  Tetter,  Calmrea  carb.  may  be  given 
pemistcntly  three  times  a  d.iy ;  if  this  fails,  Sepia,  especially  if  the  face 
is  ir^ylicated.  When  the  eyos  or  ears  are  affected  and  swollen  Rfnm 
tox.  and  JMI';'i<inna  may  ""e  t;iveu  alternately  every  three  houre  until 
hotter.  In  a!)  cases  of  '1  ''tU-r  of  the  furfurai  eous  type,  Natruin  muri- 
iticnm  may  fje  founci  of  service  when  other  remedies  fail.  Canttiarin 
is  accounted  a  general  specific.  All  persons  afflicted  with  the  disease 
should  refrain  from  the  use  of  salt  provisions,  pork,  rich  gravies,  and 
the  like ;  for  these  articles  of  diet  heat  the  bloo^l  and  augment  the 
suffering. 

Scrofula. 

This  disea«o  shows  itself  in  swelling  of  the  glands,  and  sores  upon  the 
(ice,  neck,  and  extremities.  To  rid  the  blood  cif  this  discrasia,  Arnenioum 
may  he  given  when  there  are  sores    ^r  uU-trrs  affecting  the  soft  parts. 


i: 


!! 


'  I' 


H  1 


"800" 


OUBASBS  OF  THE  SKIX. 


Sores  around  the  mouth  and  upon  the  faces  of  scrofulous  children  may 
be  cured  with  PvUatilla  or  Bryonia.  For  swelling  of  the  glands,  give  Met' 
cariut  three  times  a  day  ;  and,  if  there  is  a  tendency  to  suppuration,  give 
Hepar  nUph.  In  some  children  of  scrofulous  taint,  vaccination  wjll  brng 
uut  sores  on  the  face,  hands,  and  arms.  This  has  been  ascribed  to  impure 
vaccine  matter ;  but  tiiis  is  not  usually  the  case,  as  the  best  virus  ever 
used  will  otlen  be  followed  with  this  result ;  and,  when  it  is,  Calcarea 
carb.  or  Silicea  may  l»o  given  in  daily  doses,  till  the  liunior  disap- 
pears. Ointments  that  simply  drive  these  humors  from  the  surface 
are  pernicious,  and  often  result  in  producing  worse  forms  of  the  dis- 
ease. Great  care  in  reference  to  diet  is  necessary  when  these  sores 
break  out  upon  children.  They  should  be  fed  mostly  upon  farina- 
fcous  food. 

Eozema. 
This  is  a  disease  of  tlie  skin,  that  may  bo  brought  on  by  working  in 
smeiting-furnaces,  where  the  victims  are  all  the  time  exposed  to  much 
heat,  and  are  obliged  to  work  among  cinders  and  steam.  The  appearance 
of  this  skin-disease  is  that  of  red  and  inflamed  spots  covering  tite  entire 
body  The  biliary  system  seems  to  be  raucli  deranged,  and  nutritive 
system  impaired.  Persons  thus  affected  become  very  much  prostrated, 
and  suffer  intensely  from  the  burning  and  smarting  of  the  (M-uption.  Al- 
most any  severe  exercise  that  heats  the  blood  of  those  usually  forced  to 
live  upon  an  indifferent  diet  of  unwholesome  food  will  become  subject 
to  Eczema.  To  treat  this  difficulty  successfully  is,  first  to  regulate  the 
hiiiarv  system  by  th.  -e  or  four  doses  o\i  Nux  vomica  ov  Merc ur ins  viv.A'or 
several  days;  and  thou  follow  with  Arse))i.ruiv,  Tartar  emefir.,  Vc.tro- 
leum,  or  Antimoninm  crudiim,  three  or  four  doses  every  day  ;  and, 
us  soon  as  the  appetite  and  Htomach  will  permit,  furnish  the  patient 
with  a  generous  diet,  and  let  him  change  his  employment  for  one  of 
less  exposure. 

Liver  Spots.  —  Maculasy  Moss. 
Diis  affection  consists  of  discolored  spots  upon  the  skin  of  the  face, 
sometimes  covering  the  surface  of  the  forehead  with  dark  discolorations 
of  the  skin.  Derangements  of  the  liver  are  believed  to  bo  the  cause  ;  and, 
although  these  discolorations  are  not  painful  (I'xcept  to  the  mnul),  tliey 
often  mar  the  countenance,  and  annoy  those  smitten  with  iiiese  marks. 
Tliey  can  be  removed  with  appropriate  remedies.  Sepia  is  one  of  the 
most  projninent.  Chplidonhnn,  given  th(^  same,  is  iiseful.  A  dose 
.should  be  given  morning  and  ovc^ning  persintently,  unul  the  color 
fades  and  the  spots  disappear.  To  iacilitato  this,  let  the  patient 
avoid  coffee,  milk,  eggs,  and  all  oily  food.  An  miimal  diet,  of  the 
lean  of  well-fed  beef  and  miitton,  is  profenible.  with  bivad.  Pota- 
toes, and  esculents  of  every  kind,  may  f)e  allowed  ;  ^•ct  gravy  and 
much  buttcir  are  [)ernici()iis  i  as  au'e  stimulants^  such  «;&•  uiult  li^uorH 
and  highly  seasoned  soups. 

Scurvy. 

Persons  so  situated  as  to  be  obliged  to  subsist  ^in  salt  provisions  are 

by  a  disease  ternwA  "*&corvv.       It  manitesva 


liable  to  become  affected  by 


DI8BASRS  OF  THE  SKDI. 


801 


itself  in  scorbutic  eruptions  upon  the  skin,  and  by  an  inflamed  and  sore 
condition  of  the  gums,  which  sometimes  become  so  much  affected  as  to 
cause  the  teeth  to  become  loose.  The  want  of  fresh  vegetables,  or  lemons, 
oranges,  and  other  fruits,  is  believed  to  be  sufficient  to  cause  the  difficulty. 
To  cure  the  disorder,  a  wholesome  diet  must  be  provided,  with  plenty  of 
fruit,  fresh  provisions,  and  vegetables.  The  only  remedy  necessary  to 
carry  off  the  difficuhy,  after  providing  the  proper  diet,  is  Natrum  muri- 
aiicum,  three  doses  a  day,  —  morning,  noon,  and  night.  Mereuriut 
viv..  Nitric  acid^  and  Muriatic  acid  are  also  remedies  that  have  been 
employed. 

Barber's  Itch.  —  aycoais  Mentagra. 

This  is  exclusively  a  disease  of  the  male  sex,  and  occurs  about  the 
time  the  beard  begins  to  grow  thick  and  hard.  The  disea.so  is  supposed 
to  l>3  contracted  by  using  bad  soap  upon  the  face,  when  shaving  or  washing 
the  beard.  A  dull  razor,  that  p'  ills  and  irritates  the  skin,  may  form  the 
nucleus  of  the  difficulty.  In  lal)oring  people,  exposed  to  dust,  especially 
of  tobacco,  and  where  there  is  not  particular  pnins  in  watiliing  out  the 
dust  frequently,  the  disease  is  likely  to  bo  generated.  The  disease 
resembles,  in  some  degree,  the  herpes  of  the  lips,  makes  its  first  appear- 
ance on  the  chin  in  small  clusters  of  red  pimples,  or  tubercles,  each  of 
which  is  perforated  with  a  hair.  These  pimples  increase  in  size  and  dis- 
gusting appearance,  though  not  painful,  until  arrested  bv  some  remedial 
means.  OraphiteSj  in  daily  doses,  has  often  cured.  Citric  acid^  also, 
twice  a  day,  has  proved  efficient.  Aurum  muriaticum,,  alone,  will  cure 
cases  in  those  having  psoric  or  syphilitic  taint.  Silicea^  Carbo  animalia, 
Ht/oaeuamua  tincture  (externally),  are  also  good  remedies.  Nitric  acid 
may  be  applied  m  n  diluted  form,  externally,  and  also  Sulphur 
ointment,  A  solution  of  Iodide  of  Potass.,  two  grains  to  an 
ounce  of  water,  applied  several  times  daily,  cures  stubborn  caaee. 

101 


1  '..  I  , 


DISEASES  OF  THE  HEAD. 


Headaohei  —  Cephalagia. 

This  affection  is  usually  attendant  on  other  diiHcultics,  and  must  be 
treated  with  reference  to  the  cause.  If  from  cold,  affecting  the  entire  sys- 
tem, and  accompanied  by  pains  in  the  back,  give  Nux  vomica.  If  from 
heat,  or  determination  of  blood  to  the  head.  Belladonna.  If  from  chilli< 
ness,  Ar%enicum.  For  rheumatic  Headache  in  cold,  damp  weallier,  Bry- 
onia. For  that  produced  by  constipation,  Nux  vomica.  Bilious,  Merc. 
viv.  Sick-houdaclu',  Iria  versicolor,  Sepia,  VnUotiUa,  or  Sulphur. 
Nervous  hcadacho,  Co/f'ea.  For  headache  caused  by  suppressed 
eruption,  Calcarea  or  Sulphur.  From  su[)prcssion  of  the  menses, 
Pulsatilla.  From  a  fall,  or  fatij^uo,  Ai'nira.  From  simple  cold  in 
the  head,  Aconite.  A  dose  of  four  <;lol)ules,  of  any  remedy  se- 
lected, may  bo  ro})eated  ovtsry  four  hours  until  relieved. 

Vertigo,  Swimming  of  the  Head. 

This  uncomfortable  feeling  consists  in  a  sensation  of  the  head  whirling 
around,  causing  one  to  stagger,  and  sometimes  to  fall.  If  I'rom  a  de- 
ranged stomach,  iVwx  vomica.  If  from  a  cold,  Geheminum  or  Arsenicum. 
From  (h-rancement  of  tiie  biliary  sy atem,  Aconite,  Pulsatilla,  or  Bri/onia. 
Vertigo  picnlueed  by  rush  of  blood  to  the  head,  Aconite  or  Belladonna. 
The  remedy  indicated  may  bo  repeated  in  the  usual  dose  every  two  liours. 
For  vertigo  from  riding  in  a  carriaj'o,  Cocculus.  From  a  shock  or  fall 
Amion.     Dose  and  administration  as  above. 


Bingworm  of  the  Scalp. 

This  is  a  pustular  eruption,  that  begins  at  oue  or  more  points  upon  tht» 
hairy  scalp,  and  spreads  sometimes  so  as  to  invclve  much  of  the  surfhce. 
When  there  are  a  number,  they  spread  until  tliey  coalesce  and  form  a 
continuous  eruption,  from  which  exudes  a  greenish  or  sanious  matter,  that 
mats  the  hair,  and  renders  the  \yholo  appearance  of  the  head  disgusting. 
Great  care  is  required  to  keep  the  surfiice  clean ;  and,  for  this  purpose,  no 
soaj)  should  be  used.  Water,  softened  by  the  white  of  a  raw  egg, 
is  a  better  wash.     Culcarea  may  bo  administered  in  the  usual  doso 


-4L  m 


every  morning  and  evening.  If  thin  remedy  does  not  prove  effi- 
cient, give  Sulphur  in  the  same  wsiy,  iind  also  Jfepar  aulph.,  or 
Lycopodinm.  The  head  may  be,  at  Ihe  same  time,  washed  once 
or  twice  a  day  with  a  h)ti()n  made  of  twenty  drops  of  the  tincture 
of  Sulphur  in  a  half-tmnbler  of  water. 

Scald-headi  —  Tinea  Capitis. 

This  is  also  an  eruption  \ipon  the  scalp,  tliat  may  ho  dry  or  hnmid. 
For  the  dry  Scald-licad,  Natrum  muriaticum  or  Sulphur  may  ho 
administered  twice  or  three  times  a  day.  For  the  humid  Scald- 
head,  Lycopodium,  Arsenicum,  Conium,  or  Graphites  may  he 
given  twice  a  day.  The  same  restriction  as  to  the  use  of  soap 
must  be  observed,  and  the  satno  measiu'es  for  cleansing  may  bo 
recommended,  as  in  the  case  of  pustular  liingvvorm  of  the  scalp. 


Uloers  of  the  Scalp. 

In  scrofulous  children,  these  ulcers  sometimes  occur  in  the  form 
of  small  furunculi,  or  boils,  exceedingly  sore  and  painful.  The 
best  remedies  are  Ai'senician,  Ilepar  sulphur,  Citric  acid,  and 
Siltcea.  They  may  be  given  as  required  in  daily  doses  of  four 
globules.  The  ulcers  may  be  wet  with  Uamamelis  Virginica,  after 
having  been  pricked  with  the  lancet. 

Baldness. 

When  the  hair  falls  from  the  head  by  reason  of  debility,  the 
remedies  to  be  given  are  China  and  Ferrum;  when  in  consequence 
of  piu'spnation,  Mercurius;  from  the  use  of  quinine.  Belladonna, 
or  Pulsatilla;  if  from  the  abuse  of  mercury,  Carbo  veneta.;  if 
from  gnef  or  trouble,  Phos.  acid.  If  Baldness  occurs  after  pro- 
tnicted  mflammatory  diseases,  and  nervous  and  typhoid  fevers,  give 
Calcarea  in  daily  doses  or  Heparmlph.  and  Silicea.  For  Dandruff, 
give  Lycopodium, 


I^M 


'.    1 
I 

'    .Hi       I 


1- 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


Brain  Fever. 

This  disease  comes  on  with  more  or  less  pain  in  the  head,  attended 
with  heat  and  delirium ;  the  eyes  also  exhibit  a  red  or  fiery  appear- 
ance: and  this  pain,  heat,  and  delirium  are  sometimes  followed  by  drowsi- 
ness, and  inclination  to  vomit.  The  pulse  is  usually  rapid  and  feeble. 
In  Brain  Fever,  there  is  loss  of  appetite,  great  restlessness,  short,  comatose 
naps,  and  frequent  inclination  to  cry  out  with  pain.  Aconite  is  useful 
to  commence  with,  and  this  may  be  ibilowed  with  Belladonna.  If  respi- 
ration is  hurried  and  labored,  give  Araenicum.  If  Brain  Fever  is  brought 
on  by  a  full,  or  a  blow  upon  the  head,  give  Arnica;  and  if  no  relief 
follows  in  twenty-four  hours,  Glonoine.  If  from  trouble  or  grief, 
Ignmtia.  If  from  intoxicating  drinks.  Nux  vom.  If  at  the  men- 
strual poriod,  Pulsatilla.  If  Irom  intense  study,  or  close  application 
to  business,  Sulphur  and  Nux  vomica. 


Biuh  of  Blood  to  the  Head. 

The  signs  of  this  occurrence  are  intense  headache  or  vertigo  at  first, 
which  is  followed  by  fainting,  and  oflen  with  loss  of  consciousness ;  at 
times  there  will  be  twitching  and  spasms.  The  difficulty  may  occur  from 
various  causes,  and  is  common  with  females  and  those  of  nervous  temper- 
ament. Aconite,  in  solution,  may  be  put  in  the  mouth  of  the  patient,  and 
also  the  head  may  be  wet  with  cold  water.  The  head  should  be  laid  a 
little  lower  than  the  body  ;  the  lower  extremities  should  be  rubbed,  and 
friction  should  be  applied  to  the  arms  and  hands.  Belladonna  may  be 
given  after  Aconite,  or,  in  grave  cases,  Glonoine.  If  the  rush  of 
blood  has  been  caused  by  running  and  getting  heated,  give  Arnica, 
and  bathe  the  temples  with  a  solution  of  twenty  or  thirty  drops  in 
Haifa  tumbler  of  water.  If  at  tho  menstrual  period,  give  PulaaliUa. 
In  plethoric  persons,  oxp(K<cd  to  tho  heat  of  tho  sun,  givo  Nux  vom- 
tea,  and  apply  friction  to  tho  extremities.  If  in  consequence  of  hav- 
ing drunk  stimulating  hoveragos,  Arsenicum  and  Nux  vomica.  If 
from  indigestion,  Pulsatilla.  If  from  fright.  Aconite.  If  from  ex- 
posure to  winter  cold,  Canijjhora.  Tho  dose  of  any  of  tho  remedies 
selected  may  bo  repeated  every  fifteen  minutes  until  the  patient  is 
bettor. 


Sunstroke.  —  Coup  de  Soleil, 

Protracted  exposure  to  thoahcat  of  Itio  sun  will  Bomotimcs  prodnce  ft  rod- 
den  proBtration  of  the  ncrvi'H,  and  an  intcusc  headiichc,  causing  blindness, 
vertigo,  and  extreme  senHitiveneHs  to  the  glare  of  light,  and  sometiines  a 
sudden  chillinesH  nnd  shuddering,  extremely  alarming.  This  is  termed  Sun- 
Htroke,  and  frecjuently  is  so  intense  as  to  prove  futui  in  a  few  hours.  The 
remedies  that  have  been  found  the  most  useful  are  Olonoiiie,  Belladonna, 
Phosphorus.  These  may  btj  given  singly-,  and  repeated,  until  n^lief  is  ob- 
taineil,  every  thirty  minutes.  As  soon  as  the  patient  recovers  consciousneHs, 
give  China,  in  the  usual  dose,  several  times  a  day ;  or,  if  there  be  disturb- 
ance of  digestion  and  feeble  voice,  or  entire  loss  of  voice,  Antimonium  cru- 
dum.  The  patient,  when  convalescent,  should  be  kept  out  of  the  sun,  and 
away  ft'om  strong  light.  After  one  has  suffered  from  Sunstroke,  it  may  be 
several  weeks  before  he  Ailly  recovers.  When  it  occurs  in  summer,  his  sys- 
tem will  be  exceedingly  impressible  to  the  sun's  rays  until  cold  weather,  or 
until  his  nerves  regain  their  normal  vigor.  Great  care  should  be  exercised 
in  reference  to  the  diet.  For  after  trcatmeat,  Lachesia  or  Nitvic  acid  oilen 
indicated. 


Apopldzyi  —  Ajpoplexia. 

This  alarming  disorder  is  the  result  of  a  su<lden  determination  of  the  blood 
te)  the  head,  which  produces  a  rupture  of  some  one  or  more  of  the  blood- 
vessels of  the  brain,  and  a  hemorrhage  in  the  nervous  centre.  When  only 
the  left  side  of  the  brain  sustains  this  injury,  the  right,  upper,  and  lower 
extremities  are  liable  to  paralysis.  When  tlie  right  is  similarly'  affeeted,  the 
left  side  usually  becomes  paralyzed.  When  both  hcmisplieres  of  the  brain 
become  implicated  in  the  hemorrhage,  tliere  iisn:illy  occurs  general  paralysis, 
and  the  patient  falls  entirely  senseless.  Tlii'ie  arc  premonitory  sjniptoms 
of  this  disorder,  which,  if  carefully  heedcvl,  may  suggest  a  treatment  that 
will  ward  off  the  difllculty.  These  symptoms  are  vertigo,  fulness,  and  dull 
headache,  and  sometimes  nose-bleed.  Wlien  one  feels  an  unconifortal»le 
ftllness  of  the  head,  under  which  he  walks  with  an  tnisteady  ^uit,  he  may 
find  relief  by  one  or  two  doses  of  Aconite ;  or  if  he  finds  this  niiconifortuble 
fnlncHS  takes  the  form  of  a  dull,  stupefying  lu^adaclie,  JiMulinma  miiy  b(! 
preferable,  and  is  the  leading  remedy.  If  there  is  vertigo  and  fuhiess, 
with  prostration,  Nkx  vomica  is  indicated.  In  case  of  nos(!-blecd,  give 
Aconite,  Jirifonia,  or  PulsntiUa.  These  preliminary  symptoms  may  b«'  made 
to  disappear  with  these  remedies,  when  otherwise  they  might  aiignu'iit  until 
an  apoplectic  attack  set  \\\.  Then  is  the  period  of  danger.  lint  few 
coses  of  sanguuiary  ApopKfX}'  are  cured ;  and  yet  some  do  recover. 
When  the  clot  pressmg  upon  the  brain  is  of  small  size,  and  the  lu'inor- 
rhage  comparatively  light,  an  absorption  of  the  vXoX,  may  take  place,  and 
the  patient  recover ;  but,  when  the  clot  is  too  large  to  be  (lispos<Kl  of  by 
the  process  of  absorption,  it  becomes  an  obstacle  in  the  way  of  recovery : 
and  yet  active  measures  should  in  all  cases  be  called  into  requisition. 
Aconite  should  lie  placed  in  the  mouth,  and  the  face  should  be  bathed 
with  it.  The  bowels  should  1k^  moved  by  an  enema,  and  cold  applica- 
UoDS,  or  rather  applications  of  tepid  water,  should  be  made  to  the  head. 


1 4 


';•■  • 


806 


DISEASES  OF  THE  bRAIN  AND  NERVES. 


Friction  should  bo  applied  to  the  surface  of  the  entire  body  and  the  ex- 
tremities. Belladonna  is  also  a  remedy  that  may  he  administered  if 
possible,  and  repeated  every  half-hour  or  hour.  Ignatla^  in  persons  of 
tynipliati(;  tcMnpcn'anient,  may  be  <j;iven  in  tlie  same  way.  Arnica  may 
be  administered  internally  and  externally.  The  skin  may  he;  ruhbi-d  witli 
it;  the  usual  closes  may  be  jriven  every  hour,  by  placiiiir  tlie  jilohulcs  in 
the  month.  If  the  attack  follows  tlu'  nosi'-bleed,  and  then;  is  heavy  or 
labored  breathin<;,  Arsenicum  ov  J'tdaatilla  may  be  used.  It  is  impor- 
tant to  «jet  an  action  on  the  bowels  as  soon  as  possible. 

Epilepsy,  Fits. 

This  disease  is  termed  the  Fallin<i;  Sickness,  as,  without  war?n'nj]j,  tho 
patient  loses  eonsrionsiHv>s,  and  fiiUs  i:i'(.'n>il)!i.'  to  the  jL'rouiid  or  IIkop,  with 
convulsive  met  ion  of  tlu;  limh-^,  di-^toiiioii  ol't!i'>  mii'^clcs  of  tiio  lace,  fiotli- 
inff  at  the  uioiitli  ;  and  sonit'tiines  the  month,  lips,  and  jaws  arc  spasinod- 
ieally  closed,  the  hands  clinched,  and  a  LTcncral  i'i:;i(lity  of  the  uniscles 
of  th'j  entire  body.  Alter  a  time,  the  riiiidity  pulses  oil",  and  ail  tin'  niii.'v 
cles  become  relaxed  ;  tlie  patient  then  ap])ears  to  he  in  a  (lce|)  sluinl)ei', 
and  remains  so  lor  a  lonjfer  or  shorter  period,  ;ind  then  awnkes  to  co?i- 
sciousness,  teelinv;  weaned,  but  totally  unawnre  of  any  lliini:  unn>ual  hav- 
ing occurred.  Confirmed  Epilepsy  is  rarely,  if  ever,  cured.  When  the 
iliftcase  is  not  conjxenital,  the  nuripiont  sta<re  may  be  overcome. 
Sulphur,  or  Colcami  ca/7y.,inay  Ixj  <:iven  when  the  lirst  sii^ns  of  the 
ditficulty  occur;  and  this  may  bo  followed  with  JicUadonna,  Ilyos- 
cyamus,  or  Ignatia.  When  Epilepsy  is  br()U<^hton  by  intemperance, 
it.s  first  .signs  may  bo  attacked  with  Nux  vomica,  and  the  sooner 
tho  pjitient  can  1)0  brought  into  a  state  of  total  abstineiu'e  the 
better.  Cuprnm  met.  may  be  givon  to  this  class  of  patients  when 
there  is  pain  in  the  head,  and  natisca,  attending  tho  incipient 
stage.  Opium,  when  there  is  inclination  to  sopor,  may  bo  given 
every  two  hours.  /Stramonium,  also,  when  there  is  deep  sleep  and 
loss  of  consciousness.  When  there  is  loss  of  memory  following 
one  of  these  falling  or  unconscious  fits,  give  Sulphur,  China,  FeV' 
rum,  and  Nux  vomica,  if  all  are  required  to  effoct  a  cure  ;  the  only 
hope  for  which  is  in  preserving  the  patient  in  a  condition  for  the 
curative  action  of  the  remedies.  In  all  cases,  between  the  attacks, 
no  fat  food  should  be  eaten ;  but  a  simple,  nutritious,  and  spare 
diet  should  be  adhered  to. 

Acute  Inflammation  of  the  Spinal  GotA,— My eletis. 

This  is  denoted  by  pain  in  the  back,  along  the  course  of  the  spini!, 
which  also  affects  the  spinal  nerves,  and  results  in  general  suffering  of  the 
trunk.  When  the  cervical  or  neck  portion  of  the  cord  is  implicated, 
there  i.i  pain  and  stiffness  of  the  neck,  and  pain  in  the  back  part  of  the 
head  ;  and  sometimes  the  accessory  nerves  become  so  affected  as  to  pro- 
duce derangement  of  the  organs  of  speech  and  deglutition.  Aconite  is 
one  of  the  remedies  that  must  be  employed  to  remove  the  inflammation 
when  in  this  location.  Hypericum  is  another ;  and  this  may  be  used 
mternnlly  and  externally  three  times  a  day.  Vernt.  viride  is  con- 
sidered  by   some   a   specific   remedy.      When   the   dorsal   portion 


J 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


«C7 


and  the  ex- 
ministtM'iid  if 
n  persons  of 

Arnica  may 
!  nil)bi'(l  with 
m  ;j;U)l)iiIc's  in 
!•(!  is  heavy  or 

It  is  inipor- 


waniinfj,  the 

(ir  tl  >i>i",  with 

i<!  laee,  tVoth- 
<  iii'i'  spasiiiod- 
tlie  uiuscU's 
(I  ail  the  inu>- 
deep  sluniher, 
w;ik('s  to  con- 

iiiiiisual  iiav- 
l.  When  the 
)o    :>vorc()me. 

I  siiins  of  the 
donna,  Ilyos- 
inf(Mnpciiince, 
1(1  the  sooner 
l)stinonce  the 
[KiticMits  when 
the  incipient 
may  bo  given 
leep  sleep  and 
ory  following 
',  Chimin  Fer- 
!ure ;  the  only 
ndition  for  the 
m  the  attacks, 
lus,  and  spare 

feletis. 

18  of  the  spine, 
suffering  of  the 
1  is  iinpHcated, 
ick  part  of  the 
Fected  as  to  pro- 
on.  Aconite  i* 
lie  inflammation 
is  may  he  used 
.  viride  is  con- 
dorsal   portion    i 


of  the  spinal  cord  is  beset  with  inflammation,  there  is  shortness  of  breath, 
dyspnoea,  or  fainting,  and  a  sense  of  suffocation.  There  is,  at  the  same 
time,  pain  in  the  back  and  chest,  a  rapid  action  of  the  heart.  Tlie  spinal 
accessory  nerves,  that  supply  ti»e  intercostal  muscles,  partaking  of  the 
difficulty,  renders  the  function  of  lungs,  (lia[)hrai:in,  ami  heart,  severally, 
impaired.  Aconite,  lor  the  inflammation  in  this  locality,  may  he  given  at 
first,  and  repeated  every  hour;  and  a  lotion  ol'  twenty  drops  of  the  tincture? 
in  half  a  tumbler  of  water  may  he  Jipplied  to  tlie  spine.  JJrl/adonna  may 
be  given  when  there  is  intense  pain  between  tlie  ,slM)iili|(i--IiIa(lis.  liri/o- 
nia  is  quite  essential  when  every  motion  of  the  piitient  a;:iiravates  the 
Buffering;  Conium,  when  tht;  ])ain  is  not  so  niarki'd,  but  the  respiration 
is  difficult ;  Cocculus,  also,  when  the  pain  in  the  back  iiiUcts  th  •  .-'tjuiach, 
producing  nausea  and  |)r(tstration  ;  l*uUat'dla,  wlu'ii  this  occuis  iii  v.>ung 
women  or  children,  or  in  those  of  lyinphatic  teinperaiiieiits.  'JMio  patient 
should  take  but  little  exercise,  if  any.  It"  only  the  lowi-r  portion  of  the 
spinal  cord  is  alfccted,  tliere  will  be  paiit  in  the  small  of  the  back.  The 
secretion  of  the  kidneys  may  be  diiniiiisjied  oi-  increased;  the  bladder, 
also,  may  be  implicated.  Tiie  woiub  may  be  .subject  to  neural;j,ic  pains; 
the  nerves  accessory  may  imi)licate  the  abdomen,  and  cause  severe  pains. 
Nux  vomica,  when  the  ]»ain  is  the  most  prominent  in  the  small  of  the  back, 
and  when  there  is  pain  in  the  bowels,  and  constipation.  When  the  bladder 
is  im[>licated,  or  spasmodically  closed,  UijoscyaniUH  is  the  remedy.  When 
there  is  too  great  secretion  of  the  urine,  Nux  voiu.  and  Sulphur  will  tAy- 
viate  the  difficulty.  When  this  portion  of  the  spinal  cord  is  all'ectecl,  the 
womb  may  become  subject  to  neuralgic  pains.  JJclhtdunnn,  t'Icula,  Jy- 
natia,  and  Ifux  vom.  are  all  valuable  remedies.  Conium,  to  remove  the 
inflammation  of  the  cord,  may  be  given  every  three  hours,  until  the  pain 
ceases.  If  spasms  attend  the  difficulty,  give  IIifOHcijainus  every  two 
hours,  as  long  as  tiiey  last,  or  else  Ljnalia  or  lielladonua.  If  the  inflam- 
mation is  brought  on  by  a  fall,  or  shock  upon  the  nerves,  give  Hi/peri- 
cum  every  two  hours,  and  bathe  the  back  witii  a  lotion  of  the  tincture, 
-forty  drops  in  half  a  tumbler  of  water.  Bryonia  is  also  good  for  inflam- 
mation of  the  cord  in  the  lumbar  region,  and  especially  when  motion 
augments  the  suffering.  The  diet  for  all  persons  having  the  nervous 
centres  implicated  must  be  simple  and  nutritious. 


Paralysis,  Palsy. 

When  the  whole  nitisctilar  system  becomes  so  feeble  and  trembling  as  to  bo 
no  longer  controlled  by  the  will,  it  is  a  ease  of  Palsy  ;  and  tliin  is  brought  on 
by  some  trouble  in  the  nervous  centres.  It  attends  Apoplexy,  Epilepsy,  and 
other  atfcctions  incident  to  the  nervous  centres.  Intlamniation  of  the  ISpinai 
Cord  will  often  produce  the  affection.  The  palsy  may  affect  only  one  hand  or 
one  cheek ;  or  it  may  be  more  general,  and  all  the  muscles  may  bo  smitten 
with  paralytic  weakness.  Belladonna  is  often  indicated  for  right-sided  paral- 
ysis, and  is,  perl-ini-..  She  best  remed}',  in  the  majority  of  caies.  Pulsatilla  is 
one  of  the  bes'  raiv  lies  for  this  disortler :  give  a  dose  of  it  three  times  a 
day.  If  this  tovj  t.tt  cure,  give  Cocctdus,  in  the  same  waj',  or  Ifux 
vomica,  China,  .>r  Iijiatia.  For  palsy  of  the  tongue,  give  Galcarea;  for 
palsy  of  the  fac;,  luihotilla ;  for  palsy  of  the  arms  and  legs,  give  MercuriuM 


IMAGE  EVALUATION 
TEST  TARGET  (MT-3) 


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Sciences 
Corporation 


23  WEST  MAIN  STREET 
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DIPHTHERIA. 


AN  exudative  inflammation  of  tlie  throat,  during  the  progress  of  which  a 
dirty,  grayish  membrane  is  exuded  upon  the  tonsils,  aud  often  upon  the  phar- 
ynx and  posterior  nares.  The  disease  is  commonly  usliercd  in  by  the  follow- 
ing symptoms:  chilliness,  headache,  pains  in  the  back  and  limbs,  excessive 
prostration,  fever,  some  difficulty  iu  swallowing,  though  not  always,  and  ofteu- 
sive  breath.  Later  appear  acrid  running  from  the  nostrils,  or  bleeding,  as 
rather  an  unfavorable  indication ;  swelling  of  the  external  throat;  and  some- 
times, in  very  severe  cases,  vomiting  or  hoarseness,  and  other  indications  that 
the  disease  is  invading  the  larynx  or  trachea. 

This  disease  is  now  almost  univei'sally  considered  in  some  degree  contagious, 
and  for  this  reason  the  patient  should  be,  so  far  as  possible,  isolated  from  tlioso 
who  are  not  in  charge  of  the  case.  All  his  excreta  should  be  disinfected  willi 
a  strong  solution  of  Sulphate  of  Iron  at  onre.  The  room  sliould  be  well  aired 
constantly.  The  throat  should  l)e  gargled,  to  prevent  decomposition,  wiih 
glycerine  and  water  mixed,  one  part  of  glycerine  to  seven  of  water,  to  be  used 
every  two  hours,  or  oftener  in  severe  cases.  Small  pieces  cf  ice  allowed  to 
dissolve  in  the  mouth  have  a  favorable  influence.  The  patient's  strength 
should  be  sustained  by  nourishing  liquid  food,  such  as  broth  of  beef,  lamb, 
mutton,  or  fowl;  milk,  or  milk  and  raw  egg;  oatmeal  gruel;  oysters,  iu  cold 
weather,  are  allowable.  Stimulants  are  not  recommended,  except  as  a  gargle, 
as  much  as  formerly;  though  in  severe  cases,  with  alarming  sinking  of  vital- 
ity, brandy  in  small  doses  may  do  good,  when  repeated  often. 

Dangerous  symptoms  have  resulted  from  the  patient  being  allowed  to  sit  up 
too  soon.  Tlic  membrane  should  begin  to  disappear  on  or  before  the  fifth  day, 
else  grave  symptoms  may  be  apprehended,  such  as  delirium,  epistaxis,  vomit- 
ing, croup,  or  paralysis  of  the  heart.  The  urine  should  be  watched  carefulh , 
as  albuminuria  is  generally  present  in  a  mild  form,  and  sometimes  complicates 
convalcscev'^e,  inducing  dropsical  swellings,  etc. 

In  severe  cases  the  patient  should  exercise  care  against  a  relapse  for  at  least 
three  months. 

Be  sure  that  your  house  is  properly  drained.  Local  filth  is  the  most  common 
exciting  cause  of  this  dreaded  and  fatal  disease. 

For  the  benefit  of  those  who  cannot  secure  the  advice  of  a  competent  physi- 
cian in  this  grave  disease,  the  following  brief  but  trustwortliy  indications  for 
its  treatment  are  given :  -^ 

For  the  premonitory  symptoms,  such  as  chilliness,  flushed  face,  headache, 
backache,  and  fever,  OelsemiHtn,  ten  drops  in  half  a  tumblerful  of  water,  a 
teaspoonful  every  half-hour  until  the  fever  subsides.  Should  there  be  no  im- 
provement in  twelve  hours,  give  Gimidfuga  in  the  same  way.  This  remedy 
has  proved  of  great  service  in  the  ha^  ds  of  physicians  of  both  schools.  For 
the  throat  symptoms,  the  most  frequently  indicated  remedies  are  the  several 
preparations  of  Mercurius,  the  Mercurius  biniod.  taking  preference,  in  water, 
and  repeated  hourly.  This,  or  the  Mercurius  cyanuretum,  may  be  altf  mated 
with  Cimicifufja,  or  Oelsemium,  or,  later,  iu  obstinate  continuance  of  the  mem- 
branous exudate,  with  Phytolacca  decandra.  When  the  breath  is  very  putrid 
early  in  the  attack,  and  the  membrane  offansive,  with  fever,  darkly  flushed 
face, delirium,  Baptisia  is  better  than  Oelsemium,  or  any  other  remedy.  Should 
the  tonsils  swell  rapidly,  and  the  throat  and  external  face  have  a  puffy  appear- 
ance, Apts  mel.  is  indicated,  in  place  of  the  mercurial  preparation...  It  should 
be  given  in  water,  hourly.    Should  croupous  symptoms  begin,  indicated  by 


ie  foi-  at  least 


Qost  common 


hoarseness,  whistling  breathing,  dusky  complexion,  or  doughy  pallor,  croupy 
cough,  Sponyia  or  lodium  will  be  the  main  reliance,  together  with  the  inhala- 
tions of  the  vapor  of  boiling  water.  Lachcsis  has  saved  cases  of  a  grave  type, 
which  have  resisted  the  before-mentioned  remedies.  When  bleeding  from  the 
nose  becomes  troublesome  and  alarming,  the  best  remedy  Is  Carho  Veg.y  to- 
gether with  a  free  local  use  of  ice.  The  remedies  should  not  be  changed 
oftener  than  once  in  twelve  hours,  as  it  is  a  disease  slow  to  show  improvement 


Homoeopathic  Treatment  of  Diphtheria. 

Two  views  have  been  taken  with  regard  to  the  intimate  nature  and  cause  of 
diphtheria.  Most  physicians  regard  it  as  an  essential  fever,  and  are  of  the  opin- 
ion that  the  local  alfections  of  tiic  throat  and  air  passages  arc  secondary,  and 
are  but  local  manifestations  of  llic  special  condition  of' the  system,  and  that 
they  have  the;  same  relation  that  the  local  affection  of  the  skin  and  mucous 
membranes  hav(!  to  the  eruptive  fevers.  Tlie}',  however,  admit  that  the  general 
disorder  is  increased  ami  inten-iiied  by  tlie  absorption  of  tlie  sentic  matters 
of  the  local  disorder,  Ihcreb}'  producing  the  blood  poisoning  of  ^eptictemia. 

The  othei  vio-.v  is  what  is  called  the  genu  theory.  According  to  tiiis  view, 
the  disease;  is  caused  by  a  vegetable  organization,  which  naturalists  call  sphero- 
bactcria  or  micrococci,  which,  finding  access  to  the  throat  through  the  nostrils 
and  the  mouth,  fasten  upon  the  mucous  membranes  of  the  tonsils  and  fauces, 
and  produce  an  intlammation  which  is  characterized  by  the  effusion  of  a  fibri- 
nous exudation  called  diplitherile.  This  is  no.  all:  under  the  conditions  favor- 
able for  their  life  and  growth  tliey  possess  an  enormous  power  of  reproduction. 
From  this  centre  of  infection  these  germs  find  their  way  into  the  different  tis- 
sues of  the  body,  and  acting  as  ferments,  give  rise  to  deleterious  chemical  prod- 
ucts which  destroy  life.  These  vegetable  parasites,  according  to  this  theory, 
are  as  inseparable  from  the  diphtheritic  process  as  the  bacteria  of  decompo- 
sition are  from  putrefaction  and  decay.  Without  bacteria  there  can  be  no  diph- 
theria. In  grave  cases,  these  pa.-asites  are  found  everywhere,  in  the  smallest 
patches  of  membrane,  and  in  immense  numbers  in  the  different  tissues  of  the 
body.  They  are  the  cause  of  embolism,  of  metastatic  abscess,  and  the  inten- 
sity of  the  disease  increases  with  their  number.  These  are  the  theories  of 
diphtheria. 

The  duration  of  the  disease  depends  upon  its  severit}\  The  period  of  incu- 
bation occupies  from  two  to  eight  days.  In  mild  cases  the  membrane  com- 
mences to  be  shed  on  the  fourth  day  ;  in  severe  cases  not  before  the  tenth  or 
twelth  day,  and  it  may  take  four  or  more  days  to  finish  it. 

The  membrane  is  detached  in  the  same  way  as  any  slough  or  necrotic 
tissue,  by  the  process  of  suppuration.  Whatever  theory  is  adopted,  the  local 
treatment  is  of  primary  and  equal  importance  ;  for  the  mucous  membrane  of 
the  throat,  if  it  is  the  avenue  through  which  germs  find  entrance  to  the  body, 
is  also  the  generator  of  those  irritant  poisons,  the  absorption  of  which  con- 
taminates the  system  and  destroys  life.  No  specific  has  as  yet  been  discovered 
for  this  disease  The  object  of  the  treatment  is,  first,  to  put  a  stop  to  the 
spread  of  the  disease,  and  to  bring  about  a  retrogression  of  the  inflammatory 
process,  with  the  removal  of  the  membrane  ;  secondly,  by  the  most  perfect  dis- 
infection and  antiseptic  cleansing  of  the  mouu\  and  throat,  to  prevent  the 
absorption  of  injurious  products  of  decomposition  from  the  surfaces  of  the 
diseased  tissues. 

In  order  to  accomplish  the  above  results,  the  local  treatment  by  the  applica- 
tion of  disinfectant  and  antiseptic  remedies  is  now  in  vogue. 


812 


MISCELLANEOUS  DISEASES. 


1-^. 


i.Ui'  . 


y: 


Cauterizing  substances  are  considered  hurtful,  and  but  seldom  used.  The 
most  common  remedies  now  resorted  to  are  carbolic  acid,  salicylic  acid,  per. 
maugauate  of  potash,  choral  hydrate,  sulphite  of  soda,  benzoate  of  soda,  and 
chlorate  of  potash.  These  various  substances  have  been  applied  in  solu- 
tion by  means  of  a  sponge  or  a  brush,  in  the  form  of  spray,  and  in  the  form 
of  a  powder,  taken  dry  into  the  mouth  combined  with  sugar, 

I  think  that  the  best  way  to  treat  the  throat  is  by  the  frequent  inhalation  of 
a  hot  steam,  applied  in  hourly  sittings  of  about  fifteen  minutes'  duration.  Thest* 
may  be  medicated  with  chloride  of  sodium,  or  ihe  chloi^te  of  potash,  about 
twerty  grains  to  the  ounce.  Such  fluids,  steadily  flowing  over  the  surfaces  of 
the  mucous  membranes,  wash  away  masses  of  mucus,  remnants  of  food,  and 
other  products  of  decomposition.  They  assist  nature's  work  of  promoting  sup- 
puration, which  is  the  legitimate  way  in  which  these  pseudo-membranes  are 
shed;  and  by  combining  this  treatment  with  the  use  of  strong  gargles,  com- 
posed of  the  solution  of  any  of  the  above  disinfecting  substances,  we  more  com- 
pletely prevent  septic  absorption  than  by  any  other  treatment  ever  used.  The 
steam  may  be  generated  in  any  ordinary  kettle,  and  conducted  to  the  patient's 
mouth  through  any  suitable  tube.  The  general  treatment  of  the  patient 
ie,  as  in  every  other  infectious  disease,  to  be  8u.staining. 

Tonics,  such  as  sulphate  of  quinine  and  the  tincture  of  the  muriate  of  iron, 
are  also  always  indicated. 

It  has  been  claimed  that  alcohol  conjoined  with  quinine,  given  freely  from 
the  first,  is  an  effective  curative  agent.  Alimentation  is  an  essential  part  of 
the  treatment.  The  diet  should  be  highly  nutritious;  milk  and  animal  broths 
are  of  this  class. 

Patients  affected  with  this  disease  should  be  at  once  isolated.  Thorough 
disinfection  of  the  dejections,  and  of  all  articles  which  have  been  in  contact 
fith  patients,  and  of  the  apartments  which  they  have  occupied,  is  to  be  recom- 
mended, and  all  defects  of  drainage  must  be  remedied. 

Belapsing  Fever. 

A  fever  has  lately  made  its  apptnrance  in  some  of  our  large  cities,  having 
all  the  characteristics  of  a  common  '.yphoid,  that  apparently  passes  through  all 
its  stages,  and  then  reproduces  itself,  and  the  same  round  occurs  again.  Each 
siege  lasts  about  seven  days.  Several  of.  these  in  succession  make  the  condi  - 
tion  of  the  patient  precarious,  and  the  prognosis  unfavorable.  The  treatment 
is  with  stimulants,  and  the  usual  remedies  for  low  fevers,  such  as  Ars.,  Carbo 
vegetabilis,  Bryonia,  and  Bhus  tox.  Doses  as  usual,  and  repetition  of  the  rem- 
edy selected  every  three  hours.    A  stimulating  diet  always  required. 

Black  Tongue. 

In  warm  climates  and  in  a  low  country,  there  are  biliary  derangements,  ac- 
companied with  low  fever,  and  a  black  coating  upon  the  tongue.  This  is  what 
ki  termed  the  Black  Tongue.  Carbo  veg.  has  been  given  freely,  even  the  crude 
powder,  a  teaspoonful  at  a  dose. 


Blftok  Vomit. 

Tliis  is  another  bilious  disease,  that  results  trom  superabundance  of  carbon 
in  the  blood,  and  a  wretched  derangement  of  the  liver  and  stomach,  which 


iriate  of  iron, 


s  Ars.,  Carlo 


causes  copious  vomitings  of  black  bile.  Araenicum,  given  every  hour,  has 
I'cmedied  this  difficulty.  After  the  vomiting  is  arrested  by  the  use  of  Arneni- 
cum,  give  Oarbo  veg.,  China,  Shua,  or  Bryonia.  Whichever  remedy  is  selected 
by  the  indications  should  be  repeated  every  hour  or  two  hours,  until  complete 
recovery  takes  place.  As  soon  as  the  patient  can  take  nourishment,  give  beef- 
tea  and  other  nourishing  soups,  and  then  more  solid  aliments. 

Nightmare.  —  Incuhus. 

The  characteristic  symptoms  of  this  distressing  condition  are  semi-con- 
sciousness, and  a  sense  of  inability  to  extricate  one's  self  from  some  imaginary 
weight  or  seizure.  It  may  be  caused  by  some  defect,  in  the  circulation,  or 
indigestion.  The  sufferer  is  generally  supposed  to  bo  asleep;  but  in  some 
cases,  ho  knows  when  persons  are  about  him,  and  yet,  unless  he  is  spoken 
to  or  moved,  or  by  effort  himself  can  voluntarily  move  his  foot  or  hand,  he  is 
liable  to  remain  spell-bound,  under  a  sense  of  weight  or  oppression.  To 
relieve  one  when  thus  affected,  turn  or  shako  him.  The  remedies  that  may  be 
employed  to  prevent  Nightmare  are  .drr^ute,  when  there  is  a  feverish  condi- 
tion of  the  system;  Nux  vomica,  when  there  is  indigestion;  and  also  PuUatiUa 
and  ISulphur. 

Hysteria. 

This  is  a  name  applied  to  a  great  variety  of  nervous  derangements,  that  for 
the  most  part  are  dependent  upon  nervous  debility.  It  may  manifest  itself  in 
an  irresistible  inclination  to  weep  or  laugh;  sometimes  in  fainting  and  spasms, 
shortness  of  breath,  screeching,  and  a  sensation  of  choking.  Aconite  will 
sometimes  quiet  the  nerves;  Ignatia,  if  there  is  an  inclination  to  weep;  Ilyos- 
cyumua,  if  inclined  to  laugh;  PuUatillay  if  connected  with  the  menstrual 
period.  For  hysteric  mania,  Hyoacyamna,  Stramonium,  or  Belladonna. 
Either  of  the  remedies  may  be  given  in  the  usual  dose,  and  repeated  every  two 
or  three  hours  until  relief  is  obtained;  and  it  is  also  recommended  that  auoh 
persons  ride  out  in  the  open  air,  and  seek  change  of  scene. 

Hydrophobia.  —  Babies. 

The  bite  of  rabid  dogs  is  productive  of  this  disease.  The  poison  commum- 
cated  by  the  bite  may  remain  in  the  system  for  an  indefinite  period  ;  and  then 
all  at  once,  the  sight  of  water  or  some  polished  metal  will  throw  the  vic- 
tim into  indescribable  distress  and  madness,  which  are  apt  to  increase  and  ter- 
minate in  death.  A  dread  of  water  is  an  unmistakable  sign  of  the  disease. 
When  one  is  bitten  by  a  rabid  animal,  the  effect  may  bo  extinguished  by  an 
immediate  resort  to  cauterization.  A  heated  poker  brought  as  near  to  the 
wound  as  possible  without  contact  is  believed  to  be  effectual  in  destroying  the 
poison  ;  or  the  application  of  Nitrate  of  Silver  immediately  may  also  have  the 
same  effect.  Hydrophobia  has  been  cured  by  the  persistent  use  of  Belladonna 
in  the  usual  dose,  repeated  every  hour  or  two  houra  for  several  days  ;  ITyoscyor 
mus  may  also  be  employed  in  the  same  way;  Cantharis  has  been  recommended 
as  an  antidote  to  Rabies.  Lnchesis,  and  even  copious  draughts  of  whiskey, 
have  been  found  useful,  Nothing,  however,  has  been  found  more  salutary  as 
an  immediate  resort  than  dry  or  radiating  heat. 


DISEASES  OF  THE  EYE  AND  LIDS. 


"Hi 


i'l 


ikW 


Stye. 

This  is  a  small  tumor  on  the  lid,  about  the  size  of  a  pea,  which 
is  quite  painful.  Aconite  will  often  cure  in  a  day  ;  Pulfiatilla,  also, 
affords  speedy  relief ;  Belladonna ,  Avhen  the  inflammation  of  the 
stye  causes  redress  of  the  eyeballs;  Stajph.  prevents  their  recur- 
rence, taken  once  daily  awhile. 

Inflammation  of  the  Eyelids. 

When  the .  entire  lids  become  involved  in  acute  inflammation, 
A.conite,  in  the  usual  dose,  may  be  given  every  two  hours  until 
relieved  ;  Puis.,  the  same  way,  when  there  is  burning,  with  flow  of 
tears.  If  the  lids  become  congested,  red,  and  swollen,  give  Bella- 
donna. If  the  inflammation  is  chronic,  give  Calcarea  once  a  day, 
or  else  Srdphur  or  Ilepar  sulphur.  If  dependent  upon  gastric  or 
bilious  derangement,  give  Nux  vomica  or  Mercurius  every  two 
hours  until  relieved,  the  latter  especially  when  there  are  cutting 
pains,  worse  nights. 

Iritis,  Inflammation  of  the  Iris. 

The  little  circle  in  the  front  of  the  eyeball,  which  we  call  the  Iris, 
is  subject  to  inflammation.  It  may  result  from  a  cold,  or  from  injury, 
or  from  some  impurity  of  the  blood.  When  from  a  cold.  Aconite 
speedily  affords  relief.  If  very  painful,  Belladonna.  If  from 
injury.  Arnica  or  Aconite.     The  patient  must  be  kept  in  a  dark 


To 


eighth 


room   until  the   inflammation   passes  off. 

resort  has  been  had  to  Morphine,  in  one 

repeated  every  four  hours  if  necessary. 

external  applications   in  Iritis   ever  prove 

used,  none  are  better  than  water  in  which  six  grains  of  Opium  to  a 

ffill  has  been  boiled. 


relieve  acute  pain, 

of  grain  doses. 

It   is   doubtful   if  any 

beneficial.     If  any 


arc 


«f< 


Scrofulous  Sore  Eyes. 

In  persons  of  a  strumous  constitution,  a  cold,  or  any  undue  exposure 
of  the  eyes,  may  cause  them  to  be  the  seat  of  scrofulous  inflammation  ; 
in  which  event,  there  will  be  a  redness  of  the  eyeballs,  and  swelling  and 
ulceration  of  the  lids,  and  a  greater  or  less  accumulation  of  matter  be- 
neath the  lids.  This  disease  is  often  very  painful,  and  destructive  to  the 
?oats  of  the  eye ;  and,  what  is  worse,  it  becomes  the  fruitful  source  of 

814 


DISEASES  OF  THE  EYE  AND  LIDS. 


816    I 


cataract  and  blindness.     When  the  eyes  first  becomf,  inflamed  and  burn- 
ing, Araenicwm  may  be  given  ;  when  the  lids  are  implicated,  give  Calca 
rea  ;  when  the  inflammation  passes  otf,  leaving  white  spots  on  the  cornea, 
give  Sulphur^  Hepar  sulphury  or  Uonium.    Daily  doses  of  the  remedy 
selected  will  be  sufficient. 

Syphilitio  Sore  Eyes. 

Sometimes  syphilis  will  affect  the  eyes,  and  threaten  the  destruction  of 
sight.  The  lids  will  inflame  ;  tlie  cornea  will  be  congested,  and  of  a 
bluish  red  :  the  conjunctiva  will  become  the  seat  of  inflammation,  and 
sometimes  of  ulceration.  MercurluB  iod.  may  be  given  first,  while  the 
patient  is  kept  in  a  quiet  and  darkly  illuminated  room,  two  doses  daily, 
if  the  patient  has  already  been  treated  with  Mercurius,  give  NitriG 
acid  or  Hepar  sulph.  If  considerable  matter  exudes  from  under  the 
lids,  give  Aurum  once  a  day ;  and  if  the  eyes  itch  continually,  give 
Sulphur. 


Oataraot. 

This  film,  that  obstructs  the  sight  of  the  eye,  is  undoubtedly  the  sequel 
of  scrofulous  inflammation,  or  injury  of  the  crystalline  lens.  It  is  simply 
an  abnormal  growth  of  a  film  over  the  pupil  of  tiie  eye,  partially  if  not 
wholly  obstructing  the  sight.  Conium  mac.^  given  twice  a  day.  Merc, 
iod.  is  also  a  good  remedy ;  Phosphorus,  Causiicum,  or  /Sulphur 
may  be  indicated.  Either  may  be  repeated  twice  a  day  when 
selected. 


Eheumatio  Sore  Eyesi 

Rheumatism  of  an  inflammatory  character  may  fall  with  great  force 
upon  the  eyes,  and  produce  severe  pain  and  temporary  blindness.  Nux 
vom.^  Belladonna,  Bryonia^  and  Aconite,  are  remedies  that  may  be  con- 
sulted. Bryonia  may  be  given  three  times  a  day,  when  every  effort  to 
open  the  eyes  is  attended  with  pain ;  Belladonna,  when  the  pain  is  such 
as  to  give  the  sensation  of  the  eyeball  being  too  large  for  the  socket ;  and 
also  when  there  is  a  feeling  as  if  the  eyeball  would  burst.  Sulphur,  for 
dull  pain  in  the  eyeballs,  and  the  sight  impaired.  Rhus  whea  the 
eyes  are  pink,  and  lame  on  moving  them. 

Gonorrhoeal  Sore  Eyes. 

When  the  eyes  become  inoculated  with  gonorrhoeal  matter,  there  will 
be  smarting,  and  then  inflammation  and  swelling  of  the  lids,  and  such 
serious  infiltration  as  to  close  the  eyes ;  and,  in  a  very  brief  period,  a  per- 
fect disorganization  of  the  texture  of  the  eye  will  take  place.  As  soon  as 
the  character  of  the  inflammation  becomes  known,  it  is  well  to  make  some 
compresses  of  linen  a  half-inch  thick,  and  bind  them  tightly  over  the 
eyes,  and  then  give  Canno^is  every  three  hours  for  two  or  three  days ; 
afterwards,  give  Oantharia  in  the  same  way ;  and,  after  the  smarting  pain 
begins  to  cease,  carefully  remove  the  compress,  keep  the  patient  in  a  dark 
room,  and  Sulphur^  in  daily  doses,  may  complete  the  cure. 


W'K-V] 


^  nf  •■ ' 


■xn\ 


S16 


DISEASES  OF  THE  ETE  AHD  UM. 


Speoks  on  the  Oornea. 

Little  opaque  spots  on  the  cornea  may  be  left  after  scrofulous  inflam* 
mation  has  passea  away.  These  may  be  removed  by  daily  doses  of  Sul- 
phur or  Euphrana. 

Watery  Eyes. 

When  the  eyes  are  watery,  or  prone  to  become  so,  from  slight  exposvre 
to  wind  or  cold,  the  diiEculty  may  be  obviated  with  daily  doses  of  Pulach 
iillaf  Mercurius  vivus,  or  Lachesis.  Blood-shot  eyes  will  bo  re- 
lieved by  dftily  dosea  of  Euphrasia. 

Squinting,  Strabismus. 

What  is  termed  crosa-eyed  in  persons  is  usually  the  sequel  of  some 
cerebral  disturbances,  that  have  deranged  the  normal  action  of  the  little 
muscles  that  regulate  the  position  of  the  eyeballs,  and  give  them  an  ab- 
normal or  squinting  appearance.  Sometimes  daily  doses  of  Hyoacyamm 
or  Belladonna  will  entirely  remedy  the  difficulty.  SHORT-siOHTEDNRSf 
may  be  remedied  by  daily  doses  of  Sulphur^  Lycopodittnit  or  Pxd 
aatilla. 


DISEASES   OF   THE   EAR. 


Inflammation  of  tlie  Ean 

When  there  is  inflammation  and  swelling  of  the  external  ear,  and  it 
has  a  red  and  fiery  appearance,  Pulsatilla  may  be  administered  twice  a 
day.  If  the  swelling  and  inflammation  extend  within,  so  as  to  close  the 
external  orifice,  give  Belladonna  twice  a  day  until  the  difficulty  passes 
aw.'iy.     If  suppuration  threaten,  Ilepar  sulj)h. 

Earache. 

This  may  result  from  cold,  or  from  gathei-inf^s  within  the  ear;  or 
it  may  i)ossil)ly  ho  neuralgia,  or  proceed  from  decayed  teeth  ;  or,  in 
children,  from  teething.  When  from  cold,  give  Chamomilla  or 
Dulcamara  three  times  a  day ;  if  from  injury,  Hypericum  or  Ar^ 
nica;  if  from  gatherings,  Ilepar  sulph.  or  Qalcarea;  if  from 
decayed  teeth,  Mercurius  viv.;  if  in  teething  children,  Pi/^.sa/e/^a, 
two  doses  a  day;  if  the  pain  is  neuralgic,  give  aVax  vomica  or 
Uelladoima. 

Running  of  the  Ears.— OWorr^cea. 

Ottorrhoea  may  be  occasioned  by  a  cold,  when  there  are  no  sores.  For 
this,  give  Pulsatilla;  when  from  sores  in  tiie  ears,  Oalcarea.  If  thia 
should  fail  of  cure,  try,  in  succession,  Sulphur ^  Mercurius  utw.,  and 
Silicea. 


^      Deafness,  Hardness  of  Hearing. 

To  remedy  this  difficulty  when  produced  by  a  cold,  give  N^ux  vomica 
every  night  until  relieved.  For  that  which  occurs  ai'ter  scarlet  fever, 
Oalcarea,  and  for  that  after  measles,  give  Pulsatilla;  from  hardened 
wax,  Sulphur;  if  from  rush  of  blood  to  the  nead,  or  congestion,  AoonUe 
or  Belladonna;  Causticum,  if  these  fail.  The  remedies  may  be 
repeated  every  four  hours  until  relieved. 

Nervous  Deafness. 

When  the  nerves  of  the  ear  lose  their  vitality,  and  Deafness  results  as 
the  consequence,  Phosphoric  acid  may  be  given,  in  drop  doses,  twice  a 
day ;  or  Sulphur  may  be  given  every  night,  or  Nux  vomica,  or  Causti- 
oum,  in  like  manner.  When  Deafness  occurs  from  Rheumatism,  Pulsa- 
tilla may  be  given  three  times  a  day.  Arsenicum,  Nitric  acid,  Calcarea^ 
and  Mercurius  viv.  may  likewise  be  consulted.  If  Deafness  occurs  from 
suppressed  eruption,  the  remedies  are  Sulphur,  Oalcarea,  Graphites,  or 
Causticum,  in  daily  doses.  If  Deafness  is  the  sequel  of  malarious  fevers. 
Phosphorus  or  Phosphoric  acid,  in  daily  doses ;  if  from  sudden  check  of 
nose-bleed,  or  discharges  from  the  nose  or  ears,  Hepar  sulphur,  or  Lache- 
sis;  if  from  enlargement   of  the  tonsils.  Nitric  acid,  Mercurius^  oi 

Aurvm.  8i7 
103 


T 


DISORDERS  OF  THE  NOSE. 


Nose-bleed. —^a8toa»>. 

This  trouble  arises  from  various  causes,  and  must  be  treated  accord- 
ingly. When  it  arises  from  arterial  excitement,  Aconite;  from  an  injury, 
Arnica  ;  from  rush  of  blood  to  the  head,  Belladonna  ;  if  from  inflamm'a« 
tion  of  the  lungs,  Bryonia ;  in  typhoid  fever,  Bhii  tox. ;  if  caused  by 
worms,  Gina  or  Spigelia ;  if  from  weakness  or  debility,  China^  or 
Carbo  veg. ;  if  from  cold,  or  coryza,  Nux  vomica.  Dose,  three 
times  a  day. 


Obstruction  of  the  Nose.—  Ozoena. 

Ozoena  is  an  entire  obstruction  of  the  nasal  ducts,  from  thickening  of 
the  mucous  membrane,  or  other  causes.  If  from  accumulation  of  the  mu- 
cus, Pidsatilla;  if  from  suppressed  eruption.  Sulphur,  Lt/copodium^  and 
Galcarea;  if  from  scorbutic  tendency,  Bryonia;  if  with  dry  crusts, 
Aurum,     The  usual  dose,  three  times  a  day. 


Polypus  of  the  Nose. 

Not  unfrequently,  a  morbid  growth  attached  to  the  mucous  membrane 
of  the  nose  will  fill  the  entire  nostril.  This  is  termed  a  Polypus,  and  is 
perfectly  curable.  Calcarea^  when  the  disease  appears  in  scrofulous  sub- 
jects; Sanguinaria,  when  a  cold  has  been  the  exciting  cause;  Sepia, 
when  there  is  pain  in  the  head  and  nausea ;  and  Staphy%agria,  when  it  is 
the  sequel  of  other  disorders.  The  medicines  may  oe  given  in  the  usual 
dose,  and  repeated  every  four  hours. 

818 


DROPSIES,  HYDROPS. 


A  OENEAAL  swelling  of  the  whole  exterior  surface  of  the  body,  and  a  sen- 
Bation  of  weakness,  is  termed  General  Dropsy,  because  the  water  infiltrates 
into  the  cellular  or  subcutaneous  tissue  all  over  the  body.  Local  dropsies 
may  affect  the  chest,  abdomen,  head,  womb,  and  testes. 

Qeneral  Dropsy,  Anasarca. 

This  is  caused  by  Cellulitis  and  infiltration  of  water  into  the  areolar 
tissue,  causing  one  to  swell  all  over  the  body.  There  is  {;;enerally  some 
thirst  and  fever  that  ushers  in  General  Dropsy.  Arsenioum  in  the  usual 
dose  may  cure  the  disease  when  it  seems  to  arise  from  a  low  state  of  the 
system.  When  it  is  the  sequel  of  Scarlatina  or  Erysipelas,  give  Helleborm 
nig.  tlirco  tim(!s  :i  day.  If  after  a  Hilioiis  Fever,  give  Mercurius 
viv.     Following  Scarlet  Fever,  Apis,  or  Terebinth. 

'     Dropsy  of  the  Bellj,  —  Ascites. 

When  inflammation  of  the  peritoneum  terminates  in  Dropsy  of  the 
Abdomen,  Apia  melifica  may  be  given,  every  three  or  four  hours,  for  sev- 
eral days.  If  it  fails  of  effecting  a  cure,  Apoeynum  may  be  given,  in  the 
same  way,  and  in  like  manner,  Bryonia,  Ilelleborus  nig.,  and  Ar- 
senicum. Tapping  is  somttimes  necessary,  when  the  ijeritoneal  sack 
is  filled  with  water,  and  dees  not  yield  to  rcniodios. 


Dropsy  of  the  Ohest,  or  Hydrothoraz. 

The  cause  of  this  affection  is  inflammation  of  the  pleura,  causing  an 
accumulation  of  serum  in  the  pleural  cavity.  Apis  melifica  in  the  usual 
doses,  repeated  at  intervals  of  three  or  four  hours,  will  often  effect  a  rad- 
ical cure,  and  so  will  Apocynum.     If  these  fail,  use  Sulphur, 

Dropsy  of  the  Heart. 

This  is  an  accumulation  of  water  around  the  heart,  in  the  cavity 
of  the  pericardium.  Spigelia  ov  Apis  mellifica  will  generally  cure. 
Sulphur  is  efficient  in  many  cases.  Bryonia,  if  from  pericarditis 
or  rheumatism. 


I 


ftv- 


820 


D&OPSIES,  HTDBOPS 


Dropsy  of  the  BTa.m.  —  ffydrocepIialua. 

Inflammation  of  the  brain  may  terminate  in  an  eft'usion  of  serum  in  the 
arachnoid  cavity,  and  is  often  fatal.     Hyoioyamua  in  the  usual  dose,  re- 

reated  four  or  five  times  a  day,  may  prove  beneficial.     Af>i8  melifica  has 
>ocn  om[>l()y(M]  in  tho  siinic  way,  also  Ildleborus. 

Dropsy  of  the  Womb.  —  Hydro  metra. 

In^aramation  of  the  womb  often  terminates  in  this  affection.     Bella 
donna,  Apia  melifica,  Araenicum^  and  Helleborus  nig.  have  been  employe* J 
against  it. 

Dropsy  of  the  ^OTotvim,  —  Hydrocele. 

This  consists  in  the  scrotum  becoming  filled  with  serum  or  water,  after 
inflammation  and  swelling  of  the  testes.  It  may  be  caused  by  Gonorrhoea, 
or  it  may  be  the  sequel  of  Scarlet  Fever.  The  same  remedies  employed 
in  other  local  dropsies  may  be  employed  ;  or,  these  failing,  tho  water 
may  bo  drawn  off,  and  a  weak  solution  of  iodine  may  be  injected 
into  tho  sack  by  a  surgeon. 


Ovarian  Dropsyi 

Inflammation  of  the  ovaries  is  the  cause  of  this  difficulty.  Artenioum 
will  generally  have  a  good  effect,  and  so  will  Conium,  and  also  Apii 
melifica  and  Puls<UiUa ;  either  remedy  in  the  usual  dose  may  be  admm- 
litered  every  three  hooxs,  with  the  prospect  of  relief. 


SUROICAL   DISEASE8. 


Oonoossion  of  the  Brain. 

Tins  is  the  result  of  a  fnll  or  blow,  and  may  be  relieved  by  Arnica, 
usual  dose,  and  repeated  if  necessary.  Should  stupor  and  inability 
to  retain  food  persist,  try  Glonoine. 


Oonoussion  of  the  Ohest. 

This  may  be  produced  by  some  sudden  mechanical  'jury.  If  tliere  is 
fever,  give  Aconite  every  tliree  hours.  If  from  having  heer  compressed 
mechanical!}  ,  Arsenicum  may  prove  serviceable;  and  so  may  Arnica,  Put' 
Batilla,  and  Nux  vomica,  Bryonia^  and  China.  Any  of  the  remedies 
selecuu  may  be  given  in  the  usual  dose  every  tiiree  hours.  In  all  cases 
let  the  diet  be  simple,  and  use  friction  externally ;  and  when  there  has 
been  a  blow  upon  the  head,  causing  the  concussion,  pour  a  stream  of  cold 
water  from  a  small  pitcher  or  coffee-pot  for  thirty  or  forty  seconds. 


Sprains. 

A  sprain  may  be  more  or  less  severe.  Sometimes  it  may  implicate 
only  the  muscles,  and  at  others  the  ligaments,  involving  the  apparatus  of 
the  joints.  A  sprain  of  the  wrist  requires  Arnica,  internally  and  exter- 
nally at  first,  and  then  a  compress  of  tepid  water,  covered  with  a  dry 
bandage.  A  sprain  of  the  hip-joint  or  shoulder-joint  requires  Ledum, 
with  a  lotion  of  the  same  of  twenty  drops  to  half  a  tumbltM'  of  water, 
applied  by  means  of  wetting  with  it  a  compress,  covered  with  a  dry  ban- 
dage. A  sprain  of  the  knee-joint  should  be  treated  with  Arnica,  exter- 
nally and  internally,  as  above,  and  also  with  Pulsatilla  after.  Sprains  of 
the  ankles  are  soonest  cured  by  applying  compresses  of  cold  water, 
and  dry  bandages  over  them,  and  Ity  the  administration  of  Ledum 
internally.     Should  this  fail,  use  Bryonia.  , 


ligury  of  a  Nerve. 

The  place  which  Arnica  has  in  surgery  m  the  tres^ment  of  ordinary 
braises  and  sprains  is  of  no  greater  importance  than  that  of  Hy]perieum 

SSI 


I  ' 

I  ^  ■ 


f, 


P 


The 
Lace- 


vaforatum  applied  directly  to  injuries  involving  the  nerves.  Shocks 
upon  the  nervous  system,  injuries  to  the  spine,  or  from  extracting  teeth, 
all  require  Hypericum  internally  and  externally,  in  the  usual  dose,  and 
lotion. 

Wounds.  * 

Wounds  are  of  various  kinds ;  such  as  incised,  lacerated,  punctured, 
gun-shot  wounds,  &c.  A  simple  incised  wound  needs  only  the  sides 
pressed  together,  and  compressed  with  a  strip  of  adhesive  plaster 
application  of  Calendula  externiilly  will  facilitate  the  healing, 
rated  wounds  require  careful  adjustment  and  dressing,  and  then 
let  the  dressing  bo  wot  frequently  with  a  dilute  tincture  of  Calen- 
dula; and  where  it  is  supposed  tlio  trunks  of  nerves  are  implicated, 
use  Hypericum.  Any  of  these  remedies  may  be  used  internally,  in 
the  usual  dose,  three  times  a  day.  Contused  wounds  require  com- 
presses of  crld  water  and  Arnica;  while  Arnica^  Ruta,  and  Hy- 
pericum may  be  administered  in  the  usual  form  internally. 

Hemorrliage  from  Wounds. 

To  remedy  protmcted  hemorrhage  from  wounds,  give  Arnica  or 
Calendula  internally,  and,  with  a  lotion  of  forty  drops  of  either  in 
half  a  tumbler  of  water,  wet  compresses,  and  apply  externally. 

Hernia,  or  Bupture. 

There  are  two  kinds  of  rupture  met  with  among  persons.  One  is 
termed  the  femoral,  and  is  near  the  groin ;  and  another  is  termed  umbilical, 
and  is  near  the  navel.  There  is  a  '  'vd.kind,  where  the  sack  descends 
into  the  scrotum ;  and  it  is  termed  scn)tal  or  inguinal  hernia.  When 
either  has  been  of  long  standing,  well-adjusted  trusses  must  be  worn,  or 
else,  lor  scrotal  hernia,  a  suspensory  bandage.  For  recent  inclination  to 
rupture.  Aconite  will  subdue  any  inflammatory  symptoms.  Arnica,  if 
caused  by  a  strain ;  Xfux  vomica,  in  case  of  constipation  of  the  bowels. 
The  remedies  as  indicated  may  be  given  in  the  usual  dose,  three  or  four 
times  a  day.  For  strangulated  hernia,  JVux  vom.  every  half-hour ; 
and  if  this  affords  no  relief.  Opium  the  same.  Lycopodium  and 
Sulphur  follow  these  well,  given  three  times  daily.  The  patient 
should  be  in  a  recumbent  posture  upon  the  back. 

Luzations,  or  Dislooations. 

These  consist  in  the  removal  of  the  head  of  the  bone  from  its  corre- 
sponding cavity,  where  it  forms  the  joint.  After  dislocation  is  reduced, 
the  joint  may  be  bathed  with  a  lotion  of  forty  drops  of  the  tincture  of 
Aconite  in  half  a  tumbler  of  water,  while  four  gfcbules  may  be  used 
internally  to  allay  any  febrile  excitement.  Arnica  lotion  prepared  and 
used  in  the  same  way  will  relieve  the  soreness.  The  usual  dose  of  this 
remedy  may  be  administered  internally,  and  repeated  two  or  three  times 


SUBGICAL  DISEASES. 


823 


a  day.    To  remove  the  pain  and  suffering  of  luxations  in  general,  Arnica^ 
Aeomte^  and  Bhust  tax.  may  be  given  as  required. 


Fraotures. 

When  there  is  a  separation  of  bony  fibres,  either  simple  or  compli- 
cated, and  the  fracture  has  been  properly  reduced  and  bandaged,  and 
splints  have  been  called  into  requisition  to  aid  the  system  in  recovery 
from  the  shock,  give  two  or  three  doses  a  day  of  Arnica  internally,  and 
wet  the  bandages  with  a  lotion  of  the  same.  If  there  is  fever,  giv9 
Aeonite  or  Bryonia. 

Burns  and  Scalds. 

By  a  burn  is  understood  a  sore  or  blister  caused  by  dry  heat.  By 
scald  is  understood  that  produced  by  some  heated  fluid,  a^  water,  spirits, 
or  oil.  The  former  is  soonest  relieved  by  the  application  of  cotton,  pro- 
vided the  skin  is  not  broken.  The  latter  by  cotton  dipped  in  lime-watei'. 
If  the  skin  is  broken,  it  will  be  necessary  to  use,  in  each  instance,  a  salve 
made  of  lard  and  finely  prepared  caroontite  of  lime.  In  all  cases  of 
burns  or  scalds,  internal  remedies  are  required ;  Aconite,  in  case 
of  much  fever ;  Amenicum,  or  Cantharis,  if  there  is  much  burning, 
smarting,  and  thirst ;  Apis  mel. ,  if  there  is  swelling,  and  iuHani- 
mation  following  as  a  sequel. 

Snake  Bites. 

These  are  to  be  treated  somewhat  afler  the  manner  of  the  bites  of  rabid 
animals :  that  is,  by  dry  or  radiating  heat  at  first,  and  then  by  cauteriza- 
tion ;  internally,  Lachem,  Apia  mdifica,  and  Eyosa/armts.  Either  may 
be  given  every  two  hours ;  at  the  same  time,  there  is  good  authority  foi 
drinking  copiously  of  whiskey  or  other  alcoholic  spirits.  Several 
drops  of  tincture  of  Iodine,  repeated  every  fifteen  minutes,  have 
saved  some  cases. 

Stings  of  Insects. 

Aconite,  Belladonna,  Merc,  viv.,  are  remedies  for  internal  administiu- 
tion,  either  of  which  may  be  given  three  times  a  day  ;  Arnica  lotion,  weak 
solution  of  Nitric  add,  or  Lemon  juice,  may  l)e  sipplied  externally. 
Dilute  Aqua  ammonia  is  a  good  antidote  as  a  lotion. 

The  Removal  of  Tumors. 

Nearly  all  tumors  require  removal  with  the  knife.  It  is  not  our  pur- 
pose to  specify  the  nature  of  the  operation,  but  rather  to  point  out  a 
treatment  to  be  pursued  after  their  removal.  When  cancerous  tumors 
are  removed,  An'tenicum  should  be  persistently  given,  every  three  or  four 
hours,  with  the  view  of  preventing  the  cancerous  diathesis,  or  condition 
from  reproducing  the  same.  Wiiere  fibrous  tumors  are  cut  out,  gwcCalen- 
dula  three  or  four  times  a  day,  and  apply  it  to  the  wound.  Adipose 
tumors  require,  eStiv  their  removal,  PnUaiilla,  three  or  four  times  a  day. 
Fungous   tumors   require,  afler  removal,  C(doarea»     The  fungoid  oi 


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824 


SURGICAL  DISEASES. 


medullary  tumors  are  mainly  subject  to  medical  treatment,  and  various 
remedies  may  aid  in  curing  them.  Conium^  Arsenicumj  Sulphur^  Ow- 
prum  rnety  and  Calcarea  may  be  consulted.  Encysted  tumors  are  em- 
bedded in  the  skin,  and  require  dermic  treatment.  Nitrum^  Natrum 
muriaticum,  and  Natrum  carb.  may  be  employed,  internally  and  exter- 
nally. Scrofulous  tumors  require  Aramieumy  QraphiteSy  Juglaiu  regiay 
and  Calendula.  The  two  last  named  may  be  used  internally  and  exter* 
nally.  Scrofulous  tumors  require  Arsenicum,  Graphics,  and  Ca- 
lendula. The  two  last  named  may  be  used  internally  and  externally, 
several  times  a  day. 

Lumbar  Absoess. 

A  very  malignant  sore,  that  discharges  a  cheesy  matter,  and  from  whicb 
very  few  recover.  Calendula,  Hepar  sulphur,  and  Mercuriua  may  be 
given  internally,  and  Calendula,  Baptisia,  and  Arnica  may  be  used  in 
the  form  of  lotions,  to  apply  externally. 

Ulceration  of  the  Bone. 

For  bone  ulcers,  Aurum  met.,  Siliceu,  and  Calcarea  may  be  given  in 
daily  doses,  —  one  remedy  only  at  a  time :  Aurum  met.,  for  bone  ulcers 
caused  by  sjrphilis ;  Silicea,  if  from  injury ;  Calcarea^  if  from  scrofula. 
For  ulceration  of  the  hip-joint,  Arsenicum,  three  times  a  day ;  of  the  knee- 
joint.  Sulphur^  or  perhaps  Pulsatilla,  twice  a  day. 

"Rickets.— Bachiiis. 

Disorder  of  the  nutritive  functions  may  end  in  distortion  of  various 
parts  of  the  system,  and  give  r'u  to  various  deformities  of  the  head,  trunk, 
and  extremities.  Remedies  directed  to  the  digestive  system  must  first  be 
employed,  in  order  that  a  healthy  nutrition  may  be  established.  Mux 
vomica,  Pulsatilla,  Ferrum,  and  China,  either  of  which  may  be  given  in 
the  usual  dose  three  times  a  day  ;  after  which,  Calcarea  carb.  may  be 
given  in  daily  doses  persistently,  followed  I)y  Silicea.  Good  .'inimal 
food  niiiy  he  allowed  as  a  diet.  Frccjucnt  bathing  with  salt  water, 
and  friction,  arc  also  to  be  commended. 

White  Swelling. 

This  is  a  form  of  scrofula,  and  requires  the  same  remedies  used  in  other 
scrofulous  complaints.  Arsenicum,  Jodium,  Calcarea^  and  Sulphur  may 
be  employed  ;  and  whichever  remedy  is  selected  may  be  given  twice  in 
twenty-four  hours.  Pulsatilla,  Bryonia,  and  Nmi  vom.j  in  like  manner, 
may  be  given,  one  at  a  time,  and  repeated  every  four  hours,  when  there 
is  any  pain  in  the  affected  joints. 

Dropsy  of  the  Joints. 

Friction  externally,  and  some  kind  of  soap  liniment,  and  then  the  ap- 
plication of  compresses.  Apis  melifica  may  be  given  internally,  every 
four  hours,  or  else  Pulsatilla,  Arsenicum,  Bryonia,  or  Oonium. 


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8DBOI0AL  DISEASES. 


825 


Stiff  ZoioLii*-- AnchyloaU. 


This  difficulty  involves  the  tendons,  ligaments,  and  bones,  which  in 
some  instances  become  united  at  their  extremities.  These  joints  may  be 
showered  with  cold  water,  rubbed  with  a  stiff  brush,  bathed  with  soap 
liniment ;  while  SvlphuXy  in  daily  doses,  may  be  given  internally,  or  else 
Aurum  mur.,  Nitrio  acidi  or  Jodiwn. 


Anenrism. 

Aneurisms  are  pulsating  tumors  formed  of  arterial  blood.  Aconite  is  a 
good  remedy  to  administer,  three  or  four  times  a  day ;  Digitalis^  also,  in 
the  same  way ;  Valerian^  in  the  usual  dose,  when  the  tumor  appears  to 
be  in  the  abdomen.  For  Varicose  Aneurism,  bandaging  is  required, 
while  Hamamdu  Virg.  may  be  administered  internally. 


Varicose  Veins. 

When  the  entire  lower  extremities  are  involved,  bandaging  with  a 
roller,  or  lace  stocking,  must  be  employed,  while  Hamamelis  Virg.  is 
administered  several  times  a  day,  interiially.  Pulsatilla,  for  preg- 
nant women  thus  aftected,  and  follow  with  Lycopodium,  after  three 
weeks. 

Goitre. — Bronchocele. 

This  is  an  enlargement  of  the  thyroid  gland,  and  causes  a  swelling  of 
the  neck.  Jodium,  externally  and  internally,  is  said  to  be  a  sure  remedy. 
Kali  hydriodicum^  the  usual  dose  three  or  four  times  a  day,  may  also  be 
used.  Spongia  is  also  a  valuable  remedy,  and  so  also  are  Merc,  iod., 
Merc,  biniod.  The  remedies  must  be  used  persistently  until  the  goitre 
disappears. 

Wry  Neck.  —  Torticollis. 

This  is  owing  to  the  contraction  of  some  of  the  cervical  muscles* 
Stimulating  liniments  may  be  employed  externally,  while  N'uxvom.^ 
lihns.  Sulphur,  Bryonia,  or  Pulsatilla  may  be  administered  in- 
ternally. 

Fistula  in  Ano. 

This  difficulty  requires  Silicea^  Calcarea,  or  Sulphur,  in  daily  doses. 
If  an  operation  has  been  performed,  and  the  Sphincter  ani  has  been 
divided,  Arnica  may  be  given  three  or  four  times  a  day,  or  perhaps 
OalendtUa  ;  after  which,  consult  PuUatUla  and  Nux  vom. 

104 


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DISEASES  OF  WOMEN. 


Derangement  of  the  Function  of  Menstraation. 

Fbom  the  age  of  puberty  until  the  change  of  life,  the  health  of  th« 
female  system  depends  upon  regular  menstruation,  varying  in  intervals 
from  twenty-six  to  twenty-nine  days.  With  this  standard  in  view,  the 
irregularities  as  to  time  are  easily  noted.  By  the  period  of  puberty  la 
understood  the  age  capable  of  bearing  children,  which  is  denoted  by 
menstraation  taking  place. 

Aihnents  at  the  Age  of  Puberty. 

Immediately  preceding  the  first  menstrual  period,  the  breasts  increase 
in  size,  the  voice  is  changed,  the  system  becomes  rapidly  developed,  and 
the  mind  matured.  There  may  be  headache,  dulness  of  the  eyes, 
pains  in  the  lower  abdomen,  lassitude,  capricious  appetite,  and,  not 
unfrequontly,  a  premonitory  Icucorrhoea.  To  relievo  these  ailments, 
Aconite;  four  globules  may  1  (>  given  first;  Pulsatilla  may  be  given 
after  Aconite,  to  remove  the  pains  in  the  abdomen,  and  to  promote 
menstruation.  If  there  is  much  pain,  and  the  function  is  tardy  in 
making  its  appearance,  give  Galcarea  or  Sulphur,  and  then  follow 
with  Pulsatilla  every  four  or  six  hours  until  the  period  commences. 
In  case  of  considerable  leucorrhcea,  give  Sepia,  or  perhaps  (rJ'a- 
phives.  When  the  periods  become  establi'^hed,  they  should  last 
from  three  to  five  days.  If  scanty  at  first,  give  Ferrum,  and  follow 
with  Pulsatilla;  if  there  is  intense  headache,  give  Belladonna',  if 
there  is  hysteria,  and  much  agitation  and  suffering,  give  Hyoscyamus; 
and,  during  the  interim,  let  the  young  lady  take  strengthening  food 
until  signs  of  the  recurrence  of  another  period.  If  it  comes  on 
normally,  it  is  well ;  but  if  tardy  or  painful,  resort  again  to  Pul- 
satilla, Hyoscyamus,  Belladonna,  and  Graphites,  as  they  may  be 
indicated ;  and  continue  this  treatment  from  time  to  time  until 
regularity  is  established.  If  tardy,  with  pains  in  the  back,  Kali 
carb. 

Interrapted  Menstruation. 

This  may  be  caused  by  cold,  fright,  fevers,  diarrhoea,  and  dysentery, 
and  by  pregnancy.  When  by  cold,  or  getting  the  feet  wet,  Aconite,  at 
first,  to  remove  any  febrile  excitement  or  headache,  and  then  PvisatiUa. 

92* 


DISEASES   OF   WOMEN. 


8iT 


If  this  fail  to  remove  the  obstruction,  give  Galcarea,  and  follow  with 
Niix  moachata ;  should  this  fail,  try  tiulphur.  When  menstruation 
is  interrupted  by  fright,  and  there  is  intense  headache,  give  Aconite, 
and  follow  with  Belladonna  or  Ignatta,  and  fin.ally  with  Pulsatilla. 
When  fevers  weaken  and  depress  the  sj'stem,  so  as  to  interrupt  thai 
function,  first  reduce  the  fever,  and  then,  V,y  properly  nourishing  the 
patient,  the  period  may  return.  The  same  rule  may  be  observed  in 
treating  the  interruption  caused  l)y  Diarrhoea  or  Dysentery.  These 
diseases  should  be  treated  and  cured  by  appropriate  remedies,  and 
the  period  will  be  likely  to  return  spontaneously.  If  otherwise, 
i-esort  may  be  had  to  Pulsatilla,  Belladonna,  Sepia,  Galcarea,  and 
other  remedies,  according  to  indications. 


Excessive  Menstruation. 

When  the  flow  is  excessive  or  weakening,  Ipecac,  and  China  may  bo 
employed,  —  the  first  to  regulate,  the  last  to  strengthen  the  system  ;  and 
this  treatment  will  be  found  necessary  at  ciicii  pciiiMl,  until  duly  regu 
lated.     Calcarea  should  be  given  once  daily  between  the  periods. 

Menorrhagia,  ar  Profuse  Bleeding  from  the  Womb. 

This  indicates  a  want  of  tone  in  the  uterus,  if  not  a  state  of  disease, 
and  is  usually  attended  with  fainting,  pain  in  the  back,  nausea,  and  hys- 
teria. When  from  a  want  of  tone,  or  debility,  China  or  Ferrum  may 
arrest  the  difficulty  ;  if  from  disease  or  inflammation,  Belladonna  or  Ar- 
unicum  ;  when  there  is  fainting  and  nausea,  Ipecac.  ;  pain  in  the  back, 
JSfux  vomica,  JVux  moschala,  or  Ignatia,  especially  if  the  flow  is  dark 
O!'  almost  black,  with  fainting  and  drowsiness ;  for  hysteria,  give 
Hyoscyamns.  The  patient  should  lie  in  bed  until  relieved,  and 
should  begin  sitting  up  with  great  caution.  A  generous  diet,  easy 
of  digestion,  shcmld  be  supplied  patients  of  this  description.  When 
the  strength  will  permit,  this  class  of  patients  should  seek  fresh  air, 
and  should  avoid  warm  baths.    Bathing  with  tepid  water  is  far  better. 

Painful  Menstruation.  —  Dysmenorrhcea. 

Some  ladies  suffer  intensely  at  every  menstrual  period.     They  have 
ohills,  headache,  fever,  colic,  and  most  excruciating  pains  in  the  womb. 
Aconite  must  be  given  for  the  fever,  Belladontia  for  the  chills  and  head 
ache,  ^  locyntfi  for  the  colic,  and,  for  the  pains  in  the  uterus,  Hyos- 
cyar/ius,  Pulsatilla,  Oimicifuga,  or  Rhus. 

Ailments  attending  Change  of  Life. 

Thb  occurs  about  the  forty-fifth  year  of  life,  and  is  denoted  by  irregu- 
larities, —  profuse  menstrual  periods,  great  irregularities,  pam  m  the  hwd, 
melancholy,  mania,  loss  of  memory,  and  great  nervous  depression.  For 
profuse  menstruation  at  this  period,  give  Arnica  or  Lachem;  tor  head- 
ache. Belladonna  or  Sepia;  for  intense  pains  in  the  womb,  Arsenicum 
and  Conium:  for  Melancholy,  Lachesis,  or  perhaps  Petroleum;  tor 
mania  StramMiium :  for  loss  of  memory.  Sulphur,  China,  or  Calcarea. 


Ailments  daring  Fregnanoji 


Some  ladies  are  t'^mbled  much  with  morning  sickness  in  the  early 
stage  of  pregnancy,  and  this  is  often  cured  with  Cocculus  or  Nux  vomica  ; 
if  with  heartburn,  Cimicifuga  or  Mercurius  viv. ;  if  with  water-brash 
of  a  hot  or  acrid  nature,  Arsenicum.  Sometimes  theee  derangements 
are  so  stubborn  that  no  remedies  seem  to  relieve.  Simple  sirup y  by 
the  wineglassful,  has  been  taken  by  some,  Champagne  wine  by 
others,  hard  Cider  by  others.  The  simple  resort  will  sometimes 
relieve ;  and,  at  others,  nothing  seems  to  afford  relief.  Discharge 
of  blood  from  the  uterus  may  be  cured  with  China.  Leucorrhcea, 
Tery  profuse  and  debilitating,  requires  Sepia  twice  a  day ;  corroding 
discharges,  Calcarea  twice  a  day ;  for  rheumatic  pains,  Caulophyl- 
lum;  for  painful  breasts,  bathe  with  Phytolacca;  for  threatened  mis- 
carriage, Ipecac,  Sabina,  China,  Arsenicum,  and  Belladonna;  for 
sleeplessness,  Nux  vomica  or  Ars.,  and  a  light  diet  at  night;  for 
iK)se-bleed,  Carho  veg..  Aconite,  Belladonna,  JJachesis,  and  Mer' 
eurius,  a  dose  of  any  one  of  them  twice  a  day. 


LABOR,  PARTURITION. 


False  Fains. 


There  ia  a  kind  of  pain  that  afflicts  parturient  women,  that  simply 
aggravates  and  unsettles  tho  nerves.  (Jimicifuga  or  Caulophyllum 
will  usually  control  this.  When  true  labor  pains  commence,  they 
may  be  regarded  as  normal  if  they  come  at  regular  intervals,  and 
increase  in  force  and  [Vequency  as  the  labor  progresses.  No  medi- 
cine is  needed  ;  and  waiting,  with  patient  labor,  will  accomplish  the 
object.  After  the  child  is  l)orn,  a  dose  of  Pulsatilla  will  aid  in  ex- 
pelling the  placenta.  If  there  is  hemorrhage,  elevate  the  hips  and 
depress  the  head,  and  give  a  dose  of  Secale  comutum;  if  anything 
more  complicated  occurs,  call  on  an  experienced  midwife. 


Milk  Fever. 

About  the  third  day  after  labor,  there  is  a  struggle  in  the  system  to  fill 
the  breasts  with  milk,  attended  with  fever.  Give  Bryonia  or  /*uZ^ 
satilla;  if  the  milk  is  tardy  in  coming,  give  Calcarea. 

Difficult  Urination. 

After  labor,  there  may  be  difficulty  in  passing  urine,  which  Ar- 
senicum or  Hyoscyamus  will  usually  relieve,  if  aided  with  cloths 
wrung  out  of  warm  water  applied  to  the  region  of  the  bladder ;  or 
else  Aconite  may  be  used  instead  of  Hyoscyamus^  and  sometimes 
Pulsatilla,  or  Canlharis. 


Soreness  after  Delivery. 

A  painful  soreness  of  the  muscles  after  delivery  may  be  relieved  by 
the  internal  administration  of  drop  doses  of  Arnica  in  a  spoonful  of  water, 
while  at  the  same  time  a  towel  wet  with  Arnica  tincture  may  be  applied 
to  the  abdomen.  If  there  is  soreness  of  the  vagina,  fc  ty  drops  of  the 
tincture  of  Calendula^  in  half  a  pint  of  tepid  water,  may  be  used  as  an 
injection. 

AVt9 


830 


LABOR,  PARTUBITION. 


OoDstipation  of  the  Bowels. 

This  condition  after  labor  may  be  removed  by  one  or  two  doses  of  Nuat 
vomica^  or  perhaps  by  the  same  of  Lycopodium  ;  if  they  fail,  the  bowels 
should  be  moved  by  an  enema  of  warm  salt  water. 


Excoriated  Nipples. 

Soon  after  the  breasts  fill  with  milk,  and  the  child  begins  to  nurse,  the 
nipples  are  apt  to  become  sensitive,  and  sometimes  exceedingly  sore.  For 
\  fittle  sensitiveness,  or  slight  irritation,  bathing  the  breasts  with  a  solu- 
tion of  Arnica  will  help  them  ;  or  perhaps  a  solution  of  powdered  Boraz 
will  do  as  well.  If  the  soreness  amounts  to  a  decided  inflammation,  and 
tlie  exterior  of  the  nipples  crack  and  bleed,  a  more  careful  and  efficient 
treatment  is  needed.  When  putting  the  child  to  the  breast  excites  great 
pain  in  the  gland,  and  severe  after-pains  at  the  same  time,  the  internal 
administration  of  Belladonna  is  necessary,  —  two  or  three  doses  during 
twonty-four  hours  ;  and,  at  the  same  time,  wet  a  compress  with  Arnica 
tincture,  and  apply  to  the  nipple.  Arnica  also  may  be  given  internally. 
Wlien  Belladonna  fails,  Bryonia,  when  the  pains  are  worse  in  damp,  cold 
weather.  As  an  external  application,  a  decoction  of  Oak  bark  has  been 
found  useful,  and  also  the  same  of  the  Apple-tree  root.  A  solution  of 
Alum,  Tannin,  or  Sulphate  of  zinc,  has  been  employed  ;  but  if  the  skin 
is  cracked,  and  blood  oozes  out  every  time  the  child  nurses,  it  is  of  little 
service.  A  weak  solution  of  Citric  acid  is  better,  two  drops  to 
an  ounve  of  Avater,  The  host  external  application  for  healing  the 
cracks  is  the  Glyceroh  of  aloes,  which  is  made  by  dissolving  one 
ounce  Aloes  in  four  ounces  of  Glycerine.  This  is  the  best  prepara- 
tion known  to  heal  an  inflamed  and  cracked  surface  on  any  part  of 
the  body.  At  the  same  time,  Sulphur,  llepar  sulphur,  Calcarea, 
and  Nitric  acid  may  be  administered  internally.  It  is  hardly  neces- 
sary to  add,  that  whatever  lotion  is  used  extemalty  must  be  carefully 
washed  off"  with  warm  milk  and  water  before  the  child  is  allowed  to 
nurse. 


Suppression  of  the  Milk. 

After  the  breasts  have  once  filled  with  milk,  and  it  disappears,  a  return 
may  be  promoted  by  the  internal  use  of  Calcarea  carbonica,  followed 
with  Pulsatilla,  or  Phytolacca,  while  the  patient  is  required  to  drink 
chocolate,  or  table  beers.  ,     . 

Induration  of  the  Breasts. 

When  the  breasts  cake,  or  portions  of  them  seem  hard,  like  a  potato, 
rub  them  well  with  lard,  and  give  internally  Carbo  animalis.  In  a  ma- 
jority of  instances,  these  hard  cakes  will  disappear  if  carefully  attended 
to.  When  lard  fiiils  to  soften,  try  dry  rubbing  with  the  hand.  If  tlif 
breasts  ache,  give  Belladonna;  if  there  is  fever,  Aconite,  or  Phytolojcca.  If 
inflammation  sets  in,  and  cannot  be  scattered,  give  Hepar  sulphur  to  hasten 
it  to  a  crisis.    Poultices  of  flaxseed  meal  may  also  be  applied  to  hasten  suppu 


LABOR,  PARTURITION. 


831 


ration.  If  it  is  found  necessary  to  lance  the  abscess,  lut  it  be  done  with 
an  opening  in  the  direction  of  the  milk-ducts,  and  not  across  them ;  for, 
when  once  severed,  the  parts  never  unite  perfectly  again.  After  the 
matter  has  discharged,  some  emollient  salve  spread  on  chamois  skin  may 
be  applied,  for  the  double  purpose  of  protecting  the  breasts  and  healing 
the  sore. 

Suppression  of  the  Loohia. 

The  flowing  after  delivery  is  termed  "  Lochia,"  and  should  continue  foi 
ten  days  or  two  weeks.  If,  through  any  unfavorable  influences,  the  flow 
is  suppressed,  the  whole  system  will  be  more  or  less  disturbed.  If  simply 
arrested,  Pulsatilla  may  be  given  every  two  hours,  for  at  least  a  day  ;  and, 
if  there  is  no  return,  give  Secale  comutum.  If  still  the  suppression 
seems  stubborn,  and  the  head  begins  to  feel  liglit,  and  the  nerves  become 
unstrung,  give  Hyoscyamua,  and  i-eneat  every  three  hours  until  better, 
or  there  is  indication  tor  a  change.  Sulphur  will  sometimes  remove  the 
difficulty.  If  the  light-lieadedness  be  very  marked  and  maniacal,  and 
there  is  no  inclination  to  sleep,  a  decided  advantage  may  be  found  in  the 
use  of  Belladonna.  If  the  lochia  should  finally  return,  and  be  of  offen- 
sive odor,  give  Mhus  tox.;  if  much  thirst  and  dryness  of  the  throat,  Arsen- 
icum; in  case  of  diarrhoea,  Arsenicum  and  Mercurius  viv.,  repeated 
every  two  hours.  The  application  of  tepid  cloths  to  the  abdomen  is  rec- 
ommended, until  the  lochia  returns.  Should  the  lochia  continue  too 
lonof,  —  that  is,  beyond  the  seventeenth  day,  —  Rhus, 

Child-bed  Fever. 

A  low  form  of  fever  frequently  sets  m  about  the  fourth  or  fiflh  day 
after  confinement,  sometimes  severe  enough  to  prostrate  the  patient  for 
weeks.  Every  day,  she  will  suffer  from  pain  in  the  head  and  copious 
perspiration ;  the  hair  falls  out.  This  fever  sometimes  continues  imtil 
a  diarrhoea  sets  in,  and  the  patient  sinks  into  a  typhus  and  expires. 
Therefore,  at  the  first  manifestation  of  this  fever,  Bryonia  should  be 
given  eveiy  three  hours  ;  and  this  may  be  followed  with  Rhus  tox.,  in  the 
same  manner.  In  case  of  diarrhoea  and  prostration,  give  Arsenicum  or 
Veratrum  alhum.  If  there  is  sallowness  of  the  complexion,  give  Mer- 
curius  viv.  A  very  light  mutton-broth  may  be  given  for  nourishment. 
Should  there  be  a  general  pain,  and  aching  of  the  whole  body,  give 
PhosphoriM  two  or  three  times,  and  especially  if  the  diarrhoea  should  be 
lark  and  watery.  If  the  fever  should  be  subdued,  and  convalescenr 
established,  allow  the  patient  a  little  wine  and  water,  beef-tea,  and  a  grad- 
ual approach  to  more  substantial  aliments.  Should  the  above  reme- 
dies fail,  any  typhoid  symptoms  present  themselves,  Baptisia,  hourly. 

LencorrhoBa  after  Confinement. 

A  flux  of  this  kind  may  result  from  general  debility,  and  requires  for 
its  removal  a  good  nourishing  diet.  China  may  be  given  three  or  four 
times  a  day  at  first,  and  afterwards  Sqtia  or  Caiearea. 


fe; 


832 


LABOR,     ..BTUBrnOM. 


Falling  of  the  Womb. 

In  some  cases,  after  child-birth,  there  will  be  falling  of  the  womb. 
This  may  be  the  result  of  a  weakened  condition  of  the  muscles  that  retain 
the  womb  in  its  place.  When  this  trouble  is  of  an  aggravated  form,  and 
is  attended  with  copious  Leucorrhoea,  Nux  vomica  may  be  given  every 
evening.  The  patient  should  allow  herself  to  be  as  little  upon  the  feet 
as  possible,  —  rest  being  one  of  the  essential  conditions  for  gaining 
strength  and  for  obviating  the  difficulty. 


Hemorrhoids,  or  Piles. 

For  the  piles  consequent  upon  a  tedious  labor,  Arnica  may  be  given 
every  morning  and  evening,  or  perhaps  Hamamelis^  if  they  are  inchned 
to  bleed ;  also  Nux  vomica  and  Sulphur^  when  there  is  severe  constipa- 
tion and  hemorrhage  at  every  stool.  Sulphur  in  the  morning,  and  Nuz 
vomica  in  the  evening.  Stewed  prunes,  Graham  toast,  and  chicken 
loup,  may  enter  into  the  diet. 


DISEASES  OF  INFANTS. 


Crying. 

When  a  young  infant  is  inclined  to  cry  continually,  and  sleeps 
but  little,  give  it  one  or  two  globules  of  Coffea^  and  repeat  every 
four  hours. 

Golio. 

For  infantile  colic,  which  may  be  caused  by  flatulence,  give  Cham- 
omilla;  put  one  or  two  globules  upon  its  tongue.  If  this  does  not 
relieve,  give  a  globule  of  Nux;  if  restless,  and  throws  up  its  food, 
after  the  Nux,  give  a  globule  of  Coffea.  Verat.  album  is  an 
excellent  remedy  for  infantile  colic,  and  Dioscorea  has  a  great 
reputation. 

Infantile  Diarrhoea. 

There  will  generally  be  a  diarrhoea  after  an  infant  has  nursed  the 
first-fruits  of  the  breast.  If  excessive,  give  one  or  two  globules  of 
Pulsatilla;  if  attended  with  colic,  give  the  same  of  Chamomilla; 
if  the  diarrhoea  is  acrid  or  scalding,  give  Arsenicum,  one  or  two 
globules ;  if  with  excessive  vomiting,  give  Ipecac. 


Infantile  Dysentery. 

When  young  infants  are  observed  to  strain,  and  have  frequent  itool., 
and  sometimes  pass  mucus  and  blood,  give  Ipecac.,  one  globule,  or  elto 
MermnaaL  If  they  cry  out  after  each  stool,  and  the  intestine  protrudes, 
give  one  or  two  globules  of  Ignatia.  If  they  refuse  the  breast,  give 
Aconite.    In  case  of  heat  in  the  head,  give  Belladonna, 

Inability  to  take  the  Breast. 

Some  infants  are  congenitally  opposed  to  nursing  the  breast ;  and  all 
the  coaxing  and  trying  which  a  patient  perseverance  can  supply  avails 
but  little.  Such  infants  require  to  be  fed ;  and  to  devise  for  them  a  good 
and  wholesome  nouiisliment  is  sometimes  difficult.  The  nursin<T-bottle 
must  take  the  place  of  the  breast,  and  the  child  must  be  nourished  by  it. 
One  of  the  best  preparations  of  food  for  young  infants  is  a  thin  gruel 

105  833 


■I '.  i 


•I 


made  of  a  table-spoonfiil  of  unbolted  flour  to  a  quart  of  water,  to  be 
boiled  half  an  hour,  and  then  strained  through  a  fine  strainer,  sweetened, 
and  put  into  a  nursin<;-bpttle  sufficiently  thin  to  flow  through  the  tube. 
This  food  may  bo  enriched  with  a  little  good  milk,  as  the  child  requires 
it.    Nothing  has  so  uniformly  answered  as  a  substitute  for  the  breast. 


U. 


1 ) 


H' 


Infantile  Janndioe. 

Young  infants  sometimes  become  yellow,  and  their  skin  affords  evident 
si^ns  of  jaundice.  One  or  two  globules  of  Mercuriua  viv.,  followed  by 
one  or  two  of  Pulsatilla,  JvWl  chang3  this  condition.  If  frequent  dis- 
t  liarjics  from  tlie  bowels  (ccur  after  these   remedies,  give  one  or  two 

globulus  of  At'Mcnicuvi. 

Snuffles. 

In  cold  weather,  young  infants  are  prone  to  take  cold  easily,  from  the 
slightest  change  :  ancl  they  will  show  it  by  sneezing  and  snuffling:  occasion- 
ally there  will  be  indications  of  fever,  and  heat  in  the  head.  One  or  two 
globulus  of  Aconite  may  be  given  first  and  then  one  or  two  of  N^ux  vomica. 
If  there  is  thin  discharge  from  the  nose,  give  a  globule  or  two  of 
Arsenicum.     Sambucua,  twice  daily,  is  a  good  remedy. 

Sore  Mouth,  Aphthss. 

Considerable  uneasiness  is  manifest  in  young  children  from  a  percepti- 
ble inflammation  of  the  mucous  membrane  of  the  mouth.  It  will  look  wd 
and  inflamed,  and  there  will  be  perceptible  some  little  points  or  pimples 
of  a  whitish  character.  Give  one  or  two  globules  of  Mercuriua  or  Bry- 
onia^ and  wash  the  mouth  with  warm  tea,  or  milk  and  water.  Some  have 
introduced  into  their  mouths  a  little  powdered  Borax.  This  difficulty  is 
generally  of  brief  duration,  and  is  but  a  trifling  malady. 


Thrush. 

This  is  also  a  sore  mouth  to  which  infants  are  subject,  and  a  little  more 
serious  in  its  character.  The  child  first  has  fever,  and  then  refuses  to  take 
its  food.  On  examining  the  mouthy  it  is  found  to  contain  a  number  of 
white  blisters  that  have  a  sore  and  inflamed  appearance.  One  or  two 
globules  of  Phosphorus  will  often  cure  the  trouble.  Bryonia  has  also  been 
used.  Mercuriua  viv.  may  also  be  used.  A  decoction  of  black  tea  may 
constitute  a  wash  ;  also  a  weak  solution  of  Borax.  Good  nursing,  and 
care  to  prevent  taking  cold,  are  essential.  If  with  this  kind  of  sore  mouth 
there  is  diarrhoea,  give  one  or  two  globules  of  Arsenicum.  If  the  child 
cries  much  from  colic,  one  or  two  globules  of  Cohcynih  may  afford  relief. 


Bed  Qum. 
When  an  infant  is  one  or  two  days,  or  a  week  old,  there  occurs  an 
eruption  all  over  the  body,  of  a  bright  red  appearance,  that  probably 
itches,  and  causes  the  child  some  suffering.    A  globule  oi  PvltatnUa  night 
and  morning  will  suffice  to  cure  the  difficulty. 


DISEASES  OF  INFANTS. 


836 


Betention  of  Urine  in  Toung  InfantSi 

Thi.4  difficulty  occusionally  is  observed,  nnc  a  attunded  with  much  rest< 
lessncss  and  inquietude.  An  infant  should  urinutu  ei<rht  or  ten  times  in 
twenty-four  hours  ;  and,  when  there  is  atuiluroin  this  respect,  give  one  or 
two  globules  of  Hyoscyamus,  and  repeat  every  three  or  four  hours  until 
the  (leriuigenicnt  is  (>i)vi!itod.  When  J/i/osci/armis  fulls,  give  a 
globule  or  two  of  Pulaalilla  or  Aconite, 

Teething,  Dentition. 

When  an  infant  has  attained  the  age  of  four  or  six  months,  the  pciiod 
of  teething  commences.  The  child  begins  to  drool,  and  is  restleus  and 
unt^asy,  and  frequently  cries  out  with  pain.  At  times  the  cheeks  will  be 
red,  and  tlie  head  will  be  hot ;  or  else  there  will  be  diarrhoea,  and  the  food 
will  pass  the  bowels  undigested.  The  child  is  generally  fretful  and  un- 
easy. The  most  effectual  remedy  for  the  restlessness  and  irritative  fever 
is  Ghamomilla.  Two  or  three  globules  may  be  given  three  times  a  day. 
When  the  head  is  hot,  and  the  child  thrusts  its  fingers  into  its  mouth,  give 
two  globules  of  Belladonna  ;  when  the  food  passes  undigested,  give  two 
globules  of  Pulsatilla.  Wiien  there  is  a  general  heat  of  the  body,  a'ld 
deranged  condition  of  the  stomach,  give  two  globules  of  Aconite;  if 
this  fails  to  relieve  in  twenty-four  hours,  give  Gimicifuga  every  hour. 

Summer  Oomplaint,  Cholera  Infantum.        ^ 

During  the  heat  of  summer,  toothing  children  are  prone  to  be 
affected  with  a  pi  strating  diarrha^a,  jsonietiuics  watery,  at  others 
dysenteric,  when  the  stools  are  tinged  with  blood.  In  the  first  stage, 
when  there  is  considerable  fever  and  watery  discharges  from  the 
bowels,  two  or  three  globules  of  Aconite  may  arrest  tho  difficulty, 
followed  by  Tartar  emetic;  if  the  discharges  are  profuse  and  fre- 
quent, Veratrum  album ;  if  there  is  much  thirst,  Arsenicum.  For 
discharge  of  mucus,  give  Mercurins;  when  tinged  with  blood,  give 
Ipecac.  The  dose  of  either  is  two  globules.  When  there  is  cold- 
ness of  the  face  and  extremities,  give  Carho  ver/.  If,  in  spite  of 
these  remedial  measiu-es,  the  disease  continues,  let  tho  child  be 
taken  into  the  open  air,  or  into  the  country.  A  trip  upon  tho  water 
in  a  steamboat  has  frequently  resulted  in  a  favorable  change  in  the 
condition  of  the  child.  The  diet,  aside  from  nursing,  should  be 
mutton-broth  and  beef-tea,  or  perhaps  arrowroot  or  farina  gruel. 

MarasmuSi  ETtreme  Emaciation. 

From  the  combined  effects  of  teething  and  interrupted  nutrition  and 
also  from  diarrhoea,  the  child  will  lose  its  flesh  in  a  remarkable  degree, 
and  nearly  all  the  adipose  or  fatty  tissues  will  seem  to  disappear.  Th6 
bones  of  the  face  will  become  prominent ;  the  eyes  will  sink  back  Into  theur 
sockets ;  the  skin  will  be  shrivelled  and  oose  over  the  entire  body,  and 
very  marked  upon  the  upper  and  lower  exti  nities.  The  most  prominent 
feature  of  the  disease  is  interrupted  nutriti  .1 ;  and  often  the  child's  stom- 
ach rq'ects  the  simplest  kind  of  food.     When  there  is  continual  retching. 


^^^1 


s 


836 


DISEASES  OF  INFANTS. 


give  Ipecae.j  to  allay  the  irritable  condition  of  the  stomach  ;  and  then  give 
Call  area;  or  if,  at  first,  there  is  no  nausea,  but  thirst,  give  Arsemcum. 
Sulphur  is  a  valuable  remedy,  and  also  Ferrum.  When  either  beef- 
tea,  or  barley-gruel,  or  any  other  kind  of  light  soup  or  giael,  fails  of 
being  retained  upon  the  stomach,  a  grUel  made  of  the  flour  of  the 
yelk  of  a  hard-boiled  a^^  has  supplied  the  want  of  rourishmont,  and 
promoted  the  recovery  of  marasmus  patients.  When  ihe  child  is  old 
enough  to  feed  himself,  the  yelk,  boiled  hard,  may  be  broken  in  a 
saucer,  and  seasoned  with  a  little  salt ;  and  the  child  will  pick  it 
up  a  little  at  a  time  and  eat  it.  But  if  otherwise,  to  a  pint  of  Doilin^ 
water  add  a  half-pint  of  fresh  milk  and  the  flour  of  one  yelk,  seasoned 
with  salt,  and  sweetened.  This  makes  a  gruel  that  will  flow  through  a 
nursing-tube.  This  food  contains  the  b'^st  preparation  of  iron  for  tne 
infantile  system,  and  in  many  instances  '.las  been  effectual  in  curing 
marasmus. 

Hiccough.  —  Singultus. 

This  annoying  difficulty  results  from  the  irritation  of  the  diaphragm 
and  the  oesophagus,  or  passage  from  the  mouth  to  the  stomach.  Nux 
vomica^  Ipecac.^  Pulsatilla,  and  SanAucus,  have  been  euin^oyed  as  reme- 
dies. A  single  dose  of  two  globules  of  either  may  be  administered  when 
infants  are  so  affected. 

GonvnlsioDS,  Fits. 

There  may  be  various  causes  of  these  convulsions  in  infants.  A  fever, 
an  irritable  stomach,  teething,  or  cold,  may  produce  them  ;  when  from 
fever,  give  two  globules  of  Aconite,  and  in  two  hours  follow  :nt\i  a  dose 
of  two  globules  of  Belladonna.  When  from  an  ill-conditioned  stomach, 
give  Chamomtlla,  Ipecac,  or  Ignatia;  when  irova: coXdi,  Nux  vomica 
or  Sulphur.  When  the  convulsion  comes  on  with  vomiting.  Ipecac. ; 
when  from  colic,  Pulsatilla  or  Colocynth ;  when  with  inclination  to 
sleep,  Opvum^  or  perhaps  Stramonium ;  when  from  the  sudden 
disappearance  of  any  rash  or  eruption,  Cuprum, 

EzooriationSi 

The  tender  and  delicate  skin  of  infants  is  liable  to  become  excoriated 

from  the  slightest  causes.     To  relieve  the  pain  and  suffering  attendant 

ipon  it,  give  two  globules  of  Chamom'ila,  Mercurius  viv.,  or  PulaatiUa 

internally,  and  wash  them  with  a  weak  solution  of  Arnica  or  Hama* 

melis  externally.     Should  this  condition  persist,  give  Sulph.  daily. 

Soreness  behind  the  Ears. 

When  a  child  is  teething,  and  there  is  considerable  of  the  fever  of 
dentition,  an  eruption  is  liable  to  show  itself  behind  the  ears  ;  and,  although 
this  eruption  is  believed  to  be  effectual  in  preventing  more  serious  disease 
of  the  head,  it  is,  nevertheless,  an  unnecessary  disease.  Graphites  may  be 
given  to  remedy  the  lifficulty,  a  single  dose  in  twenty-four  hours ;  and,  in 
uke  manner,  Arsenicum,  Catcarea^  and  Baryta  Carh.^  may  be  employed. 


Piiokly  Heat 


During  intensely  hot  weather,  children  are  liable  to  break  oat  with 
prickly  neat.  The  stomach  at  first  seems  slightly  deranged,  and  the 
eruption  apon  the  surface  appears  to  be  an  elimination  of  some  internal 
disorder.  There  is  sometimes  much  fever  and  headache :  for  this,  give 
two  globules  of  Aconite.  If  the  child  is  teething,  give  ChamomiUa.  If 
the  surface  becomes  red  and  inflamed,  give  Rhus  tox.  If  burning  and 
Mnarting,  give  Aneiiicwm.  In  case  of  severe  itching,  give  Sulphur. 
When  children  are  taken  out  by  their  nurses  on  a  hot  day,  they  must  not 
be  exposed  to  the  heat  of  the  sun :  shade  should  be  sought  for  them, 
where,  if  any  air  is  stirring,  they  can  get  the  benefit  of  it. 


I 


Milk-0ru8t.  —  Porngro. 

This  is  a  scabious  eruption  upon  the  scalp  cf  nursing  infants,  which  at 
first  appears  to  be  a  humid  scurf.  It  collects  as  a  slight  humor,  and 
begins  to  enlarge,  involving  more  and  more  of  the  surface,  until  that 
of  the  scalp  is  entirely  covered.  It  is  a  source  of  annoyance  to  mothers 
and  nurses.  There  appears  to  be  great  difficulty  in  keeping  the  affected 
surface  clean,  and  consequently  a  hasty  resort  to  some  drying  wash  ha? 
wrought  disastrous  effects.  When  Milk-Crust  is  suppressed,  the  irritation 
is  apt  to  fall  upon  internal  organs,  and  produce  worse  affections.  The 
tar  and  sulphur  ointments,  which  have  been  too  frequent  -  resort,  have 
had  the  effect,  in  some  measure,  to  dissipate  the  eruption ;  but  the  usual 
sequel  to  this  are  convulsions,  or  fatal  brain  diseases.  It  is,  therefore, 
recommended  as  the  most  prudent  course,  to  depend  upon  the  internal 
administration  of  remedies  such  as  eliminate  the  hutnor,  and  keep  it 
upon  the  surface.  The  purer  the  blood  can  be  kept,  the  sooner  will  the 
disease  disa|)pear.  If  no  attention  is  paid  to  the  use  of  external  agents, 
the  entire  difficulty  will  bo  eliminated  and  dissipated  in  the  course  of  a 
few  months.  Two  globules  v>i  Aconite  may  be  jjiven  when  there  is  fever, 
and  this  may  be  t'ollowed  for  a  while  with  daily  doses  of  Rhus  tox.  and 
liryania.  In  scrofulous  children,  jfive  Oalcarea,  Arsenicum,  or  Sulphur. 
In  debilitated  constitutions,  jnfivc!  Graphites,  Ferrum,  Hepar  sulphur,  anci 
Of"'na.  Lycopodium,  throe  limes  daily,  has  cured  most  obstinate 
cases.  All  oily  food  should  be  withheld.  Butter  is  not  allowable. 
After  children  have  been  weaned,  and  still  the  Milk-Crust  remains, 
a  farinaceous  food  is  best. 

Sourf  of  the  Head. 

This  is  an  accumulation  upon  the  scalp,  of  an  oily  and  dirty  appearance, 
which,  in  mary  cases,  is  the  result  of  not  being  particular  in  washing 
and  wiping  the  head  dry.  Soap  should  never  be  used  upon  the  scalp. 
and  strong  alkaline  solutions  are  injurious.  Water  softened  with  corn  or 
rye  meal  will  answer  all  the  purposes  for  cleanliness.  As  the  difficulty 
does  not  penetrate  below  the  external  skin,  Rhv*  tox.y  Pulsatilla^  OcUaa- 
rea^  and  Silicea  are  remedies,  either  of  which,  in  daily  doses,  will  be  all 
that  u  required. 


i\ 


I'M 


if; 


Sorofhloiu  Swelling  of  the  Saliyoiy  Glands. 

This  is  a  disease  somewhat  common  to  children  tf  scrofulous  parents ; 
and  it  is  of  the  utmost  importance  to  understand  well  its  character  and 
treatment.  When  these  children  take  cold,  the  glands  are  apt  to  become 
excited,  an  i  there  is  a  perpetual  flow  of  saliva  from  the  mouth ;  at  the 
same  time  there  will  be  soreness  of  the  throat,  stiffness  of  the  neck,  and 
swelling  of  the  glands  externally.  Sometimes  children  will  carry  their 
heads  to  the  right  or  left  shouWer,  when  laboring  under  the  difficulty ; 
and,  in  spite  of  the  best  efforts  to  relieve  them  of  suffering,  they  will  con- 
tinue indisposed  a  long  time.  Two  or  three  globules  of  Aconite  will 
subdue  the  initial  fever.  Mercurius  viiK  may  then  be  given  two  or 
three  times  a  day.  If  tliis  fail  to  ai'i'cst  tlie  salivation,  give  Nitric  acid 
for  a  day,  at  intervals  of  six  hours.  Belladonna  also  may  be  given  to 
remove  any  congestion  of  the  throat.  Silicea  may  be  given  afterwards 
to  aid  in  softening  the  glands.  Also,  Nux  vomica  and  Sulphur  may 
prove  to  be  useful  remedies.  The  children  should  be  kept  in  a  room  of 
moderate  temperature,  and  not  be  allowed  at  any  time  to  be  exposed  to 
extremes  of  heat  and  cold  until  they  have  fully  recovered. 


Sleeplessness  of  Infants. 

Infants  are  sometimes  smitten  with  inability  to  sleep,  as  well  as  adults. 
The  cause  is  not  always  kii^iwu.  It  is  believed,  however,  to  be  the  result 
of  some  disorder  acting  upon  their  delicate  nerves  ;  such  as  indigestion, 
excoriation,  or  overloading  their  stomachs.  If  from  an  irritable  stomach, 
give  them  Ohamomilla  or  Coffea  every  night.  If  from  any  excoriated 
surface,  that  burns  and  smar.s;  give  two  globules  oi  Arse  icum^  and  then 
apply  to  the  excoriated  surface  a  little  rye  flour,  or  Lycopodium  pow- 
der,  and  soothe  them  to  sleep  in  a  quiet  and  noiseless  room.  If  the 
sleeplessness  is  produced  by  retention  of  urine,  give  Hyoicyamus ;  if  by 
worms,  Cina.  If  the  head  is  hot,  give  Belladonna.  If  the  sleepless- 
new  is  from  feeding  the  child  too  much,  give  two  globules  of  PulsatiUa, 
If  from  constipation  of  the  bowels,  give  Nux  vomica  or  Lycopodium  at 
night.  If  these  remedies  fail,  a  tepid  bath  will  often  consummate  the 
iesired  result. 


DISEASES  OF  VARIOUS  ORGANS  AND  REGIONS. 


Passage  of  Gall-Stones. 

The  passage  of  gall-stones  is  attended  by  severe  pain  in  the  region 
of  the  stomach,  obliging  one  to  writhe  in  agony,  and  roll  from  side  to 
side.  The  strongest  men  become  subdued  when  suffering  from  the  pas- 
sage of  these  concretions.  The  pain  resembles  an  intense  colic ;  and 
sometimes  the  agony  produced  by  biliary  calculi  goes  under  the  name 
of  Bilious  Colic.  In  addition  to  the  pain  occasioned  by  the  concretions, 
there  may  be  vomiting,  headache,  cold  extremities,  and  sallow  com> 
plekion.  To  reUeve  the  suffering,  resort  has  been  had  to  Morphine  and 
Opium ;  but  those  sedatives  only  prolong  the  difficulty.  Tney  afford 
only  temporary  relief  from  pain,  and  the  use  of  them  must  be  discour- 
aged. Cathartics,  on  the  whole,  have  failed  of  accomplishing  the  pur- 
pose, and  only  weaken  the  patient.  Homoeopathic  remedies  have  some* 
times  afforded  prompt  relief;  but,  as  a  general  thing,  the  success  attend- 
ing the  most  perfect  affiliations  of  indicated  remedies  has  not  been  great. 
The  most  modern  treatment  for  biliary  calculi  is  to  administer  to  the 
patient  from  two  to  four  ounces  of  pure  Olive  oil,,  the  laxative  effect  of 
which  has  gently  moved  the  bowels,  and  brought  from  the  gall-duct 
large  numbers  of  the  concretions,  sometimes  a  dozen  or  more ;  afler 
which,  the  blackness  of  the  countenance  will  begin  to  disappear,  the 
indurations  found  in  the  region  of  the  liver  become  lessened,  the  appe- 
tite returns.  When  attacks  of  Bilious  Colic  occur,  it  is  not  always 
certain  that  the  gall-duct  is  obstructed  with  stones.  Therefore,  (Jolocynth^ 
in  the  usual  dose,  may  afford  prompt  relief;  even  when  gall-stones  have 
been  present,  and  the  suffering  and  agony  are  indescribably  great,  Puha- 
tilla  has  cured.  When  there  is  severe  pain  and  induration  in  the  region 
df  the  liver,  a  dark,  sallow  countenance,  and  black  circles  around  the  eyes, 
much  relief  has  been  obtained  by  the  use  of  Ar%enicum.  When  there 
remain  black  spots  or  discolorations  upon  the  face.  Sepia.  When 
there  is  much  vomiting  during  an  attack.  Ipecac.  External  applications 
sometimes  prove  useful.  Emollient  poultices  applied  to  the  region  of 
the  pain  have  proved  beneficial.  The  pain  attending  the  passage  of 
biliary  concretions  has  sometimes  been  mistaken  for  chronic  Inflamma- 
tion  of  the  Stomach ;  and,  on  this  account,  the  remedies  have  failed  to 

839 


;^ 


PI  I 


840 


DISEASES  OF  VARIUUS  ORGANS  AMD  REGIONS. 


control  the  suffering.  Very  many  perspns  suffering  from  chronic  Liver 
Complaint  become  victim?  to  the  suffering  produced  by  gall-stones,  and 
should  restrict  themselves  to  a  simple  but  nutritious  diet.  After  an 
attack,  the  olive  oil  should  be  taken  for  at  least  six  jnonths,  a  table- 
spoonfiil  on  retiring,  each  night. 

Cancer  of  the  Liver.  —  ^cAiitms. 

In  the  event  of  a  constant  suffering  in  the  right  side,  with  apparent 
hard  protuberances,  while,  at  the  same  time,  there  are  dark  circles 
around  the  orbits  of  the  eyes,  and  when  there  are  shooting  or  lancinat- 
ing pains  darting  from  the  i;idurated  protuberances,  a  cancer  may  be 
suspected.  If  not  too  far  advanced,  it  may  be  cured  by  the*  administi-a- 
tion  of  Arsenicum^  when  there  is  much  thirst  and  dryness  of  the  mouth, 
a  white  coating  upon  the  tongue,  and  considerable  prostration.  Conium 
maetUatum  may  be  given  three  times  a  day  when  there  is  pain  in  the 
right  side,  as  if  constricted  by  a  band,  or  tearing  and  stretching  in  the 
region  of  the  liver,  and  colicky,  abdominal  spasms. 


f^wt 


Oanoer  of  the  Stomacli. 

This  formidable  disease  often  comes  on  insidiously,  and  the  victim 
supposes  himself  to  be  a  sufferer  from  an  aggravated  form  of  Dyspepsia. 
Severe  anxiety  and  trouble  are  supposed  to  have  a  serious  influence  in 
the  production  of  the  disease.  A  constant  irritation  -of  the  mucous  lining 
of  the  stomach  may  tenninate  in  the  difficulty.  The  chief  symptoms 
denoting  the  presence  of  Cancer  in  the  Stomach  are  great  depression  of 
spirits,  a  downcast  countenance,  a  pinched  appearance  of  the  nose,  with 
the  comers  of  the  mouth  drawn  down,  and  also  a  constant  inclination  to 
retch  and  vomit  dark  matter,  somewhat  resembling  coffee-grounds,  and 
also  severe  cutting  or  shooting  pains  in  the  stomach,  with  intense  thirst. 
Ntix  vomica  has  sometimes  cured  Cancer  of  the  Stomach.  The  indica- 
tions for  its  ube  are  intensely  bitter  eructations,  and  spitting  up  of  dark 
matter;  and  also  when  the  eructations  are  followed  by  vomiting  of 
sanious  or  bloody  matter.  When  the  patient  has  suflfered  greatly  from 
anxiety  and  Dyspepsia,  Ignatia  may  be  given,  instead  of  Nux  vomica. 
When  the  tumor  can  be  diagnosed  or  discovered  by  external  manipu- 
lation, Arsenicum,  and  also  Conium,  may  be  given  twice  a  day.  Coccur 
lus  also  may  be  given  when  the  nausea  and  vomiting  are  similar  to  that 
produced  by  riding  in  a  carriage,  or  sea-sickness.  When  one  has  sui^^ 
fered  many  years  from  Dyspepsia,  and  then  begins  to  emaciate  and  spit 
up  this  dark  matter.  Nine  vomica  given  persistently  is  most  likely  to  be  of 
service.  The  patient  should  subsist  upon  broths,  beef-tea,  and  the  most 
delicate  farinaceous  diet. 


Oanoer  of  the  Intestines. 

The  symptoms  which  denote  the  presence  of  Cancer  of  the  Intestines 
are  constant  pain  in  the  bowels,  and  acrid  discharges  of  blackish  stools, 
a  very  black  or  dark  appearance  of  the  countenance,  downcast  expre»> 
lion,  a  constant  inclination  to  relieve  the  pain  by  pressure  of  the  handf 


■m 


DISEASES  OF  VABIOUS  0BGAM8  AND  BEQI0N8. 


841 


and  arms.  This  affection  generally  terminates  &tally,— the  result  being 
perforation  of  the  bowels.  When  aatopsy,  or  post-mortem  examination, 
reveals  the  fact,  it  is  then  called  to  mind  that  tite  victim  has  worn  the 
expression  and  complained  for  a  long  time  in  a  way  that  might  have 
excited  suspicion  of  the  trouble.  To  note  these  symptoms  when  they 
first  occur  may  suggest  a  treatment  that  possibly  might  avert  a  fatal  tei> 
,mination.  Ar»enunim  may  be  given  when  the  patient  has  thirst,  burn* 
ing  pain  in  the  bowels,  and  hot,  acrid  stools ;  Comum^  when  the  pain* 
appear  to  be  of  a  neuralgic  character,  and  persistent ;  Belladonna^  when 
there  is  a  painful  distention  of  the  abdomen.  The  diet  should  be  th» 
Miae  as  that  directed  for  Cancer  of  the  Stomach. 


Ganoer  of  the  Skin. 

When  inflammation  of  the  skin,  or  any  persistent  irritation,  terminates 
in  Cancer,  there  is  a  rough,  hard  tumor  of  a  bluish  appearance,  at  first 
about  the  size  of  a  common  wart.  It  sometimes  grows  into  the  shape  of 
a  tumor,  and  is  the  seat  of  sharp,  shooting  pains.  The  remedy  that  has 
apparently  cured  this  affection  is  Silicea,  in  daily  doses.  It  is  particu- 
larly indicated  when  there  is  painful  soreness  or  sensitiveness  of  the  skin, 
and  an  itching  of  the  whole  body ;  and  also  when  there  is  stinging  in 
the  sore.  To  prevent  cutaneous  ulcers  of  the  skin  from  becoming  can- 
cerous, the  same  remedy  may  be  used.  To  prevent  horny  excrescences 
from  assuming  a  cancerous  character,  Conium  or  Causticum  may  be  given 
in  daily  doses.  Almost  any  persistent  irritation  may  assume  the  cliarac 
ter  of  a  cancer.  Ichorous  ulcers,  fetid  sores,  malignant  boils  or  ulcers, 
should  be  carefully  treated  and  cured,  or  otherwise  they  may  take  on  a 
settled  or  constitutional  schirrous  character.  The  skin  should  be  kept 
clean ;  a  flesh-brush  should  be  frequently  used,  and  exercise  in  the  open 
air  is  commended.     Diet  free  from  condiments,  but  nutritious. 


Fig-Warts, 

These  are  excrescences  upon  the  skin  in  the  shape  of  a  fig,  and  hence 
their  name.  Nitric  add  and  Thuja  are  remedies  for  these  excrescences. 
Thvja  is  more  particularly  indicated  when  they  bleed  ;  Nitric  acid^ 
when  they  are  flat ;  Nvix  vomica,  when  they  are  dry.  When  they  sup- 
purate, or  are  humid.  Thuja;  wiien  they  split  or  crack,  Nitric  add.  Of 
the  remedy  selected,  give  a  dose  every  day.  For  Common  Warts, 
Thuja  is  also  the  chief  remedy,  and  should  be  given  every  two  or  three 
days.  , 

Gangrene. 

When  one  has  been  so  long  sick  as  to  acquire  bed  sores,  and  these 
become  black  and  fetid  and  deathlike,  they  are  said  to  be  gangrenous. 
They  indicate  a  low  condition  of  the  system,  and  generally  indicate  the 
employment  of  Arsenicum  in  daily  doses,  or  else  Lachem.  For  Dry 
Gangrene,  give  ArMenioum,      For  that  which  \%  humid,  ^ve  China, 


^ 


B' 


842 


DUEASES  0FVA7.I0US  OBGAMS  AND  REGIONS. 


i^^' 


For  that  which  emits  an  offensive  odor,  give  SeoaU  eomutum.  Thii 
last  remedy  may  be  given  for  gangrenous  blisters.  The  patient.  If  he 
take  it,  should  have  a  generous  cuet. 

Zona,  or  Shingles. 

In  some  cases,  there  is  a  zone  or  belt  of  vesicles,  four  or  six  inches  iu 
width,  that  extends  half  round  the  body,  on  the  right  side,  over  the  region 
of  the  liver.  These  vesicles  appear  to  be  filled  with  lymph,  rnd  are 
prone  to  burn  and  itch  to  almost  an  unbearable  extent.  It  is  believed  to 
be  a  concomitant  of  chronic  Liver  Compb.int,  and  indicates  an  exceedingly 
lov?  rendition  of  the  blood.  Mhiis  tox.^  in  daily  doses,  will  generally  cire 
the  disease.  Graphites  may  be  given  after  lihua  tox.  When  there  is 
pain  in  the  right  side  and  a  sallow  complexion,  give  Mercurius.  Bryo- 
nia will  eliminate  the  eruption,  and  aid  materially  in  the  invigoration 
of  the  system.  If  there  is  much  headache,  give  Belladonna.  If  the 
patient  is  scrofulous,  give  Arsenicum  or  Calcarea.  The  diet  of  the  patient, 
if  his  appetite  will  permit,  shoul  J  be  quite  generous.  A  little  wine  every 
day  is  recommended.  Beef  or  mutton  without  condiments,  and  the  usual 
vegetables,  are  allowed. 

*     ^         Nasal  Polypus. 

This  fungous  growth  in  one  or  both  nostrils  sometimes  proves  a  serious 
obstruction  to  respiration  through  the  nose,  and  can  be  cured,  in  most 
instances,  with  well-chosen  remedies.  When  both  nostrils  are  affected. 
give  a  dose  of  Calcarea  every  twenty-four  hours.  When  the  Polypus 
is  in  the  right  nostril,  give  Pulsatilla  ;  when  in  the  left,  give  Sanguir 
naria.    If  the  nostril  seems  plugged,  give  8epia  or  SUicea, 

Warts  on  the  Nose. 

Warts  on  the  nose  aie  sometime-s  quite  annoying,  as  they  not  only 
are  inconvenient,  but  oflen  painful.  It  is  difficult  to  let  one  of  these 
excrescences  alone ;  and,  by  constant  irritation,  it  may  become  cancerous: 
therefore,  prompt  treatment  when  they  make  their  appearance  is  requisite. 
Camtieum^  given  at  first,  will  soon  relieve  the  nose  of  this  appendage. 

Warts  on  the  Hands. 

When  warts  on  the  hands  are  prone  to  grow  thick  and  large,  and 
appear  to  be  seedy.  Thuja  in  the  form  of  lotion  may  be  applied  extern 
nally,  while  the  usual  dose  of  the  same  may  be  taken  internally.  Chir 
prum  asceticum  also  may  be  taken  internally,  and  a  wash  of  Ckiprum 
ndph.,  one  dram  to  half  a  pint  of  water,  may  be  applied  externally. 

Inflammation  of  Glands  under  the  Arms. 

A  sore  upon  the  back  of  the  thumbs,  and  sometimes  an  irritable  sore 
upon  the  bftcks  of  the  fingers  and  hands,  may  cause  soreness  and  inflam- 


tv   J 


DISEASES  OF  VABIOUS  ORGANS  AMD  BEOIONB. 


843 


mation  of  the  elands  in  the  arm-pits ;  that  is,  the  inflammation  may  be 
transferred  to  this  locality  from  the  thumb,  fingers,  or  liands.  At  first,  a 
slight  soreness  is  felt  under  the  shoulder  in  the  arm-pit,  and  the  glands 
will  swell  and  become  sore  to  the  touch  ;  more  cr  less  fever  will  manifest 
itself  at  the  time  :  and  not  unfrcquently  pain,  throbbing,  and  suppuration 
supervenes  upon  the  inflammation.  Aconite  may  be  given  to  subdue  the 
fever  and  inflammation  ;  Hepar  nulphur  may  be  given  to  promote  sup 
puration;  Belladonna  or  Bryonia  to  prevent  it.  Phytolacca,  also, 
is  a  most  useful  specific,  given  every  three  hours  until  relieved. 

Inflammation  of  the  Oroin,  Inguinal  Glands. 

The  inguinal  glands  are  situated  in  tlie  groin  ;  and  sometimes  sores  «/f 
an  irritable  character  upon  the  toes  may  operate  so  as  to  transfer  these 
influences  to  this  region,  causing  swelling  and  suppuration.  If  takf  n  in 
time,  this  soreness  may  amount  to  nothing  more  than  an  uncomfortable 
lameness,  rendering  it  difficult  to  walk.  If  not  arrested,  tiie  inflamma- 
tion will  pass  into  suppuration.  Sores  or  chancres  upon  the  integuments 
of  the  penis  may  also  cause  inflammation,  swelling,  and  even  suppura- 
tion, of  the  inguinal  glands.  When  caused  by  sores  on  the  toes,  poul- 
tices of  bread  and  milk  may  be  applied  to  ther-  to  draw  the  inflamma- 
tion from  the  groin  ;  and  Nux  vomica  may  be  ^.v^en  internally,  to  aid  in 
curing  the  difficulty.  When  this  inflammation  occurs  in  scrofulous  per- 
sons, Ar»eni(mm  may  be  given  twice  a  day.  When  the  inflammation 
proceeds  from  a  chancre,  give  Merc.  iod.  three  times  a  day ;  when  from 
suppressed  Gonorrhoea,  give  Sulphur.  Mercurial  ointment  may  be  a|»- 
plied  to  the  sores,  when  of  syphilitic  origin.  If  tkey  occur  from  Syphilis, 
Mere.  iod.  may  be  given  internally  three  times  a  day. 


cancerous: 


Milk  Leg.  —  Phlegmasia  Dolens. 

This  affection  frequently  occurs  one  week  afler  delivery.  It  consists 
in  a  swelled  condition  of  the  thigh  and  leg  of  either  the  right  or  lefl  side. 
The  skin  becomes  tense,  sore  to  the  touch,  adematous  or  dropsical,  and 
very  sensitive.  It  rarely  affects  both  limbs  at  the  same  time,  although 
in  some  instances  such  is  the  case.  It  may  sometimes  be  arrested  in  the 
incipient  stage  by  a  single  dose  of  Aconite.  In  a  more  advanced  stage, 
Belladonna  will  have  a  curative  action ;  and,  where  there  is  great  sen- 
sitiveness of  the  skin,  Rhus  tax.  When  the  victims  of  Milk  Leg  have 
been  afflicted  with  dropsy  before  confinement,  Arsenicum  may  be  given. 
In  cases  where  women  are  suffering  from  rheumatic  pains  in  the  knees, 
or  where  there  is  suppressed  lochia,  Pulsatilla.  When  the  bowels  are 
constipated,  Lywpodium  may  be  given,  and  not  repeated  for  several 
days.. 

Stone  Bruise. 

By  a  Stone  Bruise  is  understood  an  injury  upon  the  plantar,  or  under 
surface  of  the  foot,  which  becomes  inflamed,  painful,  and  suppurative. 
It  mostly  occurs  with  boys  and  girb  who  run  barefooted  through  tne  warm 


J  A 


•n 


Ic 


fcy^- 


^r^ 


I 


844 


DISIASE8  OF  VABIOUS  ORQANS  AMD  BBQION& 


weather ;  and  it  is  believed  to  be  the  result  of  stepping  forcibly  upon 
pebbles  or  other  hard  substances.  Amiea  given  cmce  or  twice  internally, 
and  a  lotion  of  the  same  applied  externally,  will  often  remove  the  pam 
speedily ;  but,  after  suppuration  has  taken  place,  the  sooner  the  matter 
it  let  out  with  a  lancet  tne  better. 

Bonioiis. 

These  protuberances  upon  the  joint  of  the  great  toe,  or  upon  the  side  of 
the  foot  immediately  back  of  the  little  toe,  frequently  grow  so  large  as  to 
interfere  with  the  wearing  of  a  shoe  or  a  boot,  and  so  painful  as  to  interfere 
with  the  comfort  of  the  patient.  In  order  to  derive  any  benefit  from  treat 
ment,  all  mechanical  interference  must  be  removed,  the  boot  or  shoe 
must  be  shaped  to  favor  the  tumor,  and  then  wet  the  tumor  a  number 
of  times  during  the  day  with  Arnica.  Antimonium  crud.  may  be  given 
internally,  or  else  Calcarea,  Sepia^  or  Sulphur.  Give  but  a  single  dose 
of  each  remedy ;  after  which,  wait  with  patience.  If  the  bunion  is  very 
painful,  give  Oalcarea ;  and,  after  two  days,  give  Nitric  acid.  If  the  pains 
are  stinging,  Lycopodium^  Silicea,  or  Sulphur.  Give  a  single  dose  of  either 
remedy,  and  wait  forty-eight  hours.  A  weak  solution  of  Nitric  acid 
will  often  moderate  the  severe  pain  of  a  bunion  in  dry  weather ;  Bryonia 
will  do  the  same  in  cold,  damp  weather.  Silicea  or  Rhux  tox.  will 
afford  great  relief  when  every  change  of'  weather  aggravates  the  pain 
and  suffering.     In  case  of  the  bunions  becoming  the  seat  of  neuralgic 

Eain,  Belladonna  may  be  given ;  and  when  they  are  made  sore  by  chil- 
lains,  as  in  scrofulous  persons,  Arsenicum  must  be  given.  The  patient 
must  not  walk  much,  but  keep  the  feet  dressed  and  warm  until  the  sore- 
ness disappears.  A  poultice  of  bread  and  milk  will  soflen  and  mollify 
the  aching  during  a  storm. 

Heotio  Fever. 

The  importance  of  this  fever  is  so  great,  that,  instead  of  elaborating 
upon  it  under  the  head  of'*  Fevers,"  it  is  introduced  here,  because  it  should 
not  be  confounded  with  other  febrile  diseases.  There  is  a  common  im- 
pression that  Hectic  Fever  and  Consumption  are  one  and  the  same 
thing ;  but  this  impression  will  be  corrected  when  we  consider  briefly 
ths  origin  of  this  fever.  |t  is  sometimes  intermittent,  and  sometimes 
remittent.  Often  a  slight  chilliness  is  felt  some  time  during  the  day ;  and 
this  is  followed  by  a  febrile  re-action,  more  or  less  severe,  and  of  a  pros- 
trating character.  Extf-eme  debility  may  cause  a  fever  of  this  kind  to 
spring  into  existence ;  and,  under  such  circumstances,  it  may  take  the 
form  of  a  low  nervous  fever,  very  slow,  and  wearing  upon  the  nutritive 
system.  But  Hectic  Fevers  show  themselves  where  there  are  local 
cnronic  inflammations  and  suppurations,  as  in  the  case  of  abscesses,  car- 
buncles, &c.  They  are  sometimes  caused  by  grief,  or  emotions  of  any 
kind.  They  are  caused  by  the  loss  of  animal  fluids ;  or  they  may 
supervene  upon  any  prostrated  condition  brought  on  by  acute  disease. 
They  result  also  from  Scrofula  and  Syph'Us,  and  from  the  poisonous  influ- 
ences of  Quinia  or  mercurial  medicines.  It  is  probable,  therefore, 
that  Hectic  Fever;  taken  in  time,  is  curable,  provided  the  organic  lesions 


i 


on  which  it  depends  are  not  of  a  fatal  or  incurable  kind.     That  which 
usually  accompanies  pulmonary  tubercles  can  only  be  overcome  by  curing 
the  Tuberculosis  of  the  lungs.     We  will  proceed  to  specify  the  treatment 
according  to  particular  indications.     Those  springing  from  debility,  and 
of  a  slow  nervous  fever,  require  the  use  of  China  and  Arsenicum.     Give 
the  China  every  time  the  fever  remits  or  intermits,  —  a  single  dose.    Give 
Arsenicum  in  ti>e  same  way  wlien  there  is  extreme  prostration  and  thirst. 
Give  Phosphoric  add  when  tliere  is  diarrhoea.     Wlien  the  fever  attends 
local  inflammation,  Arsenicum  may  be  given,  when  there  is  great  ema- 
ciation and  debility,  with  palpitation  of  the  heart,  hot,  dry  skin,  and  night- 
sweats  ;  Calcarea,  when  there  is  constant  heat  and  little  thirst,  frequent 
fluslies  of  heat,  especially  in  the  evening,  with  red  cheeks.     Calcarea 
is  also  indicated  when  there  is  loss  of  appetite,  great  debility  and  ema- 
ciation, and  also  paroxysms  of  anguish.     China  is  indicated  when  there 
is  great  paleness,  sunken  cheeks  and  eyes,  great  listlessness,  dry  and 
flaccid  skin,  great  hunger,  or  else  loss  of  appetite,  and  a  tendency  to 
Diarrhoia.     For  Hectic  Fever  brought  on  by  emotions  or  grief,  give  Phos- 
phoric acid,  followed  by  Capsicum  wiion  there  is  painless  diarrhoea,  sad,  op- 
pressed mood,  febrile  heat  in  the  evening,  smd  sweat  towards  morning     Give 
Ignatia  when  the  patient  weeps  during  the  fever,  and  hus  much  heat  in  the 
palms  of  the  hands.     Give  Graphites  when  the  patient  is  pale,  and  the 
heart  is  prone  to  palpitate.     If  the  fever  is   produced  by  debilitating 
losses,  give    China  when    from   hemorrhage;  give    N'ux  vomica  when 
from  sexual  excesses  ;  Phosphoric  acid  when  from  diarriioeu,  and  there 
is  accelerated  pulse,  anguish,  and  sweats  in  the  morning.     When  the 
fever  comes  on  after  Dysentery  or  Typhus  Fever  or  Cholera,  give  Arseti- 
ieum,  if  there  are  dysenteric  discharges,  and  if  the  patient  is  greatly 
emaciated,  and  has  laborious  breathing,  with  debility  and  palpitation  and 
thirst,  obliging  one  to  drink  frequently.      Give   Cocculus  wheii  Hectic 
Fever  sets  in  after  Typhus,  when  there  is  great  debility,  and  trembling 
after  the  least  exertion,  blue  margins  around  the  eyes,  dry  mouth,  and 
loss  of  appetite,  oppression  of  the  chest,  and  with  great  sadness  and 
anguish.    Give  Veratrum  album  when  hectic  comes  on  after  Cholera,  if 
there  is  great  weakness,  or  cramps,  or  pain  in  the  back  of  the  head  during 
the  fever.     When  Syphilis  is  attended  with  Hectic  Fever,  and  if  the  patient 
has  taken  much  Mercury,  give  Aurum  mur.  or  Slannum,  when  there  is 
great  emaciation,  and  pains  in  the  bones,  and  loss  of  appetite.     Nitrio 
add  may  be  given  when  the  hectic  fever  has  been  brought  on   by 
mercurial  medicines,  and  when  there  is  great  dryness  of  the  tliroat,  and 
varices  of  the  tongue.     In  many  cases  of  Hectic  Fever  springing  up  like 
those  named  above,  a  careful  selection  of  the  remedy,  and  corresponding 
adaptation  of  diet  and  regimen,  will  bring  about  a  large  proportion  of 
cures.     Persons  suffering  from  any  form  of  Hectic  Fever  should  be  kept 
in  an  atmosphere  of  uniform  temperature,  —  from  68°  to  70°  Farenheit , 
and  should  be  supplied  with  generous  food  when  the  appetite  will  take  it, 
and  in  some  cases  the  best  of  grape  win?. 

Night-Sweats. 

If  night-sweats  break  out  in  particular  diseases,  they  do  not  require 
any  special  consideration,  unless  it  happens  to  be  one  of  the  most  promi- 


1 


'■fq 


846 


DISEASES  OF  VARIOUS  ORGANS  AND  REGIONS. 


.1^ 


I  "I" 

if 
t 

-if 


m: 


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nent  symptoms ;  in  which  case,  it  ma^  constitute  an  important  indica- 
tion for  the  selection  of  a  remedy.  A  profuse  perspiration  of  this  kind 
which  affords  no  relief  indicates  Mercurius  or  China.  Exhausting  nij^ht- 
sweats  in  the  case  of  persons  that  hiive  become  weakened  by  disease  or 
other  causes,  point  to  Carho.  vegetahflis.  Vcratrum  album.  Sulphur.  I5ut 
tliorc  are  indivi(hials,  who  iippear  to  be  w*;!!  euough  otherwise,  who  per- 
spire copiously  every  ni}>ht,  and  sometimes  so  proruseiy  as  U>  wet  the  bed- 
clothin:;.  It  would  seem  that  sleep  induced  some  kind  of  labor  that 
wrought  the  system  up  to  this  pitch  of  perspiration.  It  is  said  to  be  most 
common  with  corpulent  persons.  Such  cases  as  only  exhibit  the  one 
symptom  of  sweating  for  consideration,  must  be  treated  as  follows :  When 
one  begins  to  sweat  as  soon  as  he  lies  down  to  i*est  at  night,  Arsenicum 
may  be  administered.     When  he  fails  to  sweat  so  long  as  he  keeps  awake, 

give  Hepar.,  if  he  is  corpulent ;  or  Calcarea  if  he  finds  the  sweats  to 
iminish  his  strength.  If  exercise  of  mind  sets  him  to  perspiring  after 
getting  into  bed,  give  Nux  vomicoy  if  there  is  a  sanguine  temperament. 
If  the  person  is  a  good  feeder,  and  eats  heartily,  and  has  these  prostrat- 
ing sweats  at  night,  let  him  eat  less,  and  take  Pulsatilla.  Exhausting 
night-sweats  that  occur  after  fatigue  require  Arnica  and  China.  If  after 
severe  mental  labor,  give  Cocculus  or  Nua;  vomica.  If  from  no  cause 
that  can  be  determined,  Carbo.  animalis.  When  no  fever  precedes  one 
of  these  exhausting  sweats,  and  there  is  great  debility  after,  China,  Fer- 
rum,  and  Qraphitea  are  appropriate  remedies.  For  the  exhausting  night- 
sweats  that  occur  after  masturbation,  China  is  also  the  remedy.  If  there 
is  uncomfortable  feeling  about  the  head,  —  a  dull  feeling,  —  give  Phos- 
phoric add.  Those  night-sweats  that  occur  after  excessive  sexual  indul- 
gence require  China,  Arsenicum,  and  Qraphites.  For  morbid  sweats  in 
general,  Arsenicum,  Arnica,  Bryonia,  China,  Ferrum,  Qraphites,  Helle- 
borus  nig.,  ffyoscyamiis,  Ignatia,  Mereuriv*,  Nux  vomica,  and  Sulphur 
may  be  consulted.  .  •  . 

Polnionary  Oonsamption. 

There  is  reason  for  a  distinct  monograph  upon  this  disease.  Much  that 
can  be  done  to  ward  off  the  disease  by  domestic  treatment  should  be  done  ; 
and,  therefore,  to  point  out  a  plain  description  and  treatment  of  the  incip- 
ient stage  is  at  least  desirable.  The  cause  of  Consumption  may  be  hered- 
itary taint  or  overpowering  influences  that  break  down  the  strongest 
constitutions.  When  hereditary,  it  frequently  exists  as  a  predisponent  in 
the  system  until  aroused  by  some  exciting  cause.  It  is  therefore  of  the 
first  importance  to  become  familiar  with  the  means  of  protecting  one  thus 
disposed  from  surrounding  influences  that  may  develop  the  hereditary 
taint.  When  a  child  of  consumptive  parents  appears  to  thrive  well  and 
grow,  betraying  no  signs  of  disease,  it  is  well  to  keep  him  surrounded  by 
such  atmosphere,  food,  and  clothing,  as  contribute  to  his  healthy  develop- 
ment, until  the  age  of  puberty.  It  is  at  this  period  that  changes  occur, 
more  or  less  fraught  with  danger.  With  the  male,  there  is  danger  ol' 
arousing  any  latent  tendency  to  pulmonary  tubercles ;  with  the  female, 
there  is  danger  of  the  menstrual  function  becoming  so  feebly  developed, 
that  it  acts  as  an  excitant  upon  any  latent  discrasia  of  the  blood.     Treat 


DISEASES  OP  VARIOUS  OUQANS  AND  REGIONS. 


847 


mt'iit  is  therefore  required  at  this  period,  not  only  to  obviate  any  derange- 
ment consequent  upon  its  occurrence,  but  to  aid  a  burthened  system  in 
])rinnfinf;  uhout  this  physiolonfical  change,  so  as  to  answer  all  the  do- 
niiuuls  upon  it.     Scpiirato  beds  shouhl  bo  insisted  upon. 

For  males  at  the  age  of  puberty,  children  of  scrof'uloufl  parents,  give 
a  dose  of  Calo.  carb.  twice  a  wr^ek,  and  restrict  tliein  to  a  strictly  nutri- 
tious diet,  free  from  fat  or  gravy.  In  case  of  their  being  children  t>f 
parents  who  had  tubercular  disease  of  the  lungs,  give  them  Lyoopudimn 
twice  a  week,  or  perhaps  Graphites,  and  direct  for  them  a  good  dii't  of 
animal  and  vegetable  food  ;  let  them  avoid  ex|)()sure  to  extremes  of  teui- 
petature ;  let  them  sleep  in  well-ventilated  apartments :  and  any  hered- 
itary tendency  to  Consum})tion  can  be  overcome.  Should  a  cough  ensue 
upon  the  period  of  pubescence,  give  Lyoopodium  or  Oalcarea  ;  if  a  short, 
hacking  cough,  give  Phosphorus  ;  if  a  tidcling  cough,  give  Pulsatilla  or 
Sepia.  By  thus  watching  the  first  development  of  cough,  and  by  giving 
the  appropriate  remedy  at  once,  the  same  can  be  cured.  In  females, 
when  there  is  great  debility  of  the  chest,  and  sometimes  a  slight  bleeding 
occasioned  by  a  trifling  cough,  give  Sauro  cerasus.  Thus,  by  noting  the 
slightest  development  of  cough  at  this  period,  and  by  being  prompt  in 
selecting  the  appropriate  remedy,  this  incipient  form  of  Consumption  can 
be  cured,  and  sound  health  be  established,  and  will  remain  until  some 
other  revolution  occurs  to  unsettle  the  system.  Any  excesses  on  the 
part  of  the  male  must  be  avoided.  Whatever  weakens  or  deteriorates 
any  of  the  functions  may  prove  an  exciting  cause,  so  long  as  there  is  any 
predisposing  influence  in  the  system.  On  the  part  of  females,  there  is 
danger  at  the  period  of  the  first  pregnancy.  This  revolution  will  either 
make  further  improvements  in  the  direction  of  sound  health,  or  it  will 
arouse  unfavorable  influences  that  depress  and  ruin  it.  Thus  it  may  seem 
plain  that  Consumption  may  be  successfully  treated  in  its  incipient  stage, 
whether  it  shows  itself  early  or  late  in  life.  If  there  is  indication  of  its 
approach  after  a  fever,  give  China ;  if  after  excessive  fatigue,  give  Lyco- 
podium  or  Stannwn.  If  excessive  venery  causes  a  development  of  con- 
sumptive symptoms,  give  Arsenicum  or  China;  if  the  shock  of  labor 
produces  depressing  effects,  give  Arnica,  China,  and  Arsenicum ;  and  if 
cough  ensues,  give  Bryonia  or  Phosphorus,  and  a  well-regulated  diet. 
It  is  believed,  that,  in  a  majority  of  instances.  Hereditary  Consumption  can 
be  erased  from  the  family  record  by  carefully  Waging  a  warfare  upon  the 
first  approach  of  the  enemy. 

But  a  different  aspect  presents  itself  in  that  form  of  Consumption 
which  comes  on  by  reason  of  a  good  constitution  having  been  over- 
taxed and  worn  out.  A  cold,  badly  treated,  may  leave  behind  a  perma- 
nent irritation  even  upon  the  most  naturally  healthy  constitutions.  A 
!ough  from  a  cold  is  not  to  be  trifled  with ;  therefore,  attend  to  the  slight- 
est cough.  Nux  vomica  may  remove  a  cough  brought  on  by  a  cold,  if 
given  at  once ;  a  dry,  hollow,  or  hoarse  cough  may  be  cured  with  Hepar 
sulph. ;  a  cough  with  heat  of  the  chest  and  soreness  of  the  lu.igs  may  be 
cured  with  Bryonia.  Long  exposure  to  cold  that  chills  the  whole  sys- 
tem .may  be  followed  by  a  violent  fever  that  fixes  itself  u|)on  the  lungs, 
producing  violent  inflammation ;  and  this,  if  improperly  treated,  ma)r  end 
in  Consumption.  Almost  any  acute  disease,  badlj  treated,  may  terminate 


^m 


>l 


•4 


Pel 


f 


848 


riSEASBS  07  VARIOUS  ORGANS  AMD  RB0I0M8. 


In  fatal  Consumption ;  therefore,  when  any  interruption  occurs  in  the 
function  of  respiration,  it  is  more  or  less  dangerous.  The  slighter  the 
interruption  the  better,  and  the  more  easily  can  it  be  removed.  But  it 
must  not  be  neglected.  An  exceedingly  slight  capillary  congestion,  if 
neglected,  may  become  chronic,  and  end  m  Tuberculous  Consumption ;  a 
slight  bronchial  disturbance,  not  properly  treated,  may  terminate  in  Bron- 
chial Consumption :  in  short,  any  of  the  ailments  of  a  trivial  character, 
which  can  be  made  worse  by  neglect,  may  demand  the  most  careful  treat- 
ment, or  otherwise  they  may  terminate  in  Consumption. 

fuflueuza)  or  Grippe,  comes  on  like  a  cold,  ^vith  sneezing  or  snivelling, 
puin  in  the  chest,  and  a  general  appearance  of  Catarrh.    Too  frequently  it 
liaa  been  neglected  in  the  first  stage,  and  it  has  run  into  the  chronic  form 
of  Bronchitis,  and  thence  into  Consumption.    Such  being  the  known  ten- 
dency, it  is  well  to  seek  the  best  of  treatment  for  this  disease  at  once. 
Arsenicum,  in  the  incipient  stage,  will  relieve  some  of  the  symptoms:  it 
will  relieve  tl»e  thin  discharge  from  the  noae  and  eyes,  the  pain  in  the  limbs, 
and  general  acliing  in  the  bones.     Euphrasia  relieves  many  casea  in  the  be- 
ginning which  resemble  Arsenicum.  Marciiriua  vio.  is  also  a  fine  remedy  for 
the  stoppage  of  the  nose,  eyes,  and  general  restlessnos  of  the  whole  system. 
Influenza  has  been  reckoned  among  the  causes  of  Consumption,  because,  in 
many  instances,  it  has  been  the  means  of  calling  into  action  certain  latent 
tendencies  that  have  ever  b(!on  dormant  until  set  upon  by  this  exciting  cause. 
.  Influenza  is  but  an  acute  form  of  Hronchitis,  and  as  such  it  must  be  treated. 
Aconite  may  be  given  if  there  is  a  quick,  full  pulse.    After  Aconite  has  softened 
the  pulse,  and  produced  moisture  upon  the  skin,  if  the  head  continues  to  ache, 
give  Belladonna ;  if  there  is  soreness  of  the  throat,  give  Merc,  viv.;  if  much 
thirst,  Arsenicum;  if  pains  in  the  back  and  loins,  Nux  vomica     In  females, 
Pulsatilla  may  remedy  many  of  the  derangements  which  influenza  produces. 
If  a  sudden  check  of  menstruation  supervenes  upon  an  attack  of  this  disease, 
give  Aconite,  and  follow  with  Pulsatilla;  and,  finally,  if  influeu/:i  shows  itself 
in  an  epidemic  form,  and  almost  every  man,  woman  and  child  become  victims. 
Aconite,  Belladonna,  Mercuriua,  and  Nux  vom.,  or  else  Arsenicum,  Apia 
md.,  Bryonia,  Calcarea  carh..  Phosphorus,  and  Sulphur,  may  constitute 
the  group  from  which  is  to  be  selected  a  remedy,  according  to  symptoms. 
It  is  an  old  saying,  with  regard  to  diet,  '^  to  starve  a  fever,  and  stutFa  cold  ;/* 
but  all  proverbs  are  not  true.     There  is,  in  every  cold,  some  degree  of 
fever  that  must  be  heeded,  because  a  too  generous  diet  would  be  likely  to 
do  harm.     A  moderate  diet  of  black  tea,  rice,  barley,  toast,  and  fruit,  is 
best.    Thus,  by  judicious  medication  and  an  appropriate  diet,  there  need 
be  no  sequel  that  causes  the  patient  to  sink  r£r,'idly  into  the  grave.     If 
otherwise,  it  will  arouse  some  constitutional  di'-.chesis,  and  this  will  render 
the  joint  action  formidable  in  the  extreme.     As  in  Tubercular  Consump- 
tion, or,  rather,  in  that  which  is  hereditary,  a  constant  vigilance  is  re- 
auired  to  put  in  action  certain  antagonistic  influences  to  overpower  the 
isease,  so  in  Bronchial  Consumption,  or  that  which  is  generated  by  a 
succession  of  ailments  that  implicate,  in  a  less  or  greater  degree,  the  mu- 
cous membrane  that  lines  the  bronchial  tubes,  an  effort  must  be  made  to 
bring  any  and  every  assault  upon  the  bronchia  to  a  successful  termina- 
tion, —  whether  a  common  cold,  a  trivial  cough,  a  slight  soreness  upon  the 
air-passages,  or  even  Pneumonia :  let  each  be  treated  persistently,  accord- 


an  in  the 
lighter  the 
d.  But  it 
igestion,  if 
itnption;  a 
te  in  Bron- 
character, 
reful  treat- 

snivellintj, 
requently  it 
ironic  form 
known  ten- 
se at  once, 
mptoms:  it 
in  the  limbs, 
OS  in  tl>o  be- 
0  remedy  for 
hole  system. 
,  because,  in 
ortain  latent 
:citin}»  cause, 
it  be  treated. 
!  has  softened 
inuestoache, 
no.;  if  much 
In  females, 
iza  produces. 
'  this  disease, 
:i  shows  itself 
iomG  victims, 
nicum^  Apis 
ay  constitute 
o  symptoms, 
tutfacold;** 
le  degree  of 
be  likely  to 
and  fruit,  is 
there  need 
a  grave.     If 
s  will  render 
ir  Consutop- 
ance  is  re- 
erpower  the 
aerated  by  a 
ree,  the  mu^ 
t  be  made  to 
i'ul  termina- 
ess  upon  the 
ntly,  accord' 


uig  to  svmptoms,  until  perfectly  cured,  so  as  to  leave  no  entailment  in  the 
form  cf  a  sequel,  to  prey  upon  the  constitution.  Hygienic  treatment 
must  correspond  with  the  auministration  of  remedies.  Well-ventilated 
apartments,  sufficient  clothing,  and  good,  nourishing  food,  cannot  fail  of 
putting  the  system  in  a  favorable  condition  for  recovery.  Regular  sleep, 
regular  meals,  and  a  well-regulated  temperature,  are  things  indispensable 


Weakness  of  the  Sight.  —  Amblyopia. 

The  term  Amblyopia  signifies  a  weakness  or  morbid  alteration  ci 
flight ;  and  there  is  every  grade,  from  mere  dimness  of  vision  to  complete 
blindness.  'A  sense  so  important  as  that  of  sight  is  entitled  to  a  distinct 
consideration,  inasmuch  as  a  variety  of  causes  may  operate  to  impair  it. 
riio  difficulty  may  be  attended  with  many  morbid  conditions  of  the 
organism,  and  a  variety  of  remedies  may  be  required  to  treat  the  affiiction. 
We  will  therefore  point  out  the  treatment  for  tiie  various  grades,  in  order. 
For  Simple  Weakness  of  Sight  in  plethoric  persons,  give  Belladonna ; 
for  scrofulous  individuals,  Cnlcarea  ;  for  weak  or  debilitated  individuals, 
China;  for  nervous  persons,  Hyoicyamua.  For  those  whose  sight  is  im- 
paired from  biliary  derangement,  Sepia  or  Sulphur.  For  Incipient 
Amaurosis,  Aurum,  Sepia^  S  'iphur.  For  Complete  Amaurosis,  not 
incurable,  give  Belladonna  to  persons  of  full  habit  ;  Calcarea  to  persons 
who  have  a  scrofulous  tendency ;  Mercuriua,  for  those  suffering  from 
hepatic  derangement ;  Phosphorus,  for  those  suffering  from  catarrhal 
atfections ;  and  for  those  subject  to  sick  headache.  Sepia.  For  Torpid 
Weakness  ok  Sight,  Phosphoric  acid.  For  weakness  of  sight  brought 
on  by  fine  work,  give  Belladonna  or  liuta.  For  that  which  occurs  fiom 
old  age,  give  Baryta  carb..  Opium,  or  Secale  comutum.  Where  weak- 
ness of  vision  occurs  after  suppression  of  the  menses,  or  hemorrhoids, 
give  Pulsatilla  or  Lycopodium.  For  that  occasioned  by  suppression  of 
Measles,  Causticum,  Stramonium,  or  Sulphur.  For  that  supervening 
upon  Rheumatism,  give  Belladonna,  Pulsatilla,  or  Rhus  tox.  For  that 
attendant  on  Gout,  give  Nux  vom.  or  Colehicum.  For  that  caused  by 
the  abuse  of  mercury,  give  Nitric  acid.  For  that  caused  by  worms,  give 
Cina.  For  that  occasioned  by  Diarrhoea,  give  Merc.  viv.  For  that 
brought  on  by  loss  of  blood,  China.  For  that  produced  by  Scrofula, 
give  Arsenicum,  Calcarea,  or  Nitric  acid.  When  produced  by  cold  in 
the  eyes.  Dulcamara  or  Nux  vomica.  That  produced  by  blows  or  con- 
cussions requires  Arnica,  Ruta,  Euphrasia.  The  remedies  chosen  must 
not  be  repeated  oftener  than  once  a  day.  When  weakness  of  sight  is 
attended  with  nervous  headache,  give  Aurmn,  Belladonna,  Bryonia^ 
Sepia,  or  Sulphur.  If  by  congestion  of  blood  to  the  head,  give  Bella- 
donna, China,  and  Phosphorus.  For  that  attendant  on  deafness,  or  noises, 
give  Cicuta,  Nitric  acid,  or  Pulsatilla.  The  remedies  need  not  be  repeated 
more  frequently  than  once  or  twice  in  twenty-four  hours.  If  weakness 
of  vision  is  attended  by  gastric  or  abdominal  ailments,  give  Cocculus^ 
Nux  vom.,  Jynatia,  or  Pulsatilla.  If  attended  by  derangements  of  the 
womb,  give  Calcarea  or  Sepia.  If  by  pulmonary  complaints,  give 
PhosplioruSy  Lycopodium^  Calcarea^  and  Svlphur,    If  by  disease  of  the 

107 


; 


850 


DISEASES  OF  VARIOUS  ORGANS  AND  REGIONS. 


l!..-1''!t  ■ 


I- 


heart,  Lache»i»,  Phosphorus^  Pulsatilla^  Sepia,  and  Spigelia.  If  by  Epi- 
lepsy, Spasm,  or  Hysteria,  Hyoscyamm,  Opium,  Stramonium,  or  S  Iphur. 
The  remedy  may  be  repeated,  if  necessary,  every  twenty-four  hours. 

The  particular  indications  for  several  of  the  remedies  may  be  stated 
•IS  follows  :  Aurum..  for  bL^.ck  spots  or  scintillations,  or  halt-sightedness, 
or  tensive  pain  in  the  eyes,  or  in  case  of  sudden  attack  after  Scarlet  Fever, 
or  during  confinement  after  duliven  .  Belladonna  for  dilated  pupils,  or 
insensible  pupils,  spasmodic  twitch.ng  of  tliu  lids,  or  mist  before  the 
eyes,  aching  and  distensive  pains  :n  the  orbits  and  forehead,  and  red  face, 
Oalearea,  for  mistiness  of  sight,  as  if  gauze  were  before  the  eyes,  espe- 
r  ially  when  reading;  for  dilated  pupils,  and  for  pressure  or  leeiing  of 
', oldncss  in  the  eyes.  Oavsticum,  for  sudden  and  frequent  loss  of  sight, 
with  sensatio!^  as  if  sometl .lUg  \^er3  stretched  over  the  eyes," or  for  dim- 
sightedness,  as  if  looking  through  a  veil  or  mist.  China,  for  weak  sight: 
the  patient  only  sees  the  outlines  of  things  near  him ;  letters  look  pale, 
and  appear  to  be  surrounded  by  white  borders ;  dilated  and  not  very 
sensible  pupils  ;  dimness  of  the  cornea,  as  if  the  eyes  were  filled  with 
smoke,  or  black  motes.  The  eyes  feci  better  after  sleeping.  Oicutay 
is  indicated  when  the  sight  frequently  vanishes,  and  when  there  is  vertigo 
or  absent-mindedness,  or  aching  pains  in  the  orbits.  Cina,  for  dimness 
of  sight  improved  by  wiping  the  eyes,  and  for  pressure  in  the  eyes  when 
reading,  as  if  sand  had  got  in.  Oimicifuga,  when  there  is  aching  pain  ia 
the  centre  of  both  eyeballs,  and  black  specks  before  tlie  eyes.  Drosera,  for 
frequent  vanishing  of  sight,  or  when  the  eyes  are  dazzled  with  the  glare 
of  light  or  of  fire.  Qelseminum,  when  there  is  a  thirst  for  light  after 
Apoplexy,  or  Congestion  of  the  Brain  Hyoscyamus,  for  squinting,  illu- 
sory sight,  and  stupefying  pains  over  the  eyes.  Mercurius,  for  parox- 
ysms of  momentary  blindness,  se-.siriveness  of  the  eyes  to  light  or  the 
glare  of  fire.  Nux  vomica,  for  red  face  and  sensitiveness  of  the  eyes  to 
light  only  in  the  morning.  Pho'splwrus,  for  paroxysms  of  sensations  as 
if  things  are  covered  with  a  gray  veil.  Pulsatilla,  for  paleness  of  the 
face,  and  disposition  to  vomit,  and  a  sensation  as  if  dimness  of  sight  could 
be  removed  by  wiping ;  for  frequent  and  copious  flow  of  tears,  and  con- 
traction of  the  pupils.  liuta,  for  mistiness  of  sight,  and  boring  pains 
in  the  orbits,  and  the  filling  of  the  eyes  with  water  in  the  open  air. 
Sepia,  for  dimness  cf  sight  when  at  work,  stripes  befoie  the  cy(?s  and 
aching  pains  in  the  eyeballs,  vith  sick  headache.  Silicea,  paroxysms 
of  sudden  obscuration  of  sight,  as  if  a  colored  veil  were  before  the  eyes. 
Sulphur,  iov  general  mistiness  of  sight,  as  if  lookin;:  through  featiier- dust 
or  black  gauze  ;  great  dryness  of  the  eyes.  Veratrnm  album,  for  profuse 
shedding  of  tears,  or  the  copious  filling  of  the  eyes  with  water.  Vera- 
trum  viride,  when  walking  brings  on  blindness,  with  fainting  vertigo 
and  dilated  pupils.  When  any  one  of  the  remedies  is  indicated,  let  the 
dose  be  repeated  only  once  in  twenty-four  hours.  In  all  affections  of 
the  sight,  the  paiient  should  avoid  hearty  meals  or  excessive  overloading 
of  the  stomrich  ;  he  should  be  regular  in  his  habits,  and  free  as  possible 
from  mental  anxiety  ;  and,  above  all,  his  habits  should  be  strictly  temper- 
ate, and  late  hours  should  be  avoided.  In  most  cases  of  defective  sight, 
the  eyes  require  '-est.  Ai;  attempt  to  exercise  them  in  readiiig  in  any 
defective  light  is  pernicious  ;  and  so  is  prolonged  reading  iu  any  light. 


n 


Paralysis  of  the  BjeMs.  —  Blepharoplegia. 

This  affection  sometimes  occurs  in  chililien,  but  very  rarely  in  adults, 
aiul  requires  remedial  treatment.  The  best  remedies  are  Belhdonna, 
Spigelia,  Sepia,  and  Stramonium.  Belladonna,  if  there  is  redness  of 
the  face  ;  Spigelia,  if  there  is  any  sifTu  of  spasms  ;  Sepia,  if  it  follows 
severe  headache,  and  sickness  of  the  stomach  ;  Stramonium,  if  there 
is  pale  face,  and  inclination  to  sleep.     Oausticutn  for  chronic  cases. 


Whooping-Oough.  —  Tusi>is  Spaamodica. 

Among  the  diseases  of  children,  we  find  this  malady  quite  common. 
The  cause  is  only  conjectured.  As  it  is  a  disease  much  dreaded  by 
parents,  we  shall  not  oidy  be  particular  in  describin;^  the  disease,  but 
also  in  pointin*^  out  the  remedies  for  the  various  sta(:;es  and  complications. 
The  cough  begins  in  the  form  of  an  ordinary  catarrh  arising  from  a  cold. 
The  child  has  coryza,  and  coughs ;  the  mother  or  nurse  may  be  aware 
that  the  disease  commences  in  this  way,  and  their  fears  may  be  that  it 
will  turn  out  Whooping-Cough.  The  catarrhal  stage  may  last  ten  days 
or  two  weeks,  and  then  a  different  and  characteristic  cough  sets  in.  This 
cough  comes  on  in  paroxysms,  in  which  a  number  of  rapid  expirations 
follow  each  other,  as  in  the  act  of  coughing,  and  with  much  violence, 
and  without  any  intervening  inspiration,  till  the  patient  turns  black  in 
the  face,  and  seems  on  the  point  of  being  suffocated ;  then  one  long- 
draw  n  act  of  inspiration  takes  place,  attended  with  that  peculiar  rough 
crowing  noise,  which  is  denoaiinated  a  whoop,  and  gives  the  disease  its 
name,  immediately  after  this  long-drawn  inspiration,  a  s;ories  of  short 
expiratory  coughs,  repeated  till  tiiy  breath  is  almost  exhausted ;  and  then 
a  second  whoop,  until  a  white  glary  mucus  is  thrown  up,  unci  this  ends  the 
paroxysm.  After  a  lap?o  of  some  little  time,  the  paroxysm  will  be  re- 
peated. During  the  urgency  of  some  of  these  paroxysms,  the  face 
becomes  red  and  swollen,  the  nose  bleeds,  the  eyes  start  from  the  sockets, 
the  little  suffertr  stamps  with  impatience,  and  clings  to  some  object  near 
him ;  and  this  frenzy  continues  till  vomiting  or  expectoration  ends  the 
paroxysm.  The  victim  pants  a  little  v/bile,  and  appears  quite  well  again, 
and  begins  to  have  a  craving  foi;  food.  The  number  of  paroxysms  that 
occur  every  twenty-four  hours  varies  in  different  subjects.  Children 
are  very  suscepLih.'e  to  the  disease,  and  it  spreads  by  contagion.  The 
ordinary  duration  of  the  disease  is  from  six  weeks  to  three  months ;  but 
it  may  run  its  course  in  three  weeks,  atiu  sometimes  not  for  four  or  five 
months. 

As  long  as  this  disease  is  ur  complicated,  —  unmixed  with  inflamma- 
tion, and  therefore  without  fever,  or  with  that  flight  inflammatory  con- 
dition proper  to  a  mild  catarrii,  —  it  is  not  a  dangerous  disease.  In  all 
probability,  it  will  run  its  course  under  the  most  favorable  ^ircum*  uiinces. 
How  much  it  can  be  abridged  by  appropriate  remedies  is  yet  a  question , 
but  the  violence  of  the  disease  mi'.y  be  moderated,  its  sequel  may  be 
guarded  against,  and  its  complications  may  be  tempei-ed,  by  the  rigiit  use 
of  remedies.     The  most  favorable  season  for  the  disease  to  rage  is  in  the 


852 


DISEASES  OF  VABIOUS  OBGANS  AHD  BEGI0M8. 


■ 


spring,  when  the  weather  ia  hflpnnitng  wortT«er     The  most  uiuayor* 
able  is  late  in  the  fall,  when  the  weather  is  augmenting  in  coldness. 
Cold  or  damp  weather  is  thought  to  protract  the  disease,  and  warm 
weather  to  abridge  it.     We  have  thus  been  somewhat  particular  in  ie- 
Hcrihing  this  malady,  in  order  to  facilitate  its  treatment  by  mothers  aad 
nurses.     We  will  now  proceed  to  direct  the  use  of  appropriate  remedie.^. 
In  the  catarrhal  stage,  give  Aconite.     If  there  is  fulness  of  the  nose,  and 
headache,  give  Belladonna.     In  case  of  asthmatic  breathing,  give  Ipecac. 
Aconite  is  the  remedy  for  a  dry,  v/heezing  cough,  with  fever  or  burning 
pain  in  the  larynx,  or  windpipe.     Belladonna  is  the  remedy  for  severe 
paroxysms,  witfi  congestion  of  blood  to  the  head,  expectoration  of  blood, 
and  bleeding  from  the  nose,  the  eyes  appear  congested,  involuntary 
stool  and  urine,  and  also  when  the  paroxysm  is  announced  with  crying, 
which  arises  from  pain  in  the  stomach,  but  not  accompanied  by  vomiting. 
Also,  in  the  first  stage,  Oarbo  veg.  may  be  given  when  the  cough  is  con- 
vulsi\'e,  especially  in  the  evening,  and  when  there  is  great  exhaustion 
after  each   coughing-spell.     Dulcamara  is   a  good  remedy  when  the 
cough  is  moist  from  the  commencement.    Ipecac,  for  the  incipient  stage, 
when  tlie  child  has  coughing-spells  so  rapid  as  not  to  be  able  to  get  his 
breath,  and  when  the  open  air  is  requisite  to  relieve  him.     Pulsatilla  is 
useful  when  the  cough  is  loose  from  the  beginning,  and  worse  towards 
evening.     In  the  second  stage,  after  whooping  sets  in,  with  vomiting, 
and  bleeding  from  the  nose  and  mouth,  give  Caulophyllum.     If  without 
bleeding  at  the  nose,  give  Drosera.     If  thu  children  suddenly  become 
rigid,  give  Cina.     This  remedy  is  specific  when  children  are  affected 
with  the  usup-i  worm  symptoms,  and  the  paroxysm  is  followed  by  a 
gui-gling  noise  from  the  abdomen.     Corallia  rubrum  is  believed  to  be  a 
sure  remedy  for  violent  spasmodic  cough  ;    short,  barking  cough  alt 
Jay,  and  towards  evening  becoming  violent  and  spasmodic.     Oaprum 
in  indicated  when  every  paroxysm  is  attended  with  cataleptic  fits,  so  that 
in  must  every  paroxysm  the  child  appears  as  dead.     Verairum  is  very 
suitable  after  Cuprum.     Drosera  is  the  remedy  when  the  paroxysigs  come 
on  at  midnight,  and  cease  before  noou,  and  are  very  severe  and  suffocat- 
ing.    Vcratrum  album,  is   indicated,   after    Drosera  and   Cuprum    have 
been  employed,  when  the  patient  is  very  feeble,  quick  pulse,  and  with  a 
sort  of  hectic  fever,  and  cold  sweat  upon  the  forehead,  and  great  thirst ; 
and  also  when  the  coughing  causes  an  emission  of  urine,  and  pain  in 
the  chest  and  loins,  and  when  the  patient,  between  the  paroxysms,  is  in  a 
comatose  state,  and  cares  not  either  to  move  or  converse ;  and  also  when 
there  is  excessive  weakness  of  the  neck,  so  that  the  victim  is  scarcely 
able  to  keep  the  head  erect ;  and  also  when  there  is  rash  over  the  body, 
or  face  and  hands.     For  the  most  severe  or  convulsive  stage  of  whoop- 
ing-cough, give  Belladonna,  when  there  is  pain  in  the  head,  or  convul- 
sions ;  give  Bryonia  when  the  child  coughs  immediately  after  eating 
or  drinking,  and  vomits  what  he  has  eaten,  and  returns  immediately  to 
finish  his  meal,  and  then  coughs  and  vomits  again ;  giro  ChamomiUa 
when  the  cough  and  vomiting  are  more  frequent  during  a  meal,  fretful 
disposition,  p-nd  worse  at  night;   give  Cauiticvm  when  the  cough  is 
better,  and  when  it  is  dry  and  hollow;   give  Hyoscr/amut  when  the 
patient  is  worse  lying  down,  and  better  on  sitting  up ;  give  Arnica 


DISEASES  OF  VARIOUS  ORGANS  AND  REGIONS. 


853 


when  the  patient  feels  sore  from  coughinf;.  After  the  cough  subsides, 
and  there  is  any  sequel  left  beliind,  give  whatever  remedy  is  indicated  ; 
Bs  Aconite  for  fever,  ^ux  vom.  for  constipation,  Phosphorus  for  catarrh, 
China  for  extreme  weakness,  &c.  If  there  is  no  loss  of  appetite,  allow 
a  substantial  diet  in  all  the  stages  of  the  disease.  Change  of  air  j? 
very  beneficial,  even  if  but  a  short  journey  from  home,  especially  to 
the  sea- shore. 


■irr 


^J  '-: 


AFFECTIONS  OF  THE  MIND. 


It  is  well  known  to  physiologists,  that  soundness  of  mind,  as  well  as 
entire  soundness  of  body,  indicates  a  condition  of  perfect  health.  The 
two  are  so  intimately  ble  y-d,  that  one  can  hardly  exist  without  thn 
other,  and  vice  vend.     An  a  \  condition  of  the  physical  system  is 

often  attended  with  manifest  u.  ndness  of  mind.  It  is  not  intended 
to  include  the  mental  phenomena  frequently  attendant  on  acute  fevers, 
as  in  Nervous,  Scarlet,  and  other  fevers,  but  such  only  as  appear  to  exist 
as  the  chief  symptom  of  disturbance  in  the  entire  system ;  and  we  will 
begin  with  simple 

Mental  Derangementi 

What  is  understood  by  mental  derangement  is  a  disordered  mind^ 
which  may  have  been  occasioned  by  one  or  more  of  a  variety  of  cau:ie3 
It  is  indicated  by  irrational  expressions  of  illusory  notions,  incohereiit 
ideas,  strange  fancies,  and  not  unfrequently  by  vicious  inclinati':r3. 
There  is,  nevertlieless,  some  specific  cause  for  every  case  of  ment'J 
alienation  that  occurs  ;  and  the  treatment  has  to  be  adapted  with  refer- 
ence to  the  cause,  when  there  is  a  cha  n  of  circumstances  that  indicateu 
it.  Nevertheless,  the  cause  is  not  always  apparent,  and  therefore  par- 
ticular symptoms  must  be  our  guide  in  affiliating  remedies.  When 
insanity  takes  the  form  of  rage,  and  the  patient  appears  to  be  governed 
by  angry  and  revengeful  feelings,  and  is  inclined  to  utter  imprecations 
and  threats  towards  his  best  friends,  give  Acovite  in  daily  doses.  If  his 
face  appears  flushed,  and  his  eyes  suffused,  and  exhibit  a  fiery  red  ap- 
pearance, give  Belladonna.  If  in  a  scrofulous  subject,  give  Oalearea. 
If  strange  fancies  seem  to  beset  the  patient,  or  complaints  are  made  of 
illusory  sights,  give  MyoscyamvA.  If  the  patient  is  inclined  to  run  away 
from  home,  or  hide  in  some  secret  place,  give  a  dose  of  Sulphur^  and 
follow  with  a  few  doses  of  Stramonium  every  three  or  four  liours. 
If  the  patient  seer.  )  depressed,  and  sighs  frequently,  give  LaolAnii. 
If  much  distress  is  evinced,  and  there  is  defective  nutrition,  give 
Nux  vomica.  For  violent  rage,  followed  by  soporific  sleep,  give  Opir 
um.  If  the  patient  laugh*  and  talks  continually,  give  Myoacyamus , 
or  if  given  to  crying,  sobbing,  or  constant  weeping,  give  Jgnat;**,    If 


■^■P 


AFFECTIONS  OF  THE  MIND. 


855 


the  patient  is  subject  to  cold  sweats,  give  Veratrum.  If  thirsty,  give 
Aramicitm.  If  there  is  great  weakness  and  prostration,  give  Chiva, 
If,  during  paroxysms  of  rage,  there  is  intense  perspiration,  give  Mercu- 
riu8.  Disposition  to  suicide,  Aurtim.  None  of  the  medicines  need  be  re- 
peated oft(!ner  than  twice  a  day.  Great  care  should  be  +aken  to  keep  the 
stomach  of'tiie  patient  at  ease,  by  furnishing  for  it  light  but  nutritious  food. 

Mania  Produced  by  Depression  of  Spirits. 

Protracted  Grief*  —  Extreme  mortification  or  chagrin,  or  intense  an- 
ijer,  may  end  in  mental  derangement.  When  grief  wears  out  the  mind, 
And  strange  fancies  begin  to  show  themselves,  give  Ignatia.  When 
Sfrea  t  mortification  on  account  of  some  exposure  to  censure,  or  on  account 
«>f  some  humbling  of  family  pride,  give  Phos.  acid.  When  disappoint- 
men  t  unsettles  the  mind,  and  chagrin  gives  rise  to  insane  imaginings, 
give  Pulsatilla;  or,  if  there  is  a  ^ .^nifest  inclination  to  hide  away  from 
I  i-i  ends,  give  Sulphur,  and  follow,  in  four  or  six  hours,  with  a  dose  of 
Hyoscyamiis.  If  the  face  is  red,  and  the  temples  beat  and  throb,  give 
Belladonna.  When  excessive  anger  and  general  moroseness  of  spirit 
•^nsue,  with  general  antipathy  towards  every  one,  give  Sulphur,  and,  in 
aix  hours,  follow  with  a  few  doses  of  Nux  vomica. 


Mania  from  Excited  Emotions. 

The  mind  is  often  beset  with  emotions  of  one  kind  or  another,  that 
often  tend  to  unsettle  and  derange  it.  An<;uish  or  forebodinj;  often  has 
this  disastrous  effect,  and  one  o''  the  principal  remedies  is  Aconite.  If 
there  is  an  attending  inclination  to  weep,  give  Ignatia.  If  there  is  dul- 
ness  or  stupor,  give  Opium,  or  if  in  females,  give  Pulsatilla.  If  mania  is 
produced  by  fright,  give  Aconite,  Coffea,  or  Nux  vain.  W^hen  fear  un- 
settles the  mind,  give  Lachesis,  Hyoscyanius,  GeUenm  n.  Opium,  or 
Pulsatilla.  When  exces.sive  joy  produces  derangcmenc  of  the  mental 
faculties,  and  gives  rise  to  strange  fancies,  give  Coffea,  Opiums  or 
Pulsatilla.  When  homesickness  unsettles  the  mind,  give  PJics.  acid. 
When  fancied  neglect  of  friends  distracts  the  imagination,  give  Caus- 
ticum  or  Capsicum.  For  unhappy  love,  and  the  derangement  of  mind 
consequent  thereon,  give  Uyoscyamus,  Ignatia,  or  Phosphoric  acid^ 
or  perhaps  Coffea,  or  JVux  vom. 

If  disappointed  affection,  or  any  cause,  produces  the  mania  oi'  suicide,  give 
Aurum.  If  excessive  jealousy  ends  in  mania,  give  Hyoscffamus.  If  rage 
ensues  upon  insults,  gi^e  Veratrum  alb.,  Belladonna,  or  Chamomilla,  if  upon 
contradiction,  give  Aconite,  and  afterwards  Ljnatia  or  ^*/a;  vom.  For  the 
concomitant  symptoms  of  insanity  from  excited  emotions,  give  Aconite  when 
there  is  headache,  feverish  heat,  or  tendency  of  blood  to  the  head. 
Give  Belladonna  when  there  is  loss  of  consciousness,  or  constant  anx- 
iety, with  fear,  weeping,  howling,  and  malice  (m  children),  and  also 
when  Aconite  and  Opium  had  proved  insufficient  for  the  consequences 
of  fright.  Give  Bryonia  when  there  is  chilliness  and  shuddering  over 
the  whole  body,  great  tendency  to  vehement  anger,  loss  of  appetite, 
nausea,  vomiting,  and  bilious  state  in  consequence  of  anger.     Give  Cap 


It. 


l._D 


856 


AFF&TnONS  01  THE  MOID. 


tieum  for  sleeplessness  caused  by  homesickness,  with  heat  and  redness  of 
the  cheeks.  Give  Chamomilla  when  anger  produces  bitter  taste  of  th» 
mouth,  nausea,  disposition  to  start,  and  vomiting  of  bilious  matter. 
Give  Coffea  when  there  is  much  nervous  excitement  after  great  joy. 
Give  Cohcynth  when  chagrin  or  mortification  produces  Spasmodic  Colic» 
or  cramps.  Should  this  condition  persist,  give  Causticum.  Give  Hyoscjf' 
amuH  wlxen  fear  produces  stupefaction  or  convulsions,  iffvoluntary  laughter 
during  sleep,  or  a  ilesire  to  run  .iway.  (Jive  Ignatia  for  grief,  disappoint- 
me't,  or  unhappj'  love,  when  there  is  deep,  gnawing,  irresistible  grief,  vomit- 
ing, headache,  vertigo,  pale  face,  convulsions,  or  epilepsy,  and  in  children 
when  they  occur  from  the  shock  of  fright  or  fear.  When  homesickness,  fright, 
or  mortification  is  attended  with  great  anguish,  restlessness,  and  trembling, 
or  sudden  starting  from  wleep,  or  accelerated  circulation  on  the  least  exer- 
tion, sleeplessness,  and  inability  to  bear  the  warmth  of  the  bed.  great  ner- 
vousness, a  disposition  to  be  quarrelsome,  and  to  complain  of  everybody  a» 
being  hateful,  and  the  patient  takes  a  dislike  to  his  own  family,  and  wishes  to 
leave  them,  and  also  when  there  is  sliivering  and  ni^rht  sweats,  give  Mer- 
curius.  Give  Niix  vomica^  when,  alter  an  angry  lit,  there  is  chilliness 
without  heat.  Give  Opium  wlien  diarrhoea  follows  excessive  joy  or  fear, 
or  when  a  sudden  start  or  fright  produces  sudden  and  involuntary  diar> 
rhcea,  with  heaviness  of  the  abdomen.  For  chronic  diarrhoea  from  fright, 
Oelsemium.  Give  Phosphoric  acid  in  all  cases  after  deep  grief,  homesick- 
ness, or  unhappy  love,  when  the  patient  is  taciturn,  dull,  or  listless,  and 
has  a  constant  desire  to  sleep,  and  has  night-sweats  towards  morning,  after 
hectic  fever  in  the  evening.  Give  Pulsatilla  when  fear  produces  cold  hands 
and  feet.  Give  Veratrum  album  when  any  emotional  excitement  produces 
diarrhtca  or  involuntary  evacuations  from  the  bowels,  with  coldness  of 
the  whole  abdomen. 


Morbid  Emotions.    ' 

A  celebrated  writer  on  insanity  considers  all  morbid  emotions  und(!r 
this  head,  and  for  this  reason :  that  all  morbid  states  of  the  mind  may 
become  so  augmented  as  to  result  in  complete  Mania  or  Monomania. 
It  is,  therefore,  well  to  understand  the  best  method  of  bringing  remedial 
action  to  bear  upoii  the  first  departure  from  sound  health  of  any  faculty 
or  emotion  of  mind.  For  anguish  or  anxiety,  no  remedy  seems  better 
adapted  than  Arsenicum,  to  be  given  morning  and  evening,  or,  perhaps, 
Pulsatilla  for  females  at  the  menstrual  period,  or  Veratrum  album  for 
veiy  weak  and  exhausted  persons.  For  apprehension  or  fear,  give  Aconite 
morning  and  evening,  especially  if  the  suftbrer  is  a  plethoric,  full-blooded 
person.  Give  Belladonna  to  one  who  suffers  much  from  headache,  or 
rush  of  blood  to  the  head  ;  or  Bryonia  if  thei-e  is  anxiety,  with  heat  of 
the  chest  and  difficult  respiration  ;  or  HyoscyamuB  for  anxiety  about  oneV 
safety,  or  religious  anxiety ;  or  Opium  for  a  kind  of  anguish  and  depres- 
sion of  spirits  that  confuses  one's  ideas,  and  is  attended  by  a  stupidity  and 
headache.  When  one  is  constantly  vexed"  and  irritable,  it  may  be  in- 
ferred that  a  corresponding  physical  condition  requires  Arsenicum  once 
or  twice  a  day,  or  perhaps  Nux  vomica.  Ignatia  is  suitable  when  there 
is  a  tendency  to  be  vexed,  and  to  weep  on  account  of  trifles.    For  one 


AFFECnONS  OF  THE  MJKD. 


857 


dness  of 
e  of  th* 

matter, 
eat  joy. 
iic  Colic, 
'  Hyoscy* 
laughter 
4appoint- 
;f,  vojnit- 

children 
IS,  fright, 
■embling, 
ast  exer- 
;reat  ner- 
ybody  a» 
«<rishes  to 
ive  Mer- 
chilliness 
^  or  fear, 
aiy  diar* 
nn  fright, 
lomesick- 
tless,  and 
ing,  after 
aid  hands 
produces 
Idness  of 


ns  und(!r 
lind  may 
nomania. 
remedial 
y  faculty 
ns  better 

perhaps, 
dbum  for 
e  Aconite 
1-blooded 
dache,  or 
h  heat  of 
)out  one'* 
d  depres- 
jidity  and 
ay  be  in- 
Twm  once 
len  there 

For  one 


always  in  haste  to  get  angry  without  reason,  give  Aurum  or  Sulphur. 
When  one  is  morbidly  suspicious  and  distrustful,  and,  in  fact,  is  a  hater  of 
his  fellow-men,  and  wishes  to  avoid  every  one,  and  to  spend  his  time  in  se- 
clusion, give  Arsenicum,  Hyoscyamus,  Pulsatilla,  or  Rhus  tox.    For  nervous 
excitement,  which  may  lead  to  mental  derangement,  give  Aconite  or  Pulsa- 
tilla; and  especially  if  there  is  great  tendencj'  to  start.     For  a  morbidly 
malicious  disposition,  give  Belladonna,  Hyoscyamus,  and  Lackesis.     For  a 
disposition  to  kill  somebody,  or  to  commit  acts  of  Violence,  give  Stramo- 
nium, Belladonna,  or  Veratmm  albrim,  morning  and  evening  until  a  change. 
For  a  morbid  disposition  to  be  audacious  or  impertinent,  give  Ignatia,  Opium, 
or  Sulphur.     For  headstrong  obstinacy,   and  disposition  to  be  quarrel- 
some, give  Belladonna,  Nux  vomica,  Iijnatia,  Lachesis,  and  Veratrum.    For 
an, artful  disposition,  or  an  involuntary  disposition  to  practise  deception  with 
no  definable  motive,  give  Lackesis  and  Mux  vomica.     \V  hen  the  mind 
is  either  beset  with  fancies  or  fixed  ideas,  give  Belladoniia,  Coceidus^ 
Stramonium,  or  Sulphur.     For  sad  and  melancholic  fancies  and  fore- 
bodings, give   Calcarea,  China,  or  Pulsatilla,  and  Petroleum.     For  a 
morbidly  serious,  silent,  and  untalkative  disposition,  give  Belladonna, 
Hyoscyamus^  and  Pulsatilla.     For  morbid  indifference  and  apathy,  give 
Arsenicum  morning  and  evening,  or  else  Phosphoric  acid,  Sepia,  and 
Sulphur,  in  daily  doses.     Moaning  and  lamenting  without  any  special 
cause  indicates  a  degree  of  insanity  that  demands  prompt  attention  ;  and 
Syoscyamus   may  be   given   three   times   a   day,  or  else  Ghamomilla, 
Coffea,  or  Ignatia.     Despondency,  despair,  and  being  tired  of  life,  as 
well  as  an  inclination  to  suicide,  are  severally  affections  of  the  mind  that 
are  subject  to  medical  treatment.     Arsenicum  may  be  given  morning 
and  evening  for  despair ;    Lachesis  for  despondency,  especially  where 
there  is  sighing,  as  if  something  awful  was  weighing  upon  the  mind. 
For  inclination  to  commit  suicide,  give  Aurum  and  Arsenicum,  especially 
if  there  is  great  anguish,  melancholy,  and  morbid  disgust  of  life.     For 
one  simply  tired  of  life,  and  anxious  to  get  out  of  this  world  by  natural 
death,  give  China,  Lachesis,  or  Nitric  acid.     For  illusions,  and  illusory 
notions,  showing  mental  difficulties,  give  Lachesis,  China,  or  Pulsatilla. 
Many  of  these  mental  difficulties  are  the  result  of  selfishness  or  mor- 
tified self-love,  and  can  be  overcome   by  strong  determination  of  the 
will  and  moral  training,  which,  of  course,  involves  more  or  less  of  jelf 
denial. 

Religious  Mania. 

This  mental  affection  is  simply  a  morbid  excitation  of  religious  senti- 
ment  and  feelings,  producing  strange  and  fanciful  ideas  of  God,  heaven, 
and  the  importance  of  certain  missions  to  which  the  victims  believe  them- 
selves specially  called.  Religious  Mania  is  characterized  by  morbid 
inclination  to  be  always  singing,  praying,  preaching,  and  performing  reli- 
gious rites,  out  of  time  and  place,  and  in  a  disconnected  and  incoherent 
manner.  The  cause  of  this  mental  affection  may  be  excitement  upon 
religious  topics,  or  during  what  is  ordinarily  termed  religious  revivals. 
The  effect  of  any  thing  of  the  kind  is  to  unsettle  the  healthy  condition  of 
the  nerves  and  that  of  the  nutritive  system.     For  Religious  Mania  iu 

108 


=?«^' 


)   '• 


U  V 


M'"., 


858 


AFFECTIONS   OF   THE   MIND. 


general,  give  Hyoacyamus  or  Stramonium  ;  for  that  which  is  attended 
vith  indigestion,  give  Nux  vomica;  for  that  which  is  accompanied 
by  torpidity  of  the  liver  and  melancholic  temper,  give  Arsenicum^ 
JdercuriuSf  Podopkyllin^  and  Ignatia.  Let  the  patient  avoid  all 
surroundings  calculated  to  unsettle  the  mind  or  emotions. 

Hypoohondriai — Hypochondriasis. 

Pinel  classes  Hypocliondria  among  the  various  forms  of  insanity,  as  it 
is  characterized  by  morbid  imaginings  concerning  one's  health.  Some- 
times the  victim  imagines  himself  void  of  strength,  or  sadly  diseased  at 
the  heart ;  he  fancies  he  sees  death  staring  him  in  the  face,  and  believes 
himself  often  in  a  dying  condition,  when,  in  fact,  there  is  not  the  slightest 
reason  for  such  apprehension.  In  the  future,  all  is  darkness  :  the  next 
hour,  the  next  day,  week,  or  year,  is  believed  by  him  to  be  pregnant  with 
something  awful.  He  never  enjoys  a  liiugh,  for  every  thing  is  clothed 
in  gloom.  If  the  subject  is  of  a  bilious  temperament,  and  has  black  hair 
and  eyes,  give  Mercurius ;  if  of  a  lymphatic  temperament,  and  inclined 
to  obesity,  give  Pulsatilla ;  if  of  a  sanguine  temperament,  and  has  red 
hair  and  blue  eyes,  give  Nux  vom. ;  if  addicted  to  tlie  use  of  intoxicating 
liauors,  give  Arsenicum  or  Nux  vom. ;  if  of  a  downcast  countenance,  and 
BUDJect  to  indigestion,  give  Nux  vomica,  Lycopodium,  or  Petroleum.  If 
caused  by  sexual  abuse,  give  China  or  Sulphur ;  when  caused  b}'  sedentary 
habits,  Nux  vomica  and  Muli^hur,  or  if  by  derangement  of  the  abdominal 
functions,  and  constii)ation,  give  Calcarea,  Lachesis,  or  Lycopodium ;  for 
one  suffering  from  languor,  mental  dulness,  or  mental  distress  and  discour- 
agement, give  China.  If  the  victim  has  the  fixed  idea  that  he  is  unhappy 
and  has  no  friends,  and  imagines  himself  surrounded  by  enemies,  China  is  also 
the  remedy.  For  a  hj'pochondriac  troubled  with  weak  digestion  and  disten- 
sion of  the  abdomen,  ill-humor  and  indolence  after  eatmg,  give  China; 
when  he  laments  on  account  of  the  future,  and  desires  to  be  alone,  give 
Natrum  muriaticum  ;  when  he  is  beset  with  ill-humor,  despondency,  and 
aversion  to  life,  give  Nux  vomica;  when  with  painful  anxiety  of  mind 
and  lowness  of  spirits.  Sulphur ;  when  he  has  great  dread  of  death,  and 
is  in  restless,  whining  mood,  give  Aurum  ;  if  indifferent  about  his  busi- 
ness or  his  own  family,  give  Sepia.  Any  of  the  remedies  named  may  lie 
given  thi-ee  times  a  day. 

Weak  Memory. 

There  are  many  conditions  of  the  physical  system  that  may  operate  to 
impair  the  memory  ;  the  most  prominent  of  which  are  those  that  produce 
debility,  —  such  as  loss  of  blood  and  other  animal  fluids,  and  intense  ap- 
plication of  the  mind.  When  occasioned  by  the  former,  give  Ghina^  Nux 
vom.y  and  Sulphur^  in  daily  doses ;  when  by  the  latter,  Nux  vom.,  Pulsa- 
tilla, or  Sulphur  ;  if  caused  by  external  injuries,  give  Arnica  or  Rhus  ;  if 
by  inebriation,  Arsenicum,  Opium,  or  Nux  vom.;  if  caused  by  violent  emo- 
tions, as  fright,  grief,  or  anger,  give  Aconite,  Opium,  Phos.  add ;  if  caused 
by  dampness,  give  Carbo  veg.,  Ehus,  Veratrum  album;  if  by  rush  of 
t)i  xl  to  the  head,  give  Belladonna.    In  nearly  all  instances  of  wetness 


AFFECTIONS  OF  THE  MIND. 


859 


of  the  memory,  it  is  connected  with  some  form  of  debility.  That  follow- 
ing epileptiform  disease  requires  Sulphur;  that  following  childbirth 
requires  China  ;  and  also  weakness  of  memory  following  an  acute  fever, 
or  any  other  prostrating  disease,  requires  China,  Jgnatiay  Nux  vom.^  and 
Anmieum.    Give  the  remedy  selected  twice  a  day. 


Hysterif  Derangement. 

The  ordinary  forms  of  Hysteria  sometimes  degenerate  into  insanity. 
The  nervous  system  becomes  shattered,  and  sucli  patients  become  tor- 
mented with  all  kinds  of  fancies,  —  sometimes  sexual,  frivolous,  and  even 
foolish.  For  Hysteric  Insanity  in  general,  give  Jgnatia,  Phosphorus,  or 
Platina;  or,  if  attended  with  uterine  derangement,  give  Aiirum,  Cro- 
cus, or  Sepia  ;  for  those  tormented  with  excessive  sexual  fancies,  give 
Phosphorus,  Pulsatilla,  or  Platina;  if  tiie  patient  acts  foolishly,  with 
much  frivolity  and  levity,  give  Apis  mel. ;  if  fitful,  laughing  at  one  time 
and  crying  at  another,  give  Crocus  or  Stramonium  ;  if  there  are  maiked 
heavings  of  the  chest,  give  PAospAorMS ;  and  if  tlie  bowels  are  consti- 
pated, persistent,  and  tedious,  give  Lycopodium  ;  if  in  any  way  connected 
with  the  menstrual  function,  give  Pulsatilla  ;  if  the  patients  are  prone  tu 
lie  and  deceive,  give  Yeratrum  album  ;  when  they  evince  an  insane  pas« 
sion  for  work,  give  Lachesis  and  Hyoscyamus  ;  when  full  of  suspicion  and 
distrust,  give  Hyoscyamus,  Mercurius,  and  Pulsatilla  ;  if  excited  exces- 
sively in  body  and  mind,  give  Aconite  and  then  Nux  vomica,  after  whicli 
give  P1u)splu)rus  or  Lachesis  ;  if  disposed  to  be  imperious,  and  exhibit  a 
passion  to  order  their  friends  about,  give  Lycopodium  or  Cuprum  ;  if  thej 
betray  a  tricky  and  maUcious  disposition,  give  iVwa;  vom. ;  if  there  is  great 
obstinacy,  give  Belladonna,  Igruitia;  if  disposed  to  hide  or  be  alone, 
give  Calcarea  ;  if,  on  the  contrary,  there  is  a  mania  for  company,  and  a 
dread  of  being  alone,  give  Arsenicutn,  Lycopodium,  Phosp/iorus, 
and  Belladonna ;  for  great  loquacity,  give  Stramonium ;  if  excessive 
mirthfulness,  give  Hyoscyamus;  if  there  is  a  disposition  to  ob- 
scenity, and  a  great  want  of  modesty,  give  Hyoscyamus,  Phosphorus, 
or  Veratrum;  if  there  is  a  great  disposition  to  sing,  warble,  or 
whistle,  give  Belladonna  or  Stramonium;  if  there  is  a  disposition 
to  make  faces  and  cut  antics,  give  Cuprum  or  Stramonium;  if  there 
is  a  disposition  to  scold  or  swear,  give  Lycopodium ;  if  given  to 
self-importance  and  pride,  give  Cuprum  to  men  and  Platina  to 
women.  Let  whatever  remedy  is  selected  bo  administered  twice  a 
day.     Diet  should  be  moderate,  and  easy  of  digestion. 

Imbecility. 

Loss  of  mind,  as  well  as  the  derangement  of  its  faculties,  comes  under 
the  head  of  Mental  Difficulties.  There  are  several  causes  that  may 
operate  to  destroy  the  intellect.  Epileptic  fits  will  in  time  render  the 
brain  an  unfit  organ  for  the  mind,  and  consequently  there  can  be  but 
little  power  or  force  in  the  mental  manifestation.  A  softening  of  the 
brain  that  may  supervene  upon  indammation  is  also  attended  with  imbe- 
cility.   Self-pcUution  is  also  a  fruitful  source  of  mental  weakness.     Con« 


:;r;i 


i.  i 


Pi'  ^ 


ffenital  idiocy  results  from  causes  not  possible  to  describe ;  but  manv  a 
bright  child  has  becume  the  victim  of  iaiocy  by  the  mal-treatment  it  has 
had  in  the  nursery.  To  quiet  crying  children,  resort  has  been  had  to  a 
variety  of  sedatives,  instead  of  exercising  patience,  to  initiate  them  into 
sleep  and  quietness.  How  oflen  do  nurses  give  poppy,  or  lettuce-tea,  to 
put  a  crying  infant  to  sleep,  little  dreaming  that  they  inflict  a  permanent 
mjury  upon  the  mind  of  the  child.  The  effect  of  paregoric,  soothing-sirup, 
and  poppy-cordial  is  of^en  disastrous,  and  the  source  of  spasms,  fits,  or 
convulsions,  that  impair  the  tender  textures  of  the  brain  so  much,  that, 
even  if  the  children  live,  they  are  apt  to  be  the  victims  of  imbecility. 
Fear  and  fright  also  are  causes  of  imbecility.  If  epilepsy  is  the  cause, 
give  Cuprum  or  Sulphur^  in  daily  doses,  or  else  Belladonna,  Ifellebcrui, 
Lache»i»^  Syoacyamus,  or  Opium.  If  caused  by  a  softening  of  the  brain, 
there  is  not  much  hope  of  the  patient  deriving  much  benefit  from  reme- 
dies. There  is  only  a  bare  possibility  that  the  difficulty  may  be  arrested. 
Hyo9cyamuA,  Sulphur  and  Apis  mel.  may  do  something  to  ward  oft  total 
and  hopeless  idiocy.  When  imbecility  is  caused  by  onanism,  give  Arseni- 
cum or  China  twice  a  day ;  when  by  sexual  excesses,  give  I{ux  vomica 
every  evening,  and  Sulphur  every  morning ;  when  from  the  effects  of 
opium,  a  persistent  course  of  restorative  treatment  must  be  decided  upon 
Give  Coffea^  in  usual  doses,  every  three  hours ;  give  also  Sulphur,  it 
the  full  strength  of  the  tincture,  in  drop  doses ;  also,  give  Ammonia  carb^, 
and  when  from  the  use  of  other  narcotics,  give  Nux  vomica  or  Jynatia 


Monomania. 

This  term  signifies  insanity  upon  a  single  matter,  when  in  every  other 
respect  the  mind  is  sound.  When  a  single  idea  seizes  the  mind,  and  mor- 
bidly dwells  there,  however  erroneous,  it  is  difficult  to  dislodge  it.  Some- 
times a  most  singular  and  absurd  idea  will  be  cherished  ;  as  that  one  is 
dead.  Dr.  William  Rush  once  had  a  patient  in  Pennsylvania  Hospital, 
who  claimed  to  be  dead  ;  and,  after  exhausting  his  ingenuity  to  convince 
him  of  the  contrary,  he  told  him  abruptly  that  he  was  dead,  and  should 
be  buried  ;  for  he  would  not  have  his  stinking  remains  there  to  pollute  tlie 
room  any  longer.  This  had  the  tendency  to  fire  up  the  anger  of  the 
pretended  dead  man  ;  and,  on  cooling  down,  his  singular  illusion  left  him. 
The  treatment  of  monomania  is  for  the  most  part  moral.  It  is  never 
prudent  to  contradict  the  patient,  or  to  show  disfavor  to  any  absurd  idea 
that  may  be  besetting  him,  but  rather  to  indulge  him  in  it.  A  celebrated 
French  writer  on  this  malady  says  of  a  case  at  the  Maison  dea  Invalides, 
that  he  fannied,  that,  if  he  urinated,  it  would  cause  a  flood  ;  and,  afler  find- 
ing that  the  patient  must  die  unless  there  was  an  evacuation  of  the  l)lad- 
der,  the  attendant  hit  upon  the  idea  of  crying  "  Fire  I  "  and  exclaiming  a* 
the  top  of  his  voice  that  the  city  was  on  fire,  and  wanting  in  water  to  ex- 
tinguish it,  said  to  the  patient,  **  to  let  the  flood  come  ;  "  it  was  wanted  to 
save  the  city  from  ruins:  and  this  appeal  had  the  desired  effect.  For  a 
mania  to  kill  some  one  person,  under  the  idea  that  it  must  be  done,  Arsen- 
icum has  apparently  proved  to  be  a  remedy.  In  a  case  quite  similar.  La' 
chena  proved  of  great  service.  For  some  of  the  fixed  ideas  in  monomania, 


remedioH  may  have  a  good  effect.  When  one  has  the  idea  of  bein^  great 
above  all  created  beings,  give  Aconite  or  Oonium.  When  one  has  an 
idea  that  he  is  hatcJ,  and  his  mind  appears  sound  in  other  respects,  give 
Aurum  or  Ignaiia.  When  he  is  tormented  with  the  idea  that  his  family 
or  friends  are  all  conniving  against  him,  and  appears  sane  on  other  suo- 
jects,  give  Sulphur,  and  then  Nuv  vom.  If  he  seems  right  on  ill  ques« 
lions,  except  that  his  mind  is  cogitating  theft,  so  that  ho  hiis  an 
irresistible  inclination  to  steal  whun  occasion  oflforg,  give  t-  'vhur, 
HulacUiUo-  # 


INSIDIOUS  DISEASES. 


I  *    * 

.  -  ■''I 


MS  ' 

\h 


Malignant  Pustule. 

Thxxv  «s  sometimes  a  low  and  vitiated  state  of  the  blood,  and  so  pow« 
erfuDy  predisposed  to  take  a  malignant,  if  not  a  fatal  tendency,  that  a 
very  slight  exciting  cause  will  arouse  a  disturbance  not  easily  quelled. 
Such  is  believed  to  be  the  origin  of  vhat  is  usually  termed  *'  the  Malig- 
nant Pustule,  a  small  pimple  upon  the  face,  regarded  of  little  account  by 
the  person,"  who,  unconscious  of  the  vitiated  condition  of  his  blood,  pinches 
it  and  irritates  it.  It  begins  to  inflame ;  a  determination  of  all  the  subtle 
impurities  of  the  fluid  takes  place  at  this  spot ;  and  a  malignant  and  disor- 
ganizing fever  pervades  the  entire  economy,  and,  if  not  arrested,  it  runs  a 
rapid  course,  and  terminates  fatally,  often  in  a  single  day,  or  before  any 
remedial  agent  can  be  brought  to  bear  to  arrest  the  process.  Pimples 
upon  the  face  should  never  b&  pinched  or  squeezed,  for  fear  of  inviting 
inflammation  to  tlie  spot,  that  migh;  re-act  in  calling  up  or  setting  fire  to 
a  discrasia  of  a  malignant  quality,  individuals  apparently  well  in  the 
morning  have  gone  to  business,  and,  ere  another  morning  came  round, 
have  foimd  themselves  fatally  prostrated  by  this  disorder.  As  soon  as 
suspected,  give  Arsenicum  every  hour  for  three  or  four  hours,  and  then 
follow  with  Nitric  acid;  and,  if  there  is  any  indication  '•f  change  for  the 
better,  loell;  if  not,  give  Muriatic  aoid,  or  Lachesis.  Jnst  us  soon 
as  any  pustule  upon  the  face  begins  to  inflame  like  a  boil,  and  there 
are  chilly  rigors  running  down  the  back,  retire  to  bed,  take  Arseni- 
cum,  and  a  change  in  the  febrile  condition  may  take  place  for  the 
better,  and  the  life  of  the  patient  may  be  saved.  V\  hen  the  faco 
begins  to  swoll,  and  there  is  delirium,  give  Belladonna  every  half 
hour,  to  hold  in  check,  if  possible,  the  tendency  to  the  brain.  After 
Belladonna,  ghe  Rhus  tox.  Very  many  cases  of  "the  Malignant 
Pustule  "  have  been  cured  by  a  timely  resort  to  proper  remedies. 
But  celerity  of  action  is  required  ;  one  moment's  unnecessary  delay 
may  be  too  hazardous  for  the  patient.  It  is  believed  that  the  brain 
and  nervous  centres  elsewhere  are  most  liable  to  speedy  implication. 
A  resort  to  sucli  remedies  as  will  guard  these  will  undoubtedly 
furnish  the  best  protection.  Consult  ^rsem'cum,  Aj>is  md,,  Bell., 
Graphites f  Merc,  Conium,  and  Sulphur, 
£68 


so  pOW" 
r,  that  a 
quelled, 
e  Malig- 
count  by 
1,  pinches 
lie  subtle 
nd  disor- 
it  runs  a 
ifore  any 
Pimples 
inviting 
ig  fire  to 
I  in  the 
round, 
soon  as 
and  then 
:e  for  the 
as  soon 
lid  there 
Arsent- 
i  for  the 
the  face 
ery  half 
I.    After 
alignaut 
emedies. 
,ry  delay 
he  brain 
ilication. 
aubt^dly 
.,  Bell., 


INSIDIOUS  DISEASES. 


863 


Spotted  Fever.  —  Fehris  Petechialis. 

This  fever  usually  begins  wit!i  great  lassitude ;  the  patient  feeli 
fatigued,  and  unable  to  be  about ;  aiul  then  a  headache  ensues,  without 
much  fever  ;  the  j)ulao  is  not  much  accelerated,  the  tongue  is  coated  with  a 
(lark  or  brown  coating,  nutrition  becomes  interru[)ted,  and  rapid  einacia- 
lion  takes  place.  After  a  while,  the  patient  begins  to  suffer  from  intense 
pain  in  the  back  and  limbs ;  a  cold  chill  comes  over  him,  and  a  febrilo 
re-action,  that  is  characterized  usually  by  great  thirst,  entire  loss  of  a|)petite, 
and  inclination  to  vomit.  During  the  febrile  excitement,  the  skin  becomoi 
discolored,  and  red  or  purple  spots  appear  in  great  numbers  upon  the  sur* 
face  of  the  body.  This  is  believed  to  be  the  crisis,  and  afibrds  an  indi- 
cation of  the  malignant  character  of  the  disease.  B'or  the  most  part,  the 
patient  lies  in  stupor,  or  perhaps  at  times  evinces  a  low,  muttering  deli- 
rium, and  inclination  to  pick  the  bed-clothes.  The  cause  of  this  fever  is 
supposed  to  be  some  malarious  poison  acting  upon  the  blood.  The  prog- 
iKisis,  or  prospect  of  the  result,  is  by  no  means  favorable  ;  yet  many  such 
cases  recover  under  proper  treatment.  In  the  first  stage,  when  the 
patient  is  complaining  of  great  weariness  and  lassitude,  give  Arnica 
every  three  hours.  When  the  head  begins  to  ache,  give  Belladonna,  and 
especially  if  there  is  any  twitching  of  the  muscles,  or  redness  of  the 
eyesi.  If  there  is  any  derangement  of  the  kidneys,  following  checked 
perspiration,  give  Rhus  tox.  For  the  intense  puin  in  the  l)a<'k,  give 
Belladonna^  and  follow  with  Vorat.  viride.  When  the  cold  chill 
ensues,  and  the  countenance  looks  pallid  and  sunken,  give  Carho 
egetabilis.     When  the  lever  appears,  and  there  is  thirst,  and  incli- 

tion  to  vomit,  give  Arsenicum,  or  perhaps  Veratrnm  album,  and 
repeat  the  renaedy  every  three  hours.  When  the  low,  muttering 
delirium  shows  itself,  give  Stramonium.  Let  the  surface  of  the 
body  be  rubbed  gently  with  a  crash  or  Turkish  towel,  and  wet  with 
tepid  water.  If  the  patient  becomes  quiet,  and  the  spots  gradually 
begin  to  disappear,  and  the  coating  upon  the  tongue  begins  to  break 
up,  and  a  normal  secretion  upon  the  tongue  begins  to  show  itself,  — 
these  are  signs  of  convalescence  ;  and  then  it  is  well  to  give  China, 
and  supply  the  patient  with  beef-tea  or  broth  in  moderate  quantities, 
and  then  with  something  more  substantial,  as  he  can  bear  it. 

Cold  Fever. 

In  some  parts  of  the  country,  there  has  prevailed  endemically  a  kind 
of  fever  which  at  first  makes  its  appearance  with  general  prostration 
and  coldness  of  the  surface  of  the  entire  body.  The  face  appears  as 
cold  as  marble,  the  nose  pinched,  the  eyes  sunken  in  their  sockets,  the 
tongue  covered  with  a  thick  white  coating,  no  appetite,  but  intense  thirst. 
This  cold  stage  lasts  for  a  longer  or  shorter  period  ;  and  then  it  is  followed 
by  a  febrile  re-action,  and  the  entire  body  becomes  intensely  heated,  the 
pulse  becomes  quick  and  feeble,  the  head  and  back  become  the  seat  of 
pain  for  a  while  ;  and  then  all  these  symptoms  disappear,  and  another  cold, 
sunken  condition  of  the  system  ensues,  and  sometimes  the  body  is  covered 
with  a  cold  perspiration,  which  lasts  for  an  indefinite  period ;  and  then  a 


864 


INSIDIOUS  DISEASES. 


M^- 


*6j' 
Ms 


more  fierce  febrile  re-action  comes  on  again,  and  elevates  the  pulse  and 
temperature  of  the  skin,  ifiving  a  flushed  appearance  of  the  countenance, 
redness  of  the  eyes,  and  heat  of  the  head  ;  when  a  warm  perspirr-'on  ter- 
minates the  febrile  heat,  and  tl)en  there  gradually  appears  the  ci^idness  of 
the  surface  again.  These  alternations  of  the  extremes  of  temperature 
upon  thu  surface  go  on  until  a  crisis  occurs  that  terminates  the  life  of 
the  patient,  or  the  disease  begins  to  wane.  But,  to  mitigate  the  severity 
of  the  disease  by  treatment,  in  the  co!d  stage,  give  Carlo,  veg.  ei'ery  four 
liours  until  the  re-action  commences,  and  tlien  give  Bryonia  or  Khu9  ;  and 
these  remedies  may  moderate  the  re-action.  If,  in  the  cold  stage,  the 
patieni  la  stupid,  give  Belladonna  ;  zfJii"  Carlo  veg.,  and  for  the  cold  pei> 
spiration,  give  Carlo  animalis.  At  ths  recurrence  of  the  fever  upon 
the  surface,  give  Arsenicum  and  Bri/ynia.  If  the  patient  has  much 
heat  in  the  head,  and  is  delirious,  give  ^eZ/acfonna  /  and,  until  theco}»ting 
upon  the  tongue  begins  to  disappeai',  do  not  thrust  any  food  other  than 
light  gruel  upon  the  patient,  but  as  soon  as  the  natural  secretion  of  sahva 
appears  upon  the  tongue,  give  beef-tea,  or  good  mutton-soup,  a  little  wine, 
and  other  nutritious  stimulants ;  avid,  as  tlie  appetite  returns,  increase  the 
strength  of  the  diet.  The  same  process  of  rubbing  must  be  employed  aa 
in  the  Spotted  Fever.  If  the  urine  is  turbid,  give  JVux  vom.  If 
the  feet  swell  during  the  convalescence,  give  Araonicum,  Apia  mel.y 
or  Hellebore. 


Putrid  Fever. 

This  fever,  as  its  name  implies,  emits  an  unpleasant  or  fetid  odor.  It 
comes  on  much  like  those  just  described,  only  the  breath  appears  to  be 
tainted  with  sonr.ething  of  a  putrid  character,  and  very  often  there  are  pu- 
trid discharges  from  the  bowels.  The  urine  lias  a  putrid  odor ;  and,  when 
there  is  any  perspiration  upon  the  surface,  it  has  the  same  smell.  The 
disease  comes  on  unobserved,  and  is  attended  with  lassitude  and  inappe- 
tency.  There  is  seldom  any  noticeable  cold  stage,  and  yet  there  is  very 
little  if  any  heat  upon  the  surface.  The  tongue  becomes  coated  with  a 
dark-brown  coating,  and  sordes  collects  upon  the  teeth  in  large  quantities. 
The  pulse  is  feeble  and  quick.;  the  skin,  for  the  most  part,  is  dry  and  of 
low  vitality.  There  is  often  more  or  less  pain  in  the  bowels,  and  a  dis- 
tension of  the  abdomen.  The  urine  is  thick  and  high  colored,  and  of  an 
offensive  odor.  The  patient  rejects  all  kinds  of  food  and  drink,  except 
water;  and  this  uniformly  has  to  him  a  disagreeable  taste.  His  nose 
is  dry  and  sore,  and  his  lips  become  dry  and  cracked ;  and  sometimes 
M  black  or  dark-colored  saliva  runs  out  of  the  corners  of  his  mouth, 
which  discolors  them,  and  gives  to  his  pale  and  sunken  countenance  a 
distressing  appearance.  The  progress  of  this  feier  is  slow  and  low,  and 
often  terminates  in  ulceration  of  ti^e  boweh.  There  is  from  the  fii-st  a 
labored  respiration  and  a  putrid  breath.  For  the  commencing  stage, 
give  Arnica;  if  this  fails  to  relieve  ino  symptoms  in  twent^'-four  hours,  give 
Baptisia;  when  the  mouth  becomes  dry  and  the  lips  cracked,  and  the 
Bordes  collects  upon  the  teeth,  give  NUrie  acid,  and  follow  with  Arseni- 
cum;  when  the  patient  complains  of  pain  in  the  bowels,  and  there  are 
putrescent  discharges  f>om  them,  give  Phosphorus;  if  there  is  involun- 
tarv  and  oainless  diarrhoea,  give  Phosplwric  add;  in  case  of  great  pros- 


mSIDIOUS  DISEASES. 


865 


iilse  and 
itenance, 
r^'on  ter- 
idness  of 
iperature 
le  life  of 
5  severity 
eery  fouf 
hiis  ;  and 
stage,  the 
cold  pei^ 
iver  upon 
las  much 
lie  costing 
ther  than 
n  of  sahva 
ittle  wine, 
crease  the 
aployed  as 
vom.     If 
Vpia  mel.i 


tration,  give  Arsenicunit  followed  in  twelve  hours,  if  no  relief,  by 
Muriatic  acid.  Putrid  fevers  aro  often  fatal,  and  especially  where 
a  putrid  diarrhoea  is  kept  up  by  the  fever.  For  distension  of  the 
abdomen,  give  Nux;  for  the  thick  and  offensive  urine,  Sulphur ^ 
Carbo  veg.y  or  Arsenicum;  should  the  putrid  stage  pass  off,  leaving 
the  patient  prostrate,  give  Chinay  wine,  egg-nog,  and  even  a  little 
orundy,  to  keep  up  the  vitality  of  the  system.  The  sooner  any  one 
r«<iovering  from  this  fever  can  take  Ught,  solid  aliments,  the  better. 

10* 


odor.    It 
pears  to  be 
're  are  pu- 
and,  when 
[lell.     The 
tid  inappe- 
ere  is  very 
ited  with  a 
quantities, 
dry  and  of 
and  ti  dis- 
and  of  an 
ink,  except 
His  noso 
sometimes 
his  mouth, 
mtenance  a 
d  low,  and 
the  firat  a 
cing  stage, 
hours,  give 
d,  and  the 
■ith  Ar9ein- 
there  are 
is   involan- 
great  pros- 


!>' 


SPECIFIC  INDICATIONS  FOR  REMEDIES  IN  FEVERS. 


In  giving  specific  indications  for  the  selection  of  remedies  in  Fevers,  a 
large  gruund.  is  covered,  inasmuch  as  nearly  all  the  diseases  to  which 
flesh  is  heir  are  attended  by  some  specifically  characterized  fever,  which 
calls  for  the  proper  remedy.  It  is  therefore  deemed  important  to  state, 
in  connection  with  the  names  of  the  important  remedies,  the  particular 
characteristic  symptoms  that  they  represent. 

Aconite  is  indicated  for  violent  heat  and  chill,  heat  about  the  head  and 
face ;  and  red  cheeks,  palpitation  of  the  heart,  pleuritic  stitches,  anguish, 
sadness  or  ill-humor,  despondency,  and  dread  of  death,  bodily  rest- 
lessness. 

Autimoniam  is  indicated  when  there  is  little  thirst,  yellow  coating  upon 
the  tongue,  bitter  taste  in  the  mouth,  eructations,  nausea,  loathing,  vomit 
ing,  and  other  gastric  derangements  ;  constipation  or  diarrhoea. 

Arnica  is  indicated  when  there  is  thirst  before  the  chill,  and  when  the 
chill  comes  on  in  the  evening  after  considerable  aching  of  the  bones ;  and 
also  when  there  is  constant  desire  to  change  one's  position  during  the 
fever ;  for  apathy,  and  pains  in  the  stomach  ;  for  want  of  appetite,  and 
aversion  to  meat  when  the  fever  has  gone  off.  It  is  particularly  indicated 
when  there  is  weariness,  listlessness,  yellow  color  of  the  skin,  and 
bitter  taste,  and  following  a  blow  or  concussion. 

Arsenlcam  album  is  called  for  when  the  chill  and  heat  set  in  simulta- 
neously, or  when  they  rapidly  alternate  with  each  other,  or  when  then* 
is  internal  chilliness  and  external  heat,  and  viee  versa;  also  for  burning 
heat,  as  if  boiling  water  was  flowing  through  the  veins ;  no  sweat  until  the 
commencement  of  sleep,  oppression  of  the  chest,  anguish  and  uueasinestt, 

Pressure  in  the  head,  vertigo,  pains  in  the  liver  and  spleen,  great  debility, 
urning  pain  in  the  stomach,  and  disposition  to  vomit,  great  uneasiness 
and  anguish  in  the  region  of  the  heart,  violent  pains  and  lameness  of  the 
extremities,  and  tendency  to  dropsy. 

BcUadouna,  when  the  fever  comes  on  with  violent  headache  with  stu 
pefaction,  marked  chilliness  and  slight  heat  or  the  opposite;  redness  of  the 
face,  with  heat  and  throbbing  of  the  temporal  arteries  and  carotids ;  entire 
absence  of  thirst  or  the  reverse ;  and  also  when  the  patient  is  irritak!«  «nd 
in  a  whining  mood. 

86ft 


BS. 


Feven,  ft 
to  which 
er,  which 
t  to  state, 
particular 

head  and 
I,  anguish, 
(lily  rest- 
ting  upon 
ng,  vomit 

when  the 
ones;  and 
uring  the 
letite,  and 
indicated 
skin,  and 

In  simuUa- 
jhen  tlieiv 
|r  burning 
it  until  the 
measiriesH, 
it  debility, 
I  uneasiness 
less  of  tne 


with  stu 
Iness  of  the 
lids ;  entire 

itabU  «nd 


SPECIFIC  INDICATIONS  FOR  REMEDIES  IN   FEVERS. 


867 


Bryonia,  for  coldness,  chill  with  red  cheeks,  heat  about  the  head,  and 
yawning  ;  or  when  the  heat  prevails  with  subsequent  chilUness,  heat  of  the 
chest  with  slight  pains  indicating  pleurisy  ;  or  when  there  is  a  coated  tongue, 
or  headache  and  vertigo  during  the  heat,  nausea  and  f  aintness  on  sitting  up. 


Calcarea  carbonica,  for  heat  in  the  face,  then  chills  ;  or  with  cold  hands, 
heaviness  of  the  head  and  limbs,  pains  in  tlio  small  of  tlie  back,  and  rest- 
lessness ;  cold,  HOur-smelling  sweat  on  the  head. 

Capsicam,  when  there  is  thirst  during  the  chill  and  fever,  and  much 
mucus  in  the  mouth,  throat,  and  stomach  ;  also  when  there  is  diarrhoea 
with  sliiny  and  burning  evacuations ;  and  when  the  patient  ir>  irritable, 
anxious,  and  oppressed  during  the  chill,  and  when  the  chill  begins  in  the 
back. 

€arbo  veg.,  when  the  chill  occurs  in  the  evening  or  at  niglit ;  thirst 
during  tiie  clsiil  only,  which  is  followed  with  fever  and  copious  sweat  and 
chilliness ;  afterwards  rheumatic  pains  in  the  teeth  and  limbs  before  or 
during  the  fever;  and  when  there  is  vertigo,  nausea,  and  red  face  during 
the  heat. 

Chamomilla,  when  tliere  is  pressure  in  tlie  pit  of  the  stomach,  hot  sweat 
on  the  forehead,  despair,  tossing  about  or  bilious  vomiting,  diarHui^a  and 
colic,  —  the  thirst,  heat,  and  swe.it  prevailing,  frecpient  urination. 

China  is  indicated  when  there  is  nausea,  canine  hunger,  headache,  an- 
guish, palpitation  of  the  heart,  or  other  ailment  previous  to  the  paroxysm  ; 
when  there  is  thirst  generally  before  or  after  the  chill  and  heat,  or  during 
the  sweat ;  when  there  is  no  thirst,  but  tendency  of  blood  to  the  head, 
headache,  red  face,  uneasy  sleep,  and  yellow  complexion.  China  is  also 
indicated  when  there  is  drowsiness,  pains  in  the  liver  and  spleen,  bilious 
or  dropsical  symptoms,  or  enlargement  of  the  liver  and  spleen. 

Cina,  for  vomiting  and  canine  hunger,  both  before  and  •  the  parox- 
ysm of  fever ;  the  face  is  pale  during  the  fever,  and  a  tendency  to  emacia- 
tion exists,  and  dilated  pupils. 

Femun  is  indicated  when  the  fever  comes  on  with  chill  and  thirst, 
headache,  and  tendency  to  congestion  of  various  organs  ;  swelling  of  the 
external  veins,  swelling  of  the  face,  especially  around  the  eyes  ;  great 
debility,  vomiting  of  the  food  when  partially  digested,  and  laborious 
breathing.  , 

Ig^atia,  when  there  is  thirst  only  during  the  chill,  and  when  this  is 
moderated  by  external  heat,  or  when  there  is  external  heat  with  partial 
internal  shuddering;  nausea  and  vomiting,  pale  color  of  the  skin,  and 

{)ains  in  the  back  during  the  chill ;  and  also  when  there  is  no  thirst,  with 
leadache,  vertigo,  and  delirium,  and  particularly  when  there  is  paleness 
of  the  face,  or  else  alternately  pale  and  red,  or  only  one  cheek  red  during 
the  heat ;  great  languor,  deep  sleep,  with  snoring ;  after  or  during  the 
fever,  eruption  on  the  lips  and  in  the  corners  of  the  mouth.  This  rem-, 
edy  is  also  indicated  for  the  fever  attending  Nettle  Rash  and  other  erup- 
tions of  the  skin. 

Ipecacuanha  is  indicated  for  a  fever  of  much  chilliness  and  little  heat, 
or  vice  versa,  and  when  the  chill  is  increased  by  external  heat,  or  when 


t 


't'i 


h «'( 


868 


SPECIFIC  INDICATIONS  FOB  REMEDIES  U;  FKVEBS. 


fir. 


there  is  little  or  no  thirst  during  the  chill,  and  great  thirst  during  the 
heat ;  and  also  when  there  is  nausea  and  vomiting,  and  other  gastric 
symptoms,  previous  to,  or  during  and  between,  the  paroxysms  of  fever ; 
and  when  there  is  a  coated  tongue  and  an  oppression  of  the  chest. 

Lachesis  is  particularly  indicated  when  chills  occur  afler  a  meal  in  w^e 
latter  part  of  tlie  day,  with  violent  pains  in  tiie  limbs,  and  pleuritic  stitches, 
oppression  of  the  chest,  and  convulsive  motions  ;  and  when  there  is  violent 
headache  during  the  heat;  delirium,  burning  thirst,  red  face, restlessness, 
internal  shudderings  during  the  licat,  livid  complexion,  debility,  prostra- 
tion between  the  paroxysms,  heat  especially  at  night,  sweat  after  the  heat, 
and  when  the  fever  is  easily  excited  by  eating  lemons  o»  other  sour  things. 

Hercurius  is  indicated  when  heat  and  sweat  appear  together,  and  when 
there  is  violent  thirst,  pains  in  the  right  side,  acid  stomach,  and  regurgi- 
tation of  sour  or  bilious  matter  from  the  stomach  ;  and  when  there  are 
pains  in  the  bones,  and  an  aching  of  the  limbs. 

Nux  Yoniica  is  suitable  for  a  fever  that  comes  on  with  great  debility, 
then  chill  and  heat ;  constant  desire  to  be  covered,  even  during  the  heat 
and  sweat ;  and  when,  during  the  chill,  the  skin,  hands,  feet,  and  face  arc 
blue  ;  and  when  there  are  pains  in  the  chest  and  abdomen,  back,  and  par- 
ticularly in  the  small  of  the  back,  or  drawing  in  the  limbs ;  and  when 
there  is  headache,  buzzing  in  the  ears,  distress  in  the  chest,  heat  about 
the  face,  red  cheeks  and  thirst  during  the  chill  and  heat ;  and  also  when 
there  are  gastric  or  bilious  symptoms,  vertigo,  anguish,  and  ccstipation. 

Opium  is  called  for  when  there  is  sleep  during  the  heat,  and  even  dur- 
ing the  chill,  with  snoring  respiration  with  the  mouth  open  ;  convulsive 
twitchings,  warm  sweat,  suppression  of  the  secretions.  Tt:is  remedy  is 
(suitable  for  old  people  and  children. 

l*uL$atiliii  is  wanted  when  there  is  no  thirst  during  the  fever,  or  thirst 
only  during  the  heat,  and  when  there  is  an  aggravation  in  the  afternoon  or 
evening,  with  headache,  anguish,  and  oppression  during  the  entire  period 
of  the  fever ;  and  when  there  is  a  red  and  bloated  face,  sweat  in  the  face, 
and  shuddering  as  soon  as  the  patient  recovers  himself;  and  also  wlion 
there  are  gastric  or  bilious  symptoms,  bitter  taste  in  the  mouth,  bilioos, 
slimy,  or  sour  vomitings,  or  diarrhoea,  alternating  with  constipation, 
')p]>ression  of  the  chest,  moist  cough,  or  headache.  PtUsatilla  is  fre- 
quently suitable  after  LacheaiSj  or  when  the  fever  comes  on  again  after 
overloading^  the  stomach  in  any  way.  Often  beneficial  after  the 
abuse  of  Quinine. 

Rhus  tox  is  suitable  for  an  evening  or  night  fever,  when  the  chilliness 
and  heat  both  make  their  appearance  simultaneously,  and  a  copious  sweat 
comes  on  after  midnight  or  towards  morning ;  and  when,  during  the  chill, 
tliere  are  pains  in  the  limbs,  headache,  vertigo,  or  toothache  ;  or  when, 
between  the  paroxysms,  there  are  convulsive  twitchings  of  the  limbs,  net- 
tle-rash, colic,  diarrhoea,  and  gastric  derangement ;  or  when  there  is  jaun- 
dice, sleeplessness,  and  tossing  about,  thirst  at  night,  palpitation  of  the 
heart,  with  anguish  and  pressure  in  the  pit  of  the  stomach. 

Teratmiil,  when  there  are  external  chill  and  cold  sweat,  or  internal 
heat,  with  dark-red  urine,  delirium,  and  flushed  &ce ;  or  when  there  is 


m 


SPKCIFIO  INDICATIONS  FOR  REMEDIES  IN  FEVEB8. 


869 


chill,  with  nausea,  vertigo,  pains  in  the  small  of  che  back  and  back  ;  or 
when  there  is  chill  alternating  with  heat,  constipation,  or  vomiting  with 
diarrlioea  ;  and  when  there  is  tbir.«t  during  the  chill  and  heat. 

With  the  above  remedies,  or  any  of  them,  the  following  remedies  may 
be  employed ;  as  Cantharis,  when  the  urinary  passages  are  involved  ;  or 
C'occulua,  when  the  patient  is  nervous  and  threatened  with  spasms,  cardi- 
algia,  and  constipation.  When  the  fever  for  which  any  of  the  remedies 
are  indicated  is  in  sensitive  persons,  made  restless  by  great  nervousness, 
give  Coffea  ;  and  especially  wiien  there  is  sweat  with  tliirst,  soft  stools,  or 
diarrhoea.  Give  Droseru^  when  there  is  violent  chilliness  with  cold  face, 
icy  cold  hands  and  feet,  nausea  and  bilious  vomiting,  headache  and  spas- 
modic cough  during  the  heat,  and  gastric  symptoms  between  the  parox* 
ysms.  Give  Hepar,  when  the  patient  has  coryza,  cough,  or  distress  in  the 
chest,  or  chill  and  thirst,  preceded  by  bitter  taste,  followed  by  heat  and 
sleep.  Give  Hyoscyamus^  when  the  fever  is  attended  by  cough  at  night, 
or  even  epileptic  attacks.  Mercurius,  sour  and  fetid  sweat,  with  palpita- 
tion of  the  heart.  Sulphur^  when  the  fever  is  from  suppressed  Itch,  with 
chills  every  evening,  heat  and  sweat  towards  morning,  fever  with  palpi- 
tation of  the  heart,  and  violent  tliirst  even  before  the  chill. 

In  case  of  any  fever  occurring  with  symptoms  described  as  being  par- 
ticular indications  for  the  employment  of  any  one  remedy,  always  select 
that  remedy*;  and,  in  all  probability,  but  few  doses  will  be  required  to 
effect  a  cure,  provided  the  patient  is  placed  in  the  most  favorable  condi- 
tion Tor  recovery  :   for  this  is  as  essential  as  the  employment  of  remedies. 

In  many  instances,  only  a  single  symptom  may  present  itself,  while  in 
other  respects  the  jjatient  may  be  well.  A  brief  consideration  of  some  of 
these  may  be  useful ;  as,  — 

Aversion  to  Food,  —  Anorexia. 

When  this  exists  as  a  mere  symptom,  or  dislike  for  food,  give  Tart, 
emetic.  If  after  gastric  affections,  give  Cldna.  For  aversion  to  food, 
accompanied  with  hunger,  give  Bryonia  or  Rhus  tox.,  or  else  Ignatia  or 
ifttx  vomica.    For  complete  loathing  of  food,  give  Ipecac-  or  Pulsatilla. 


Loss  of  Smell.  —  Anosmia. 

Thia  symptom  may  show  itself  independently,  and  c.  sists  in  a  mere 
insujceptibiiiij'  of  the  olfactory  nerves,  which  may  be  quickened  by  one 
or  two  doses  of  Belladonna^  Calcarea,  or  Sanguinaria.  If  from  paralysis 
of  the  olfactory  nerves,  give  Nux  vomica  or  Sepia.  If  from  catarrh, 
give  Calcarea^  HepaVy  tSilioea,  or  Sulphur. 


Loss  of  Taste.  —  Aguatia. 

For  the  absence  of  this  sense,  independently  of  other  affections,  give 
Natrum  mur.  and  Silicea.  For  loss  of  taste  from  purely  nervous  causes, 
such  as  paralysis  of  the  gustatory  nerves,  g'-^e  Hyotcyamua^  Nux  vom.,  or 


870 


SPECIFIC  INDICATIONS  FOR  REMEDIES  IN  FEVERS. 


I 


it 


iSIema.  For  the  same  attended  with  catarrh,  coryza,  and  other  effects  of 
cold,  give  Pulmtilla  or  Sulphur,  or  else  ffepar  or  Sepia.  Give  the  usual 
dose,  and  repeat  twice  a  day  as  long  as  is  necessary. 

For  alterations  of  taste,  viewed  as  mere  symptoms,  the  following  remo- 
dies  mav  be  employed :  Aconite,  Arsenicum,  Belladonna,  Bryonia,  Mer* 
curiua,  jRhus,  PuUatilla,  &c.  For  bitter  taste,  give  Aconite,  Bryonia, 
Mercurius,  or  iVkc  vomica.  For  the  taste  of  blood,  give  Ipecac,  or  Sul- 
phur. For  the  taste  of  pus,  Pulsatilla.  For  clayey  taste,  China,  Hepar, 
PuUatilla.  For  flat,  watery  taste,  or  iirsinid,  give  Bryonia  or  China.  For 
the  taste  of  bad  eggs,  cheese,  «fec.,  give  Arnica,  llhus,  or  Sulphur.  For 
greasy  taste,  Caiistioum.  For  metallic  taste,  give  Calc,  Lachenis,  Nux 
vomica,  or  Rhu^.  For  clah.ir;v  or  slimy  taste,  Arnica  or  Belladonna. 
For  rancid  taste,  give  Bryonia  or  Ipecac.  For  salt  taste,  Arsenicum, 
Carlo  veg.,  or  Sulphur.  For  sour  taste,  give  Calc,  China,  J\'ux  vomica, 
.ir  Sulphur.  For  other  forms  of  illusory  or  bad  taste  in  goiieral,  give 
Nux,  Pulsatilla,  or  Sepia.  For  sweetisii  taste,  give  Belladonna,  Bryonia, 
China,  Merc,  or  Pulsatilla.  When  food  tastes  bitter,  give  Coloeynth.  For 
bitter  taste  after  eating  and  drinking,  Bryonia,  China,  Pulsatilla.  When 
food  has  a  salty  taste,  give  Carbo  veg.  When  it  tastes  sour,  give  Calc  or 
China.  When  there  is  a  sour  taste  after  eating,  Nux  vom.  or  Pulsatilla. 
Sour  taste  after  drinking.  Sulphur.  P"  after  drinking  milk,  Nux  vomica. 
When  bread  tastes  sweet,  give  Mercurius.  When  those  who  use  tobacco 
imagine  that  it  has  an  acid  taste,  Staphysagria.  When  there  is  an  illusory 
taste  of  sweetness  of  beer,  Pulsatilla.  For  nauseous  taste.  Ipecac.  A 
single  dose  of  the  remedy  indicated  for  illusions  of  taste  will  generally 
correct  the  disorder.  Nearly  all  these  departures  from  the  normal  condi* 
tion  of  the  sense  may  be  indicative  of  some  peculiar  derangement  of  the 
animal  or  organic  functions,  that  the  chosen  remedy  may  avert  or  correct. 
The  value  of  these  isolated  symptoms  in  pointing  to  remedies  that  may 
be  used  as  timely  preventives  of  more  serious  derangements  can  hardly  tie 
appreciated.  As,  for  instance,  a  bitter  taste  may  forebode  a  serious  biliary 
derangement,  that  Aconite  may  prevent.  And  so  with  all  the  other  varie- 
ties of  illusory  taste  :  what  might  follow,  if  neglected,  no  one  can  tell.  It 
is  better  to  prevent  than  to  cure  a  malady  ;  and  when  the  sentinels  of 
taste  and  smell  stand  ready  to  guard  against  the  approach  of  diseases,  it 
is  always  best  to  give  heei  to  their  admonitioua. 


r 


p  effects  of 

0  the  usual 

wing  reme- 
tonia,  Mef' 
e,  Bryonia, 
•ac.  or  Sul- 
ina,  Hepar, 
Vdna.  For 
p]mr.  Foi- 
chesis,  Nux. 
belladonna. 
Arsenicum, 
hix  vomica, 
J  Moral,  give 
rt,  Bryonia, 
yeynth.  For 
Ilia.  When 
ive  Calc.  or 
Pulsatilla, 
Vux  vomica. 
use  tobacco 

1  an  illusory 
Ipecac.  A 
11  generally 
)rmal  condi' 
ment  of  tlie 
t  or  correct. 
s  that  may 
n  hardly  va 
rious  biliary 
other  varie- 
:an  tell.  It 
sentinels  of 
:  diseases,  it 


POISONS,  AND  THEIR  ANTIDOTES. 


SunsTANCES  which  derange  the  vital  functions,  and  produce  death  by  an 
action  not  mechanical,  are  denominated  poisons  ;  and  diLtinguished  writ- 
ers have  noted  three  classes  of  tliese  substances,  which  may  be  noted  as 
follows :  — 

Ist.  Irritant  Poisons,  or  those  which  produce  irritation  or  inflamma- 
tion, as  mineral  acids.  Arsenic,  Copper,  ^e. 

2d.  Narcotic  Poisons,  or  those  which  produce  stupor  or  deliniim,  and 
other  affections  of  the  brain  and  nervous  system,  as  Opium,  Pruatio 
acid,  ^c. 

3d.  Narcotic-acrid  Poisons,  or  those  which  sometimes  produce  irrita^ 
tion,  and  sometimes  narcotism  ;  sometimes  both  together.  The.«c  are  all 
derived  from  the  vegetable  kingdom  ;  as  Strychnia,  Nux  vomica,  ^c. 

As  most  everybody  is  obliged  to  be  so  situated,  that,  through  mistake  or 
accident,  poison  of  one  or  another  of  these  classes  may  be  taken  into  the 
system,  it  seems  desirable  to  be  well  instructed  in  the  use  of  antidotes, 
and  the  treatment  of  the  supervening  irritation  or  inflammation. 

If,  through  mistake  or  accident,  either  sulphuric,  nitric,  or  hydrochla- 
rio  acid  is  taken  into  the  stomach  in  poisonous  doses,  give  Chalk  or  Mag- 
nesia; or,  if  this  is  not  at  hand,  beat  down  the  plaster  from  the  wall,  and 
make  into  a  thin  paste  with  water,  and  give  this.  Soap-suds  is  another 
antidote.  Drink  freely  of  any  mild  fluid,  or  milk,  both  bef  e  and  after  the 
antidote  is  administered.  For  the  supervening  inflammation,  such  remedies 
may  be  employed  as  in  Gastritis  from  any  other  cause :  Aconite,  in  case 
of  much  fever ;  Bryonia,  if  glairy  vomitings ;  Nux  vomica,  if  th«»re  is 
sense  of  weight,  &c. 

In  case  of  Oxalic  acid  being  taktin  into  the  stomach  by  mistake,  as 
this  may  occur  from  its  resemblance  to  Epsom  salts,  it  will  be  necessary 
to  excite  vomiting  at  once  by  tickling  the  throat  with  a  feather,  or  b^  ^u 
emetic ;  and,  after,  to  administer  ChaVe  or  Magnesia  in  large  doses  sus- 
pended in  water.  These  not  being  at  hand,  break  off  the  plaster,  and 
make  a  paste  as  before.  Alkalies  will  not  answer,  as  they  would  only 
form  neutral  salts.  For  the  after-symptoms,  give  Aconite  dissolved  in 
water,  —  a  tablespoonful  after  every  paroxysm  of  vomiting,  until  they 
cease ;  and  give  the  victim  at  the  same  time,  freely,  mucilaginous  drinks, 
•nd  also  Coffta  and  Opium  as  antidotes. 

S71 


872 


POISONS,  AND  THEIB  AIITIDOTB& 


Forfommxng  vfith  Artenicy  the  first  thing  necessaiy  is  to  thoroaghW 
evacuate  the  stomach ;  and,  for  this  purpose,  give  an  emetic,  and  then  fol- 
low with  iron-nuty  or  the  Sesqui-oxid  of  Iron,  largely  diffused  in 
water ;  and  let  the  patient  drink  freely  of  mucilaginous,  rarinaceous,  or 
albuminous  drinks,  and  milk.  The  subsequent  inflammation  must  be 
treated  with  Aconite,  —  a  dose  every  two  hours  until  the  nausea  entirely 
disappears ;  Nuxvomica,  also,  for  the  inflammation  and  soreness  of  the  gas- 
tric region  ;  Brt/onia,  if  the  slightest  motion  produces  pain  ;  and  PnUatilla 
or  iV^«.?  V  tm.,  if  the  most  delicate  kinds  of  food  aggravate  tlie  suffering. 

For  Poisoning  with  Mercury,  and  Corrosive  mblimate.  —  This  is  the 
usual  form  of  Mercury  employed  for  committing  suicide  ;  and,  as  it  is  used 
for  bed-bug  poison,  it  is  liable  to  be  taken  through  carelessness  or  mistake. 
It  is  therefore  requisite  to  point  out  some  antidote  the  nearest  at  hand. 
Give  whites  of  eggs  in  abundance,  or  Gluten  if  eggs  cannot  be  had ;  or 
else  milk.  The  most  usual  form  of  the  supervening  irritation  is  Saliva- 
tion or  Mercurial  Fever.  For  these,  give  Nitric  acid,  Hepar  sulphur, 
and  obtain  for  the  patient  fresh  air  and  a  nourishing  diet  as  s>on  as 
possible. 

For  Poisoning  with  Copper. — The  blue  vitriol,  or  Sulphate  of  Copper, 
and  Verdigris,  are  the  forms  in  which  this  poison  is  most  common  ;  and, 
when  taken  into  the  system,  the  most  ready  antidote  is  the  white  of 
eggs.  Great  care  should  be  taken  to  exclude  vinegar,  for  this  acid  would 
add  virulence  to  the  poison.  To  allay  or  cure  the  remaining  irritation, 
give  Sulphur  twice  a  day. 

Poisoning  with  Antimony,  or  Tart,  emetic,  is  liable  to  occur,  as  this 
oubstance  is  sometimes  used  in  medicine  as  an  emetic.  When  given  to 
excess,  it  produces  vomiting,  attended  with  burning  pain  at  the  pit  of 
the  stomach,  followed  by  purging  and  colic,  stricture  of  the  throat,  and 
cramps.  As  an  antidote,  give  large  draughts  of  warm  water,  and  tickle 
the  throat  with  a  feather  to  induce  vomiting ;  also  the  decoction  of  any 
bark  containing  tannin,  as  oak,  hemlock,  or  cherry-tree  bark.  For  the 
subsequent  ailments,  give  Sulphur,  Cldna,  Nux  vomica,  or  Opium. 

For  poisoning  with  Zinc,  or  white  vitriol,  which  is  denoted  by  violent 
vomiting,  sunken  eyes,  and  pale  face,  cold  extremities,  and  fluttering 
pulse,  give  the  infusion  of  any  of  the  substances  containing  tannin,  and 
I'eed  the  ])atient  with  cream,  butter,  and  chalk  quite  freely. 

For  poisoning  with  Lead.  —  Red  lead  and  white  lead,  as  well  as 
sugar  of  lead,  are  liable  to  be  taken  by  mistake ;  and  their  poisonous 
effects  are  denoted  by  obstinate  colic,  spasms  of  tlie  muscles,  and  some- 
times apoplexy.  As  an  antidote,  give  water  of  ammonia,  or  liartshorn,  or 
pearlash-water,  or  any  of  the  earthy  sulphates,  as  lime,  etc.  For  Lead  Pa- 
ralysis, give  Sulphur,  and  afterwards   ^ux  vomica.     For  colic,  Opium. 

For  poisoning  with  Cantharides,  which  is  denoted  by  intense  burning 
in  the  pit  of  the  stomach,  and  pain  in  the  lower  abdomen,  feeble  voice, 
laborious  breathing,  strangury,  and  tenesmus  of  the  bladder,  headache,  and 
delirium.  To  remove  the  Cantharis  from  the  stomach,  excite  vomiting 
in  the  quickest  and  most  speedy  way,  —  by  tickling  the  throat  with  a 
feather,  or  drinking  a  strong  mustard-tea,  or  by  taking  snuff  upon  the 
tongue.  Give  Aconite  to  allay  the  fever  ;  give  Nux  vomica  and  Pulsa- 
tilla to  allay  the  irritability  of  the  stomach,  and  Arnica  to  relieve  the 


'A 


iron£ 
:hen 
used   in 
ieous,  or 
nost  be 
entirely 
the  gas- 
^idmtilla 
ring. 
is  is  the 
it  is  used 
mistake, 
at  hand, 
had;  or 
3  Saliva- 
mlphur, 
s>on  as 

'  Coppery 
}n ;  and, 
white  of 
•id  would 
irritation^ 

r,  as  ihia 
1  given  to 
he  pit  of 
roat,  and 
md  tickle 
)n  of  any 
For  the 
tm. 

3y  violent 
flattering 
nnin,  and 

well  as 

poisonous 

nd  some- 

tshorn,  or 

Lead  Pa- 

burning 
;ble  voice, 
ache,  and 
vomiting 
>at  with  a 
upon  the 
id  Pulsa- 
3lieve  the 


POISONS,  AND  THEIB  ANTIDOTES. 


873 


tenenntUy  or  straining;  or  else  spirits  of  Camphor.    This  is  believed  to  be 
the  best  antidote. 

For  poisoning  with  Morphine^  which  is  denoted  by  giddiness  and  stupor, 
the  person  becomes  motionless,  and  insensible  to  external  impressions, 
breathes  slowly,  and  lies  quite  still,  with  the  eyes  shut  and  the  pupils  con- 
tracted, the  whole  expression  of  the  countenance  being  that  of  perfect 
repose.  As  the  poison  advances,  the  features  become  ghastly,  the  pulse 
feeble  and  imperceptible,  the  muscles  excessively  relaxed  ;  and,  unless 
assistance  is  speedily  called,  death  soon  ensues.  The  first  thing  neces- 
sary is  to  remove  the  poison  from  the  stomach,  which  is  by  inducing 
vomiting.  If  soon  after  taking  the  morphine,  give  mustard-water  freely, 
or  inject  in  the  stomach  some  sulphate  of  zinc,  if  the  patient  is  too  insen- 
sible to  take  it  otherwise.  After  vomiting  is  induced,  arouse  the  victim, 
make  him  walk  up  and  down  the  room  for  hours,  until  the  inclination  to 
sleep  is  superseded  bv  nausea,  headache,  and  vomiting,  and  then  give 
him  strong  coffee  ;  and  afterwards,  to  remove  the  entailed  symptoms,  give 
Nux  vomica. 

For  poisoning  with  Prussic  Add,  when  not  fatal,  resort  to  cold  shower- 
hath,  and  inhalation  of  diluted  water-of-ammonia  vapor  ;  give,  also,  solu- 
tion of  carbonate  of  potass. 

For  poisoning  with  Charcoal  Gas,  as  from  the  fumes  of  burning  char- 
coal in  a  close  room,  resort  to  cold  affusion,  and  give  Aconite,  in  drop 
doses,  in  a  spoonful  of  water.  The  same  treatment  may  be  resorted  to 
in  case  of  poisoning  with  any  of  the  poisonous  gases,  as  sulphureted  hy- 
drogen and  carbonic  acid. 

Poisoning  by  Strychnia,  or  Nitx  vomica,  is  denoted  by  convulsions,  with 
much  anxiety  and  agitation  during  the  fits.  The  whole  body  is  stiffened 
or  straightened  ;  the  legs  pushed  out  and  forced  wide  apart ;  no  pulse  or 
breathing  can  be  perceived ;  the  face  and  hands  livid,  and  the  muscles 
violently  convulsed.  Nux  vomica,  or  Strychnia,  in  poisonous  doses,  gen- 
erally proves  fatal,  in  spite  of  treatment.  If  emetics  are  given,  and  the 
Stomach  is  made  to  disgorge  its  contents  sufficiently  early,  and  the  patient 
is  not  attacked  with  convulsions  in  two  hours,  he  will  generally  be  safe. 

In  treating  any  case  of  poisoning,  two  things  are  required :  1st,  re- 
moval of  the  exciting  cause ;  2d,  treatment  of  tli«  effects  that  remain. 
The  removal  of  the  poison  should  be  done,  if  possible,  with  little  violence, 
and  by  the  simplest  and  most  innocent  method,  either  with  the  linger,  or 
in  case  the  poison  has  been  a  long  time  swallowed,  excite  vomiting  oi 
stool  by  the  simplest  means.  Copious  administration  of  tepid  water,  irri- 
tating the  fauces  by  means  of  a  fi-'ather  or  something  similar,  or  by  salt, 
mustard,  and  snuff,  or  injections  of  tobacco-smoke ;  and  neutralize  the 
poisons  by  means  of  albumen,  vinegar,  lemon-Juice,  coffee,  camphor,  milk, 
oil,  soap,  mucilaginous  drinks,  tea,  wine,  sugar,  or,  as  it  has  Ibeen  seen, 
with  ammoniacal  gas,  iron-rust,  cliarcoal,  kitchen  salt,  Epsom  salt,  potash, 
and  starch. 

It  is  well  to  be  familiar  with  these  antidotes  of  poisons,  and  to  bear  in 
mini]  the  particular  indications,  or  poisonous  substances  that  call  for  themt, 
as  follows :  — 

AUmmen,  or  whites  of  eggs,  antidotes  such  metallic  substances  as  quick- 
silver, corrosive  sublimate,  verdigris,  tin,  lead,  and  Sulphuric  acid,  when 

110 


=r«* 


■'ill 


I 


r 


874 


F0I80NS,  AMD  THEIR  ANTIDOTES. 


the  victim  complains  of  violent  pains  in  the  stomach,  with  tenesmas,  or 
diarrhoea,  and  pains  at  the  anus. 

Vinegar  antidotes  alkaline  poisons,  and  obviates  the  ill  effects  of  acon- 
ite, opium,  poisonous  mushrooms,  belladonna,  &c. 

Coffee.  —  Strong  black  coffee,  made  of  the  berry  lightly  roasted,  and 
drank  hot,  is  an  antidote  to  opium,  nux  vomica,  belladonna,  narcotica, 
mushrooms,  poisonous  sumac,  bitter  almonds,  and  all  those  substances 
containing  prussic  acid.  It  must  be  borne  in  mind,  however,  that  the 
eause  must  be  removed,  if  possible,  first. 

Camphor  antidotes  the  ill  effects  of  poisonous  insects,  and  especial'_y 
nntharis,  whether  administered  internally  or  externally.  Camphor  also 
antidotes  the  toxical  effects  of  phosphorus,  apigelia,  and  sqntonin.  It  ia 
also  useful  for  the  after-effects  of  acids,  salts,  metals,  &c.,  after  the  poi- 
sonous substance  itself  has  been  removed  from  the  stomach  by  means  of 
vomiting,  &c. 

Milk  is  frequently  alluded  to  as  an  antidote  for  poisons  ;  but  it  has  no 
real  merit.  Mucilaginous  substances  are  better,  and  much  to  be  pre- 
ferred. 

Olive  Oil  ranks  with  milk,  and  is  much  less  useful  than  is  believed.  It 
is  useless  in  metallic  poisons,  and  even  hurtful  in  poisoning  with  arsenic. 
It  is  of  some  service,  however,  in  case  of  poisoning  either  with  Nitric^ 
Sulphuric,  or  Phosphoric  acid.  Olive  oil  and  vinegar,  administered  in 
alternation,  has  proved  serviceable  in  cases  of  poisoning  with  alkalies. 

Soap. — Castile  soap.,  dissolved  in  four  times  its  bulk  of  hot  water,  and 
drank,  will  antidote  many  cases  of  poisoning  with  Corrosive  sublimate 
and  also  with  arsenic,  or  with  any  of  the  numerous  forms  of  lead.  Soap' 
suds  is  likewise  a  valuable  antidote  for  poisoning  with  Sulphuric  and  Ni- 
tric acid.     Soap  is  hurtful  in  cases  of  poisoning  with  alkalies. 

Sugar.,  or  sugar-water,  is  quite  as  good  as  any  of  the  antidotes,  and 
much  to  be  preferred  in  cases  of  poisoning  with  paint,  verdigris,  copper, 
sulphate  of  copper,  alum,  &c.  In  cases  of  corrosive  sublimate,  in  solu- 
tion, being  taken  into  the  stomach  by  mistake,  as  it  has  been,  sugar-water 
may  be  given  before  the  white  of  an  egg.  Sugar  is  also  an  excellent  an- 
tidote in  cases  of  poisoning  with  arsenic.     The  other  antidotes  are,  — 

Ammoniacal  gas,  or  the  volatile  odor  of  spirits  of  hartshorn,  for  poi- 
soning with  alcohol,  bitter  almonds,  or  prussic  acid. 

Iron-rusty  or  the  sesqui-oxide  of  iron,  for  poisoning  with  arsenic, 
freshly  prepared. 

Epsom  salt,  for  the  various  alkaime  poisons. 

charcoal,  for  poisoning  with  putrid  fish,  meat,  or  mushrooms,  or  nmssels. 

Kdchen  salt,  for  poisoning  with  nitrate  of  silver,  and  poisonous 
wounds. 

Magnesia,  for  poisoning  with  any  of  the  mineral  acids. 

Potash  and  Sweet  Almond  oil  are  also  good  antidotes  for  acids. 

Starch,  in  solution,  is  the  best  antidote  for  poisoning  with  iodine. 

Strong  tea  is  a  good  antidote  for  poisoning  with  honey ;  and  so  is 
Wine,  for  noxious  vapors  and  poisonous  mushrooms. 

And  here  it  may  be  repeated,  that  the  first  thing  we  have  to  do,  in 
treating  cases  of  poisoning,  is  to  remove  the  poison  bv  vomiting,  and  then 
to  administer  the  suitable  antidotes.  In  case  we  should  not  be  able  to 
ascertain  what  kind  of  poison  has  been  swallowed,  we  should  first  admin- 


esmns,  ot 

I  of  acon- 

isted,  and 
narcotica, 
lubstancea 
,  that  the 

especial.^ 
nphor  also 
lin.  It  is 
p  the  poi- 
means  of 

it  has  no 
to  be  pre- 

ilieved.  It 
bh  arsenic, 
ith  Nitric^ 
listered  in 
Ikalies. 
water,  and 
!  aublimate 
d.  Soap- 
io  and  Ni- 

idotes,  and 
is,  copper, 
te,  in  sola- 
agar-water 
cellent  an- 
aro,  — 
n,  for  poi- 

;h  arsenic, 


or  niusnels. 
poisonous 

ds. 
dine, 
so  is 

'e  to  do,  in 
,  and  then 
be  able  to 

irst  admin- 


POISONS,  AND  THEIR  ANTIDOIES. 


875 


ister  the  white  of  egg ;  and  in  case  there  should  be  stupor,  give  coffee, 
quite  strong,  made  of  the  lightly-roasted  kernel.  But  if  we  should 
know  the  poison  to  be  mineral  or  metallic,  the  first  resort  may  be  to 
white  of  egg,  sugar-water,  soap-water,  or  soup-suds,  and  for  the  remain- 
ing effects  give  Sulphur,  which  has  bci'ii  ascertained  to  be  a  real  antidote 
to  the  effects  of  metallic  poisons.  If  it  should  be  known  that  ackls  or 
corrosive  substiuices  have  been  taken,  give  castilo  soap  mixed  with  four 
times  its  bulk  in  warm  water,  or  magnesia  dissolved  in  water,  or  powdered 
chalk  stirred  up  in  water,  or  a  solution  of  saleratus,  pearlash,  or  supi-r-car- 
bonate  of  soda,  in  spoonful  doses,  after  each  paroxysm  of  vomiting,  as  long 
as  it  continues;  and  afterwards  give  mucilaginous  drinks,  and,  alternately, 
coffee  and  opium,  in  the  form  of  homoeopatliic  remedies ;  and  for  the 
remaining  aihnents,  give  PubatUla.  After  the  antidotes  have  bi'on  ad- 
ministered, give  PuhatUla  for  suli)huri(:  acid,  Iiri/07iia  for  muriatic  acid, 
and  Aconite  for  other  acids,  and  especially  for  CTab-a|)ple  vinegar.  In 
case  it  should  be  known  that  alkaline  substances  have  been  swallowed  in 
poisonous  quantities,  vinegar  and  water  may  be  given  in  large  quantities, 
and  also  lemon-juice  or  cranberry-sauce,  without  sugar,  or  sour  7nUk  ;  and 
for  the  secondary  effects  of  poisoning  with  potash,  give  Coffea  or  Carlo 
veg.  If  the  poisoning  is  known  to  be  the  effects  of  spirits  of  hartshorn, 
give  Hepar  sulph. ;  if  it  should  be  known  the  patient  had  been  inhaling 
noxious  vapors,  bathe  the  patient  freely  with  vinegar  and  water,  and  let 
him  inhale  the  vapor  of  a  solution  of  hydrochloric  acid ;  and,  after  a 
return  to  full  consciousness,  give  a  strong  decoction  of  partially-charred 
coffee,  or  a  few  doses  of  Opium  or  Belladonna. 

The  vapors  of  coal,  when  having  a  poisonous  effect,  may  be  antidoted 
by  copious  draughts  of  vinegar  and  water ;  and  for  poisoning  by  an}'  sub- 
stance not  mentioned,  first  follow  the  rule  of  removing  the  poison  from 
the  stomach  by  vomiting,  and,  for  the  irritation  or  inflammation  left  bo- 
hind,  affiliate  any  homojopathic  remedy  that  may  meet  the  case.  If  there 
is  much  fever  or  arterial  excitement,  give  Aconite  every  hour  ;  if  severe 
burning  at  the  stomach,  and  thirst,  gwe  Arsenicum  or  Mereurius  ;  if  there 
is  great  soreness  of  the  muscles,  give  Arnica,  and  let  the  patient  be  bathed 
with  a  lotion  of  the  same  ;  if  it  is  known  that  any  of  the  animal  poison* 
have  been  taken  into  the  stomach,  give  a  teaspoonful  of  powdered  chai> 
coal  in  half  a  tumbler  of  water  at  a  dose,  and  repeat  after  each  vomiting 
until  the  stomach  becomes  quiet ;  and  if  a  poison  of  this  kind  has  come  in 
contact  with  the  eyes,  give  Aconite;  and,  finally,  to  guard  against  the 
infection  of  poisonous  wounds,  when  touched  with  the  fingers  or  hand,  let 
them  bo  held  in  strong  heat,  as  strong  as  it  can  be  borne,  for  ten  or 
fifteen  minutes,  and  afterwards  wash  them  with  soap. 


t  i^ 


In 


REVISED   TREATMENT. 


Pleurisy.  —  Pleuritia. 

{Treatment  continued  from  page  240.) 

Nothing  gives  so  much  and  sucli  iimnediatc  relief  to  pain  as  n 
Bubcutancous  injection  of  morphine.  Aconite  also  is  a  valuable 
sedative  in  this  stage.  It  may  be  given  in  half  or  whole-drop  doses 
every  fifteen  minutes  for  two  hours  ;  then  afterwards  a  drop,  to  be 
repeated  hourly  till  sone  impression  is  made  upon  the  heart's  action. 
Smtdler  doses  are  to  be  given  if  the  pulse  becomes  feeble. 

In  the  second  stage,  if  tiio  acute  symi)tonis  have  yielded  to  treat- 
ment as  they  usually  do,  the  t)bject  of  treatment  is  to  promote  the 
absorption  of  the  fluid.  This  is  done  by  the  judicious  use  of  saline 
cathai*tics  and  by  dure  tics,  for  the  bowels  and  the  kidneys  are  the 
natural  pumt)s  of  the  system. 

The  application  of  counter-irritants  is  also  of  use  for  this  purpose, 
such  as  the  tincture  of  iodine,  and  small  blisters,  which  are  to  be 
allowed  to  remain  on  till  vesication,  and  then  the  blister  is  to  be  dried 
up  and  a  now  one  is  then  appli(!d.  If  at  any  time  during  this  stiige 
the  effusion  is  rapid  and  excessive,  so  as  to  endanger  life,  it  is  to  be 
drawn  oft'  by  puncturing  the  ch(!st  between  the  fifth  and  sixth  ribs  on 
the  side  with  a  small  trocar,  and  the  fluid  is  to  be  drawn  ort'  by 
suction. 

Convalescence  commences  when  the  liquid  begins  to  be  absorbed ; 
and  active  medication  should  then  cease,  and  that  course  should  be 
pursued  whi-'h  will  lead  to  the  restoration  of  the  general  health. 
This  is  done  by  tonics,  a  nutritious  diet,  and  other  hygienic  means. 
If  the  effusion  ceases  to  l>o  absorbed  or  the  process  takes  place  very 
slowly,  then  that  state  of  things  exists  which  is  called  chronic  j)leu- 
risy.  Then  the  main  o1)jects  of  treatment  are  to  ert'ect  the  removal 
of  the  fluid,  and  to  develop  and  sustain  the  powers  of  the  system. 
Under  these  circumst^uices,  it  is  better  to  discontinue  remedies  which 
act  upon  the  bowels  and  the  kidneys,  at  least  for  a  time,  and  try  gen- 
eral treatment.  This  consists  of  tonics,  stimulants,  and  gentle  exer- 
cise in  the  open  air,  and  with  this  the  surgical  removal  of  the  fluids 
from  the  cavity  of  the  chest. 

The  operation  is  now  so  much  improved,  and  is  so  safe  and  simple 
and  attended  with  so  little  pain,  that  it  has  become  an  every-day 
practice,  and  an  operation  which  was  only  resorted  to  as  an  extreme 
measure  to  save  life,  is  now  admissible  whenever  the  pleural  cavity 
remains  filled  with  liquid,  after  only  a  brief  trial  of  the  remedies 
designed  to  promote  absorption. 
876 


pain  as  a 
,  valuable 
rop  doses 
rop,  to  be 
t's  action. 

i  to  treat- 
omote  the 
3  of  saline 
^8  are  the 

s  purpose, 
are  to  be 

o  be  dried 
this  stage 
it  is  to  be 

cth  ribs  on 

wn  ott'  by 

absorbed ; 

should  be 
•al  health, 
nic  means. 

)laco  very 

mic  pleu- 
10  removal 
10  system, 
dies  which 
id  try  gon- 
entle  exer- 

the  fluids 

and  simple 
every-day 
n  extreme 
ural  cavity 
B  remedies 


BBVISED  TREATMENT. 


877 


Fracture  of  the  Bone. —  Treatment, 

(Continued  J)rom  page  iM.) 

In  the  treatment  of  fractures  of  the  shafts  of  the  bones  of  the 
lower  extremities,  three  indications  shoulO  be  fulfilled :  First,  coap- 
Uition  and  fixation  of  the  fragments ;  second,  moderate  extension ; 
third,  gentle  compression  and  support.  Provided  these  reciuirc- 
mcnts  are  carried  out,  it  matters  little  what  a]>f)aratus  may  be  em- 
ployed ;  but  that  which  can  be  applied  with  the  least  disturbance  of  the 
fractui'ed  bone,  and  is  most  comfoitable  to  the  feeling  of  the  patient, 
should  be  preferred. 

The  best  mode  of  extension  and  counter-extension  now  in  use  is 
by  raising  the  foot  of  the  bedstead  about  eight  inches,  by  a  block  of 
wood  placed  under  each  fore  leg.  This  makes  an  inclined  plane,  and 
the  b;>Hy  consequently  tends  to  incline  towards  the  head  of  the  bod  ; 
this  is  the  counter-extension. 

Then  extension  is  made  as  follows :  A  strong  piece  of  adhesive 
plaster,  about  two  and  one  half  inches  wide  and  about  three  feet  long, 
is  applied  to  the  sides  of  the  leg,  extending  from  a  little  below  the 
knee,  leaving  a  loop  under  the  foot  four  or  five  inches  long.  This 
is  secured  firmly  in  place  by  a  bandage  to  the  whole  length  of  the 
log.  A  piece  of  cord  is  fastened  to  the  loop  and  passed  over  a  pulley, 
which  is  fixed  to  the  foot-l)oard  of  the  bed.  To  the  other  end  of  this 
cord  i  attached,  a  weight.  This  need  not  exceed  ten  or  twelve 
poui  ^« 

In  this  way  we  get  our  counter-extension  and  extension  :  the  body 
is  drawing  one  way  and  the  weight  is  pulling  the  other  all  the  time. 

This  is  a  simple  and  comfortable  way  of  treating  fractures  of  the 
shafts  of  the  bones  of  the  lower  extremities  which  require  extension. 
It  may  bo  applied  to  the  different  fractures  of  the  neck  of  the 
thigh  bone,  to  fractures  of  the  shaft,  and  also  to  fractures  in  the 
shafts  of  the  bones  of  the  leg. 

It  is  the  best  and  most  effectual  way  of  preventing  undue  short- 
ening that  we  have  in  use,  and  what  is  of  as  great  importance  to  the 
patient,  a  most  comfortable  way  of  keeping  the  painfiil  limb  in  the 
proper  shape.     (See  page  454.) 

Fractures.  —  Connter-exteyision. 

Modern  surgery  has  developed  two  simple  mechanical  means  of 
making  extension  and  counter-extension  for  the  purpose  of  overcom- 
ing muscular  spasm,  which  rarely  fail.  One  is  by  the  use  of  elastic 
rubber  bands,  and  the  other  by  the  attachment  to  the  limb  of  a  cord 
running  over  a  pulley  at  the  foot  of  the  bed  and  sustaining  a  suitable 
weight.  The  method  of  employing  these  will  be  given  in  detail  in 
connection  with  special  fractures.     (See  page  444.) 


'!,» 


Fractures.  —  Coaptation, 

A  great  point  is  to  have  the  splints  accurately  adapted  in  each  cai?e, 
and  the  ability  to  aft'ect  this  is  an  Iiuportant  element  of  success  in  this 
branch  of  surgery.  W  )od  may  be  generally  cut  into  suitable  shape, 
but  it  is  porha})s  easier  to  use  moulded  splints  of  leather,  felt,  gutta- 
percha, or  shellac  clot.i.  The  stjirched  or  })laster  bandage  or  guuuned 
paper  mi'-y  be  effectively  used ;  and  with  a  proper  pair  of  she:irs, 
sheets  of  tin  or  zinc  may  be  cut  into  splints,  which  will  answer 
admirably.  Woven  iron  wire  splints  are  highly  recommended.  (See 
page  445.)  . 

.  «  Bleeding  from  Wounds. 

.  One  of  the  best  methods  now  in  use  of  arresting  hemorrhage  in 
cases  of  accidenUil  injuries  of  the  large  arteries  of  the  extremities, 
is  by  suiTounding  the  limb  above  with  two  turns  of  a  piece  of  rubber 
tubing,  al>out  three  fourths  of  an  inch  in  diameter,  and  tying  it  tight. 
This  safely  and  ettectually  controls  all  bleeding. 

Advantage  is  taken  of  this  elastic  property  of  rubber  in  controlling 
hemorrhage,  in  ijerforming  what  is  called  ))loodless  operations  of 
surgery.  It  is  called  Esmarch's  metliod,  from  the  name  of  the  origi- 
nator. It  may  be  resorted  to  in  all  operations  on  the  extremities, 
whether  of  ani})utations,  the  removal  of  tumors,  or  in  the  minor 
operations  of  nduoving  needles,  and  whenever  the  bleeding  intert'eres 
with  the  perforinance  of  the  operation,, 

It  is  applied  as  follows  :  T!ie  limb  should  first  be  tightly  bandaged 
with  an  elastic  rubber  bandage  about  three  inches  wide,  from  below 
upwards,  4ind  then  surrounded  at  the  highest  point  with  a  band  or 
tube  of  rul)ber  in  the  place  of  a  tourni(iuet.  The  bandage  is  then  to 
be  removed,  when  the  operation  ra;  y  be  perfonned  in  t.<!mporarily 
bloodles,s  tissues. 

An  amputation  of  the  thigh  may  be  thus  performed  without  loss  of 
any  blood  of  consequence.     (See  page  493.) 

• 

Antiseptic    Dressings. 

Antiseptics  have  lately  attracted  a  great  deal  of  notice  in  the 
treatment  of  intlammation,  especially  residting  from  wounds, 

The  article  most  used  at  the  jiresent  time  for  this  purpose  is  car- 
bolic acid.  Lister  i,s  its  chief  advocate,  and  under  his?  u'.'tl'.ority  it 
has  established  a  position  which  deserves  attention. 

It  is  based  upon,  the  germ  theory  of  disease,  which  is  founded 
u|)ou  the  observations  of  Pasteur.  The  theory  supposes  that  anim:il 
decomposition  is  due,  not  to  the  chemical  action  of  oxygen,  or  any 
otlier  giis,  but  u>  the  presence  of  organic  germe  floating  in  ^he  almos- 


!i 


:ii: 


phcre.      Carbolic  acid  is  used  on  account  of  its  known  destructive 
effects  upon  low  forms  of  organic  life. 

These  low  forms  of  vegetable  organisms,  which  float  in  tht  air  in 
great  abundance  as  constitutints  of  the  dust,  are  called  by  naturalists 
biicteria,  of  which  there  are  map.y  varieties.  Whenever  they  tin<l 
I'utrance  into  the  boily,  tlit^re  putrefaction  is  produced. 

These  vegetable  i)arasites  are  ca[)able  of  a  wonderful  [)owcr  of  mul- 
tiplying their  s|)ecies,  —  a  single  germ  producing  in  a  few  hours  many 
thousands.  Once  admitted  into  the  body,  they  lind  their  way  every- 
where,—  into  the  nmscles,  into  the  blood,  into  the  ditferent  organs  of 
the  body, — and  they  spread  destructive  fermentittion  and  putrefac- 
tion wherever  they  go. 

In  accidental  wounds,  it  is  first  necessary  to  kill  any  septic  organ- 
isms which  may  have  been  introduced  from  the  air  or  from  contjict 
with  foreign  bodies.  We  do  this  by  thoroughly  bathing  the  surfaces 
with  a  solution  of  carbolic  acid,  of  the  strength  of  one  part  of  the  acid 
to  twenty  of  water. 

When  the  wouiuls  are  made  by  the  surgeon,  the  ijerms  are  de- 
Btroyed  by  means  of  a  spray  imbutMl  with  the  acid.  This  spray  is 
produced  by  an  atomizer,  of  which  there  are  many  kinds,  and  is 
thrown  contimially  on  1o  the  surface  of  the  wound,  until  the  comple- 
tion of  the  o{)erati()n,  including  the  ligaturing  of  the  vessels  and  the 
final  stitching  together  of  its  edges. 

Lister  also  recommends  the  use  of  carbolized  catgut  for  ligatures, 
being  of  an  animal  substance  and  finally  absorbed. 

When  the  ojjeration  is  fully  ccmipleted,  the  antise{)tic  dressings  are 
applied.  Besides  these  antiseptic  precautions,  in  cases  of  iirgo  and 
deep  wounds  a  drainage  tube  is  introduced  to  allow  for  the  escape  of 
the  serum. 

The  antiseptic  dressings  consist  of — first,  the  protector;  second, 
tlie  carbolized  gauze  ;  third,  the  mackintosh  ;  and  fourth,  another 
iayer  of  the  gauze,  and  a  bandage  of  the  same  to  keep  the  whole  in 
place.  For  the  purpose  of  protecting  the  cicatrizing  parts  from  thy 
irritating  effects  of  1;he  gauze,  a  layer  of  t)il  silk  coated  on  both  sides 
Vith  copjd  varnish,  and  afterwards  brushed  over  with  dextrine,  to 
cnal>le  it  to  become  uniformly  moistened  when  dip{)ed  into  a  watery 
solution  of  tin  acid,  is  applied  directly  over  the  wound,  the  ends  of 
the  drainage  tube  protruding  abcnit  an  inch  from  each  extremity  of 
the  incision.  The  wound  is  then  covered  with  a  layi^r  oi  antiseptic 
gauze  dip{)ed  into  'i  solution  of  one  to  forty  of  the  iKv'xd.  There  are 
then  Hu])erimi)('sed  six  other  layers  of  dry  gauze;  then  the  mackin- 
tosh or  a  piece  of  lubber  cloth  ;  then  an  eighth  layer  of  gauze  large 
enough  to  cover  in  all  the  remainder,  and  finally  a  bandage  of  the 
game. 

When  the  dressings  are  renewed,  it  is  to  be  done  under  the  spray, 
trreiit  cfire  being  taken  not  to  admit  any  nun-carbolized  air. 


880 


BEVIdED  TKEATMEirr. 


1] 


The  dressings  are  not  to  be  changed  until  the  discharge  has  begun 
to  soak  through  and  appear  below  the  edge  of  the  rubber  cloth. 

The  antiseptic  gauze  is  made  by  impregnating  cotton  cloth  of  open 
texture  with  a  mixture  of  carbolic  acid  one  part,  resin  five  parts, 
paraffine  seven  parts.  The  resin  acts  as  a  vehicle  for  the  acid,  while 
the  paraffine  is  added  to  prevent  inconvenient  adhesiveness.  (See 
page  440.) 

Poisoning    Aocidents. 

Poisons  >nay  be  classified  under  two  heads;  viz.,  mineral  and 
vegetable. 

In  the  treatment,  three  objects  are  to  be  kept  in  view :  first,  to 
get  rid  of  the  poison  ;  second,  to  stop  its  action ;  and  third,  to  avert 
its  tendency  to  death. 

The  first  indication  is  accomplished  by  the  administration  of 
emetics  to  cause  vomiting,  or  by  the  use  of  a  stomach  pump.  The 
simplest  way  to  provoke  vomiting  is  to  give  large  draughts  of  luke- 
warm water,  and  to  thrust  a  finger  down  the  throat. 

A  teaspoonfnl  or  two  of  mustard  in  warm  M^atcr  is  oftentimes  an 
eflectual  emetic.  Some  of  the  emetics  are  ipecacuanha,  tartar  emetic, 
sulphate  of  zinc,  and  sulphate  of  copper. 

Sulphate  of  zinc  in  twenty-grain  doses  is  about  the  best.  The 
second  indication  is  to  use  an  antidote.  The  third  indication  is  ful- 
filled by  palliating  the  symptoms,  and  neutralizing  the  after  efiects  on 
the  constitution. 

Aftor  copious  vomiting,  soothing  liquids  should  be  given,  such  as 
oil,  milk,  bcaten-up  raw  eggs.  These  are  useful  when  the  poison 
has  been  of  an  irritating  character. 

If  the  patient  be  much  depressed  in  body  or  mind,  the  hands  and 
feet  cold,  the  lips  blue,  the  face  pale,  a  cold  perspiration  on  the  fore- 
head and  about  the  mouth,  some  stimulant  may  be  administered. 
Strong,  hot  tea  is  the  best,  because  it  is  a  chemical  antidote  to  many 
poisons.  Strong  coflee  is  a  good  stimulant.  Brandy  and  other 
spirits  are  sometimes  necessary.  Sometimes  when  the  powers  of  life 
are  much  depressed,  artificial  heat  also  is  necessary.  (See  page 
496.) 


Acute    Rheumatism. 

Since  1875  two  new  remedies  for  rheumatism  have  come  into  use ; 
viz.,  salicylic  acid  and  its  salts,  and  salicin,  the  active  principle  of 
the  willow  bark. 

When  given  at  the  commencement  of  an  attack,  it  oftentimes 
arrests  the  course  of  the  malady  as  effectually  as  quinine  arrests  the 
intermittent  fever,  or  as  opium  and  ipecacuanha  arrest  dysentery. 
It  exerts  such  a  beneficial  influence  that  it  is  recognized  by  the  profes- 


and 


IS  and 

le  fore- 

Istered. 

many 

other 

of  life 

le  page 


[iiple  of 

sntimes 
38ts  the 
lontery. 
1  profes- 


sion as  u  specific.  From  ten  to  fifteen  grains  of  salicylic  acid  or  the 
salicylate  of  soda  should  he  given  every  two  hours  until  relief  is  ob- 
tained. Thi.s  usually  takes  place  in  from  twelve  to  thirty-six  hours. 
In  n)ost  cases  liui  fever  and  swelling  will  abate  within  the  above  time. 
If  not  entirely  arrested,  the  disease  is  xci'y  much  shortened. 

W' hen  the  spc(!ifi(!  etle<!t  is  produced  on  the  system,  it  causes  ver- 
tigo, headache,  jinging  in  the  cars.  Th(*se  symptoms  indicate  that 
the  medicine  sliouid  be  given  in  smaller  doses  and  with  longer  inter- 
vals.    (Sec  page  41G.) 

The    Temperature    of   the    Body. 

The  use  of  the  thermomet(?r  is  an  important  addition  to  the  means 
of  making  physical  examination,  and  is  one  of  the  iniprovements  ia 
modern  medicine. 

It  is  intendtid  to  measure  the  heat  of  the  body. 

The  best  kind  now  in  use  is  the  self-registering. 

The  bulb  of  the  instrument  is  to  be  placed  in  the  warmest  part  of 
the  body,  and  should  be  allowed  to  remain  there  for  eight  to  ten 
minutes. 

Some  place  it  under  the  tongue  ;  some  in  the  axilla. 

Sometimes  it  is  necessary  to  introduce  it  into  the  rectum  or  vagina. 
In  these  parts  the  temperature  is  a  degree  higher  than  in  other 
parts. 

The  normal  temperature  of  the  body  is  from  98°  to  1)9°  Fahrenheit, 
in  the  great  mnjoi'ity  of  persons. 

Exceptionally  it  may  bu  half  or  a  whole  degree  either  above  or 
below  this  range. 

The  normal  Ibutuations  are  inconsiderable  in  comparison  with  the 
variations  of  disease. 

The  natural  variations  in  health  are  as  follows  :  The  temperature  is 
at  its  minimum  at  five  o'clock  a.  m.  ;  the  maximmn  is  reached  in  the 
latter  part  of  the  afternoon,  and  then  continues  till  five  o'clock  A.  M. 

By  means  of  the  thermometer  wo  are  able  to  detei'mine  all  differ- 
ences with  precision. 

The  increase  of  heat  in  different  febrile  diseases  rarely  exceeda 
110°  Fahrenheit,  and  as  a  rule  the  amount  of  increase  is  a  criterion 
of  its  severity. 

An  in<'n!ase  to  1(»0^  Fahrenheit  or  101°  is  evidence  of  mildness  of 
the  disease. 

If  the  IhcrmoiMctcr  indicates  steadily  10')°  Fahrenheit,  it  is  certain 
that  the  disease  is  severe. 

A  persisting  lein]u'ra1ine  sibovt!  H)h°  Fahrenheit  denotes  that  there 
is  great  danger,  and  an  increase  to  108°  to  110°  Fahrenheit  is  usually 
a  fiital  sign. 

The  abnormal  changes  of  temperature  consist  of  more  or  less  in- 

VTOiUiQ. 


IJ>^'- 


Diminution  below  the  normal  .stnndaid  i«  comparatively  rare  ;  yet 
it  sometimes  occurs  and  is  of  some  importance. 

In  the  course  of  typhoid  fever,  a  sudden  decrease  may  indicate 
intestinal  hemorrhage.  Scmietinies  the  temperature  falls,  without  hn- 
provcment  in  the  otlua*  symptoms.     This  is  an  unfav()ral)le  symptom. 

The  value  of  thermometric  changes  dei)ends  in  no  small  measure 
upon  the  symptoms  Avith  which  they  are  associated. 

Fysemia. 

This  frightful  afTection  has  been  called  the  banc  of  surgery.  It  is 
I'.iused  by  a  peculiar  poison,  resulting  from  the  fermentation  and  dis- 
integration of  the  tissues  of  a  wound,  which"  is  taken  into  the  system 
either  by  the  veins  or  absorbents,  and  is  usually  accompanied  by  the 
ix)rnuition  of  collections  of  pus  in  the  various  tissues  and  organs  of  the 
body.  It  follows  very  tritling  as  well  as  severe  injuries,  and  it  is  a 
frecijuent  sequela  of  surgical  operations,  oftentimes  of  a  very  slight 
character.  The  only  tenable  theory  which  can  explain  the  different 
phenomena  of  this  dfsease  is,  that  the  pyromic  condition  is  caused  by 
the  absorption  of  septic  material,  sometimes  in  a  fluid,  sometimes  in 
a  gaseous  state,  which  unfits  the  blood  for  the  processes  of  healthy 
nutrition,  induces  capillary  stagnation  and  its  consequences,  low 
forms  of  inflammation  in  difl'erent  parts  of  the  body,  as  in  the  joints 
and  serous  cavities,  and  may  finally  produce  those  secondary  deposits 
of  pus,  in  any  or  all  parts  or  organs  of  the  body,  called  metastatic 
abcesses. 

When  an  internal  organ  is  involved,  the  result  is  generally  fatal. 
When  suppuration  attacks  the  integuments  ov  the  extremities,  there 
is  a  fair  chance  of  recover3\ 

Thence  the  disease  has  been  divided  into  two  classes  :  the  intenial 
or  acute,  the  external  or  chronic  pytemia.  When  jwieniia  involves 
the  internal  organs,  the  course  is  usually  rapid  and  fatal.  A\'hen  it 
attacks  the  external  j)arts,  it  is  slow  in  its  course  and  may  he 
recovered  from. 

Duration  of  the  DiseaNO.  —  Sometimes  its  course  is  so  rapid  that 
the  patient  may  die  in  two  or  three  days  after  the  appearance  of  tin; 
symptoms.  As  a  rule,  however,  bad  cases  terminate  during  the 
second  week.  Some  go  on  for  six  or  seven  weeks.  In  cases  which 
recover,  the  patient  goes  through  a  long  illness  and  may  be  left  per- 
manently crippled  l)y  secondary  affections  of  the  joints.  As  a  rule, 
the  longer  a  patient  lives  the  better  the  hopes  of  a  successful  ending. 

Pyicmic  symptoms  generally  make  their  appearance  after  the  fourth 
day.  The  first  symptom  is  a  chill ;  this  is  repeated  at  iiTegular 
intervals,  and  is  followed  by  profuse  aud  exhausting  sweats. 

The  hot  stage  which  characterizes  the  malarial  paroxysms  of  inter- 
mittent fever  is  usually  absent  or  but  slightly  marked.     During  the 


■•-J 


B ;  yet 

idicute 
lut  im- 
iptom. 
casure 


.    It  is 
nd  dis- 
system 
.  by  the 
s  of the 
1  it  is  a 
f  slight 
ifFerent 
used  by 
iinics  in 
healthy 
es,   low 
e  joints 
leposits 
tastatic 

y  fatal. 
s,  there 

nteniiil 
nvolvos 
iVheii  it 
may  bo 

|)i<l  tliat 
c  of  the 
il  Iho 

s  which 

eft  por- 
s  a  ruio, 

ending, 
le  fourth 

iTCffular 

of  inter- 
ring the 


course  of  the  attack,  the  teniperaturc  of  the  body,  which  is  naturally 
98^°  Fahrenheit,  may  rise  six  or  eight  degrees,  and  in  ordinary  casea 
its  fall  is,  as  a  rule,  gradual.  The  greatest  elevation  of  temperature 
corresponds  with  the  period  of  rigor.  Diu'ing  the  sweating  stage  the 
teni;i)eraturo  falls  again.  Should  the  fall  be  sudden, a  general  break- 
down of  the  powers  of  the  patient  is  indicated.  The  pulse  rate  varies, 
according  to  the  violence  of  the  attack,  from  ninety  to  one  hundred  and 
thirty.  The  respiration  is  usuidly  rapid,  from  forty  to  llfty  a  minute, 
and  in  many  c:ises  a  h;iy-like  odor  of  the  breath  is  present,  which 
is  considered  pathognomonic  of  the  disease.  The  coimtenance  is 
flnshed,  the  skin  dusky,  sallow,  sometimes  jaundiced  and  marked 
with  sudamina. 

The  tongue  is  coated,  and  there  is  a  complete  loss  of  ajipetite,  and 
often  nausea  and  vomiting.  The  urine  is  frequently  albuminous. 
When  the  brain  is  involved  there  will  bo  sleeplessness,  or  delirium 
of  a  low,  unittering  kind ;  some  unconsciousness,  from  which  the 
patient  can  be  aroused  only  to  relapse. 

Intense  pain  usually  attends  the  secondary  complications,  though 
it  is  sometimes  remarkable  how  slight  the  symptoms  often  are  when 
severe  local  disease  exists. 

The  wound  becomes  sanious,  serous,  and  fetid ;  sometimes  the 
secretions  are  arrested  and  the  surface  becomes  dry  and  glazed  ; 
sometimes  absolute  sloughing  occurs.  Union,  if  progressing,  will 
become  disunion,  and  all  reparative  action  ceases.  As  the  disease 
progresses,  the  symptoms  become  profoimdly  typhoidal,  and  the 
patient  may  die  comatose  or  from  exhatistion. 

The  exciting  causes  of  pyaemia  are  very  obscure.  It  attacks  the 
healthy  as  well  as  the  fr"-ble,  those  surrounded  by  perfect  hygienic 
influences  as  well  as  those  who  are  exposed  to  deleterious  influences. 
It  is  found  not  only  in  hospitals  but  in  private  practice  ;  but  it  is 
more  prevalent  in  unhealthy  places,  in  the  overcrowded  wan'  i,  and 
in  those  spots  where  ventilation  and  drainage  is  bad.  It  lurks  among  < 
the  poorly  housed  and  poorly  fed  and  clad,  and  wherever  those  influ- 
ences exist  which  are  depressing  to  the  vital  powers 

The  general  treatment  in  these  cases  is  of  i)aramount  importance. 
It  is  the  duty  of  the  surgeon  to  see  that  the  patient's  room  is  well 
ventilated,  and  that  it  is  frequently  jiiu'ilied  by  cleansing  and  disin- 
fectants. 

The  wound  is  to  be  kept  clean  and  well  drained. 

The  dressmgs  should  be  changed  as  often  as  four  times  a  day,  and 
saturated  with  disinfectant  lotions. 

When  sloughing  exists  the  charcoal  poultice  should  ))o  applied,  uad 
every  measure  pursued  which  will  insure  the  utmost  cleanliness  of 
the  patient  and  his  surroundings. 

The  curative  treatment  is  to  be  conducted  on  the  same  principles 
which  guide  the  surgeon  in  the  management  of  all  cases  of  a  typhoidal 
character. 


t:: 


884 


RBVISBD  TREATMENT. 


h.>^ 


,rv- 


Tho  bowels  if  constipated  are  to  be  opened  by  a  gentle  laxative, 
and  the  different  secretory  organs  restored  to  a  healthy  action  as  far 
as  possible. 

The  vital  energies  of  the  patient  are  to  be  maintained  or  stimu- 
lated, and  everything  that  tends  to  lower  them  must  be  warded  off. 

(^uiqine  is  the  most  val(ial>le  remedy  we  have  for  the  treatment  of 
pyicmla.  Some  surgeons  give  it  in  largo  doses  and  speak  highly  of 
its  effects.  It  is  valuable  in  doses  of  four  or  five  grains  every  three 
(ji-  four  hours.  It  may  be  combined  with  iron  advantageously  in 
some  cases.  The  best  combination  is  with  the  citrate  of  iron.  Four 
gniius  of  each  arc  to  be  given  four  or  five  time    a  day. 

Stimulants  are  also  of  great  importance  to  maintain  the  powers  of 
life.  In  some  cases  it  isinecessary  to  employ  them  freely  to  keep  up 
the  waning  strength. 

The  diet  should  be  as  nutritious  as  the  patient's  assimilative  powers 
will  bear.     Milk  and  tho  animal  broths  arc  tho  best. 

When  the  stomach  rejects  nourishment  it  must  be  given  by  the 
rectum,  enema  of  beef  tea  and  milk  with  b>andy  being  administered 
every  four  hours. 

When  tho  nervous  system  is  disturbed  by  pain  and  want  of  rest 
and  sleep,  some  of  the  forms  of  opiates  or  anodynes  are  to  be  given, 
small  doses  frequently  repeated  being  better  than  large. 

Should  diarrhoea  exist  it  is  to  be  kept  under  control.  It  should 
not  be  chocked  suddenly,  as  it  appears  to  have  an  eliminative  ten- 
dency in  cases  of  blood  poison. 

Carbonate  of  ammonia  in  ten-grain  doses  five  or  six  times  a  da} 
is  a  valuable  remedy  when  other  tonics  cannot  be  tolerated. 

When  secondary  abscesses  form,  they  should  be  opened  and  kept 
cleansed  by  some  disinfectant  fluid,  such  as  carbolic  acid  or  the  solu- 
tion  of  the  chloiiuate  of  soda,  in  their  proper  strength. 


laxative, 
\n  aa  far 

ir  stimu- 
rded  otF. 
itmcnt  of 
hij^lily  of 
ery  three 
jously  in 
u.    Four 

towers  of 
>  keep  up 

re  powers 

3n  by  the 
ainistered 

it  of  rest 
» be  given, 

It  should 
ative  ten- 

les  a  da} 

and  kept 
the  solu- 


MARRIED  LADIES'  PERPETUAL  CALENDAR. 


Tbb  otility  of  these  tables,  as  serving  for  a  faithful  and  confidential  friend  in  matters  of  nrarat 
interest,  cannot  fail  uf  being  perceived.  Tbo  young  and  newly-marricd  mi^ht  bo  spareii  an 
nnpleosaiit  amount  of  eraburr.issmont  by  consulting  tlie  Calendar  as  to  the  timo  of  coiitiiiement, 
wliich,  in  reckouiM{^  the  full  period  of  gestation  280  days  from  conception,  niiiy  be  very  nearly 
approximated;  or,  m  ttie  event  of  the  time  of  conception  being  uncertain,  from  the  period  of 
quickening,  which  she  con  usually  note,  she  may  reckon  140  days.  It  will  bo  perceived  that  the 
Calendar  hus  three  columns  of  figures,  denoting  the  days  of  the  months  noted  ut  the  head  of  each. 
TLe  first  column  gives  the  date  of  conception;  the  second,  that  of  the  period  of  quickening;  and 
the  third,  that  of  delivery.  Thus,  if  a  lady  dates  the  period  of  conception  .Ian.  1, 1870,  quickening 
will  occur  May  20,  and  confinement  about  the  8th  ot  October  followuig;  or,  if  she  is  ignorant  of 
the  time  of  conception,  bv  consulting  the  middle  cohunn  as  to  the  time  of  quickening,  if  it  occurs 
May  20,  she  may  expect  her  confinement  to  occur  about  the  8th  of  October  following;,  or  140  days 
after  the  period  of  quickening.  The  date  in  the  first  column  is  that  of  conception ;  the  correspond- 
lr.g  date  in  the  second  column  is  that  of  quickening;  and  the  corresponding  date  of  the  third  col- 
omo,  that  of  confinement. 


Janaary. 


ClMMp'ii.  Qmclcen'g.  Deliv'n. 


Ian. 

I 

2 

8 

4 

6 

« 

7 

8 

9 
10 
11 
12 

18 
14 
16 
16 
17 
18 
19 
20 
21 

aa 

38 
24 

25 
26 
27 
28 
29 
80 
81 


May 

20 

21 

22 

23 

24 

25 

26 

27 

28 

29 

30 

81 

June 

1 

2 

8 

4 

6 

6 

7 

8 

9 

10 

11 

^-K 

18 
14 
16 
16 
17 
18 
19 


Oct. 

8 

9 
10 
11 
12 
13 
14 
15 
16 
17 
IS 
19 

20 

21 

22 

23 

24 

25 

26 

27 

28 

20 

80 

81 

Nov. 

1 

2 

8 

4 

6 

« 

r 


JFettmary. 


Blarch. 


April. 


Omeep'it,  Qukken'g.  Deliv'ii. 


Feb. 
1 
2 
8 

4 
6 
6 
7 
8 
9 
10 
11 

12 
13 
14 
15 
16 
17 
18 
19 
20 
21 
28 
28 

24 
26 
26 
27 
28 


June 

20 

21 

22 

23 

24 

25 

26 

27 

28 

29 

30 
July 
1 
2 
8 
4 
6 
6 
7 
8 
9 
,10 

11 

12 

18 
14 
16 
16 
17 


Nov. 
8 
9 
10 
11 
12 
13 
14 
15 
16 
17 
18 

19 
20 
21 
22 
23 
24 
26 
26 
27 
28 
29 
80 
Deo 
1 

a 

8 

4 
i 


Omeep'n.  Qaicken'g.  Deliv'i/. 


March 

1 

2 

8 

4 

6 

6 

7 

8 

9 
10 
11 
12 
13 
14 

16 
16 
17 
18 
19 
20 
21 
22 
23 
24 
26 
36   . 

27 
28 
89 
80 

ai 


July 

18 

19 

20 

21 

22 

23 

24 

25 

26 

27 

28 

29 

80 

31 

Aug 

1 

2 

8 

4 

6 

6 

7 

8 

9 

10 

11 

la 

18 

1' 

u 

6 

..'.7 


Dec. 

6 

7 

8 

9 
10 
11 
12 
13 
14 
15 
10 
17 
18 
19 

20 
21 
22 
23 
24 
25 
26 
27 
i( 
29 
80 
81 
Jarj. 
t 

a 
8 
4 
6 


Ctmetp'H.  Quiektn'g.  /Jklivy 


April 

1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

16 
16 
17 
18 
19 
20 
21 
22 
28 
24 
26 
36 

27 
38 
39 
80 


Aug. 

18 

19 

20 

21 

22 

23 

24 

25 

20 

27 

28 

2U 

30 

31 
Sepu 
1 
2 
8 
4 
6 
« 
7 
8 
9 

10 

11 

13 

18 
14 
16 
U 


Jan. 

6 

7 

8 

9 
10 
11 
13 
13 
14 
16 
16 
17 
18 
19 

20 
21 
2Si 
23 
24 
25 
20 
27 
28 
29 
30 
81 
Fek 
1 

a 

s 

4 


h 


I  "^ 


n 


t'tii 


!■■■ 


? 


J 


886 

IfABBIED  LADIES'   fERPETUAL  CALENDAR. 

May. 

Jane. 

July. 

AuKvat                   1 

CtawW  gMfefanV.  iM<«V. 

OMMvtk  Quidim'i.  DMxft 

Cbiwqiti.  QhMmii'v.  DtUi^t. 

Otmeip'n.  Quiektn'g 

DM^ 

Kay 

Sept     Feb. 
17          6 

June      Oct    March 

July    Nov.    April 

Aug. 

Dec. 

Ma, 

1 

1         18           8 

1         17          7 

1 

18 

8 

3 

18           6 

2         19           0 

3         18           8 

3 

19 

0 

8 

10           7 

8         30         10 

8          19           9 

8 

20 

10 

4 

30           8 

4          31          11 

4          30          10 

4 

21 

11 

6 

31           0 

6          33          13 

6          31          11 

6 

22 

12 

6 

33         10 

0          38          18 

6          23          13 

0 

S3 

18 

T 

38          11 

7          34          14 

7          23          13 

7 

24 

14 

8 

34          13 

8          36          16 

8          24          14 

8 

25 

16 

B 

36          18 

0          30          16 

9         25          16 

0 

20 

16 

10 

30          14 

10          37          17 

10          20          10 

10 

27 

17 

i; 

37          16 

11          38          18 

11          27          17 

11 

28 

18 

13 

38          10 

13          39          10 

12          28          16 

13 

20 

19 

18 

30         17 

18          80         20 

13          29          19 

13 

30 

30 

14 

80          18 

14          81          31 

14          30          20 

14 

31 

31 

Oct 

Not. 

Dec. 

Jan. 

16 

1         19 

16            1          22 

15            1          21 

15 

1 

32 

16 

3         30 

10           3         33 

10           2          22 

10 

2 

28 

IT 

8          31 

17            8         24 

17            3          23 

17 

8 

34 

18 

4          33 

18           4          26 

18           4          24 

18 

4 

36 

10 

6          33 

10           6         36 

19            6          25 

19 

6 

36 

30 

0          34 

30           0          27 

20            0          20 

20 

6 

27 

31 

7          36 

31            7          28 

31            7          27 

21 

7 

38 

33 

8          30 

33            8         30 

22           8          28 

22 

8 

39 

38 

0          37 

38           0         80 

28           9          20 

23 

0 

30 

24 

10         38 

34          10         81 

24          10         80 

24 

10 

81 

March 

April 

May 

June 

36 

11          1 

36         11           1 

26          11            1 

35 

11 

1 

36 

13           2 

30         13           2 

36          13           3 

26 

13 

3 

37 

18           8 

27         18           8 

37          13           8 

27 

13 

8 

38 

14           4 

28          14           4 

28          14            4 

28 

14 

4 

30 

16           6 

30          16           6 

29          15           5 

29 

15 

6 

80 

16           0 

80          16           6 

80          10           0 

80 

10 

0 

81 

17           7 

81          17           7 

81 

17 

7 

Septonbflr. 

■ 

October. 

November. 

December. 

OMQi'a. 

Qwletm't.  JWJW. 

Omnp'n.  QiOAaCg.  Dtliv'f. 

CiMKapV  QalektH'g.  JMUv^f. 

Omap-n.  QuidtaiV 

iMi*>. 

Sept. 

Jan.     Jbho 
18           8 

Oct      Feb.     July 
1         17           8 

Not.    March  Aug. 
1         20         -8 

Dec. 
1 

April 
19 

Sept 

3 

10           0 

2         18           0 

3         31           9 

2 

20 

8 

8 

30         10 

8         10         10 

8         33          10 

8 

31 

0 

4 

31         11 

4         20         11 

4         38          11 

4 

39 

10 

6 

33          13 

6          21          13 

6          24          13 

6 

2 

11 

• 

38          18 

0          33         18 

6          25          18 

0 

i 

13 

7 

34          14 

7          38          14 

7          26          14 

7 

3> 

IS 

8 

36          16 

8          24          16 

8          27          15 

8 

30 

14 

0 

30          10 

0          36          10 

9          28          10 

9 

27 

16 

10 

27          17 

10          30          17 

10          29          17 

10 

28 

10 

11 

38          18 

11          37          18 

11          80          18 

11 

29 

17 

13 

39          10 

13          38          10 

13          ;)l          19 

12 

80 

18 

18 

80          20 

March 

April 

May 

14 

81          31 

18           1         30 

18            1          20 

18 

10 

Fob 

14           3         21 

14           3         21 

14 

3 

30 

16 

1         33 

16           8         22 

15           8          23 

15 

8 

31 

16 

2         28 

10            4         23 

10           4          38 

10 

4 

32 

17 

8          24 

17            6         34 

17           6          34 

17 

6 

28 

18 

4          26 

18            0         36 

18           0          36 

18 

0 

24 

10 

6         20 

10            7          20 

19           7          26 

19 

7 

26 

30 

0          27 

30            8         37 

20           8    ,     37 

30 

9 

26 

31 

7         28 

21            0         38 

31            9         38 

31 

0 

27 

33 

8         20 

33          10         39 

22          10         29 

33 

10 

28 

38 

4         80 

38          11         80 

23          11          80 

28 

11 

20 

July 

34          13         81 

34          13         81 

24 

la 

80 

34 

10         i 

•   Aug. 
36         18           1 

Sept 

Oct 

26 

11           2 

3S         18           1 

26 

18 

36 

12           8 

30          14           3 

30          14           3 

20 

14 

37 

IS           4 

37          16           8 

37         16           8 

27 

16 

38 

14           6 

36         10           4 

38         16           4 

28 

10 

30 

16           6 

39         17           0 

30         17           6 

29 

IT 

W 

16           7 

SO         18          « 

SO         IS           6 

SO 

IS 

1      SI         18          7 

•1 

It 

PRONOUNCING  DICTIONARY. . . .  GLOSSARY. 


AB-no'MEW.    The  belly, 

A-ck-tah'  ii-lum.  The  Rockot  for  the  hcnd 
of  tlio  thi)!li  hone;  an  anciout  vesoel  for  hold- 
init  vinegar. 

Ah-dom'j-nal  c'av'i-ty.  The  cavity  of 
the  hclly. 

Ad-diic'tor.  a  Tntiscle  whioh  draws  one 
part  of  the  tKxiy  towards  aiiottiur. 

Ab-8Ur'iiunth.  Ulaiuls  and  vcshcIs  which 
absorb  or  Ruok  up  suhstances  from  within, 
or  without;  also,  niudicincs  which,  tboui;h 
nearly  or  quite  inactive  themselves,  alMorb, 
or  combine  with  acid  matter  m  the  Btomach 
o;  bowels. 

A-€ko'mi-on.  That  part  of  the  scapuin,  or 
shoulder-blade,  which  unites  with  the  coilar- 
bone. 

Ai^nii-oiN'B-A.    The  white  of  the  eye. 

A1/TKU-A-TIVE8.  Medicines  which  ^nudu- 
ually  reestablish  health,  without  sensibly  in- 
crcasinK  the  circulation,  or  aupneiiting  the 
perspirat'on,  urine,  or  other  excretions. 

Al'vecvlak.  Kelatiut;  to  the  sockets  of 
the  teeth. 

Al'vine  (Al'trin),  Relatins  to  the  Intes- 
tines, as  alvine  ditcharyts,  —  discharges  from 
the  bowels. 

A-MOK'PHOim.    Havlnp;  no  reKnlarform. 

Ah-ni-ot'ic  LiQ^uin.  The  fluid  surround- 
ing  the  fetus  in  the  womb. 

An-^8-tiik'i4ia.    Suspended  sensibility. 

An-as'to-mosb.  The  unitint;  ot  arteries 
and  veins  bv  Joining  their  mouths. 

AN-CHir-Lo'»iH.    A  stiff  or  useless  joint. 

AN-i-MAi/oi'-L,f;.  Animals  so  small  that 
tliey  can  only  Ihj  seen  with  a  microscope. 

An-<e'mi-a.  Privation  of  blood;  a  com- 
paratively bloodless  Ftato. 

An'o-dyneh.  Medicines  which  diminish 
sensibility,  abate  pain,  and  induce  sleep.  It 
should  always  lie  remembered  that  anodynes 
when  frequently,  and  long  taken,  lose  their 
Influence  in  disease. 

Ant-a'cius.  Preparations  which  neutral- 
ise acidity  of  the  stomach  and  bowels. 

Ant-al'ka-i.iiis.  Agents  which  neutralize 
alkalies. 

An-ta-phro-dis'i-acs.  Agents  which  les- 
sen or  blunt  tlie  sexual  propensities. 

An-tiiki.-min'tics.  McMlicincs  which  des- 
ttoy  and  expel  worms. 

AK'Ti-noTKs.  Medicines  which  counteract 
and  destroy  the  effects  of  poison. 

An-ti-pe-ri-od'ich.  Medicines  which  pre- 
vent or  cure  diseases  of  a  perioilical  character. 

An-ti-piii.o-ois'tics.  Medich)CR  or  diet 
which  remove  or  appease  inflammation. 


An-ti-spab-mod'kis.  Medicines  which  pre- 
vent or  idlav  spasms,  commonly  called  cramps. 

An-ti-hypii-i-lit'ic8.  Medicines  which 
cure  syphilis. 

An-ti-sei-^tic.  Whatever  checks  or  coun- 
teracts putrefaction. 

AN-Ti-sroH-nt/Tirs.  Articles  wliich  pre- 
vent ami  cuiv  scurvy. 

A-pe'ki-ent8.  Medicines  which  gently 
OiKjn  the  bowels. 

A-piio'ni-a.    a  loss  of  the  voice. 

Apii-k(»-i>18'i-ac8.  Medicines  supposed  to 
excite  and  promote  the  sexual  appetite. 

A-pon-eu-ro'8I8.  The  mentbranoiw  ex- 
pansion of  tendons  and  muscles. 

A-re-o'la,  a  colored  circle,  as  tins  circle 
around  the  nipple. 

Ar-o-mat'ic8.  Medicines  which  have  a 
gntteful,  spicy  smell,  and  un  agreeable,  pun- 
gent taste. 

A8-piiyx':-a  Suspended  animation  ;  b|>- 
parent  death. 

Ab-then'ic.  Relating  to  debility;  or  to 
disease  marked  by  debility. 

AB-TRiN'GENTti.  Meilicincs  which  have  tho 
power  to  eonstringe  or  pucker  up  the  tissues 
of  the  IkkIv.  and  thereby  check  discharges. 

At^RO-piiy.    a  wasted  condition;  leanness. 

Ax-ii^'la.    The  arn>-pit. 

AtrsHiUL-TA'TioN.  The  art  of  detecting 
disease  by  listening  to  the  sounds  of  the  lungs, 
heart,  etc. 

Aii-Top'sY.  Personal  inspection,  —  used  in 
the  sense  of  a  post-mortem  examination. 

Azote'.  Nitrogen;  one  of  the  constitu- 
ents of  the  ntmo-sphere. 

Bron'chi-a.  The  pipes  which  convey  the 
air  through  tho  luni;8. 

Bitr's*  Mu-co'sa.  Small  sacs,  situated 
under  tendons,  ai)out  the  joints,  containing  a 
Htiekv  fluid. 

Cai/cii-uts.  a  solid,  unoi-ganized  Ixxly 
formed  in  the  kidneys,  or  bliulder,  and  called 
a  stone.    The  plural  is  calculi. 

CAp'ii.-i.A-nv.    Small;  resembling  a  hair. 

Cap'sui.e.  a  membraneous  bag,  enclos- 
ing a  part. 

Car'ti-laoe.  Gristle  attached  to  the  ends 
of  the  l)ones. 

Car-.min'a-tiver.  Medicines  which  expel 
wind  from  the  stomach  and  bowels,  and  allay 
tho  pain  caused  by  it. 

Ca-tiiar'tic8.    Medicines  which  purge  tho 

t)OWClH* 

Oer'Vix.    Tlienock.     Cer^vix  U'ter-i.  Th« 
neck  of  the  womb. 
Car'i>i-ao.    Kelating  to  the  heart. 


/■ 


/ 


888 


GLOSSARY. 


m 


If]'- 


Car'pal.    Relating  to  the  wrist. 

Cat-a-me'ni-a.  Tlio  nuntlily  flow  of  fe- 
males. 

Ca-tiiak'bih.    PurKini;. 

Catii'k-tkr.  a  tuliu  for  drawing  ofl*  tlie 
urine. 

Cel-i.u'lar.    Rcluting  to  ccIIh. 

Ckr'k-iikal.    Kelnting  to  tlie  briiin. 

CiiA-i.Yii'K-ATK.     roiittiininK  iron  or  Htecl. 

CiiK-M»)'8i8.  A  KWi.'lliii;{  of  the  t'vc,  in 
wliicli  till!  oje  proji'i'tH,  with  u  depresKJon  In 
the  centre. 

Ciio'i.A-noouK.  A  ine<lii'ine  which  causes 
a  (llschnrdc  of  bile. 

Ci.o'Nic;  Si'AHMH.  Spasms  which  arc  rly;l(l 
and  relaxed  alternately. 

Coi.-i.i'yi'A-Tivi;.  This  term  Is  applied  to 
excessive  and  exhaiistin!;  disdmrtces. 

Co-u>h'tki:.m.    The  lirst  secretion  of  milk. 

Co'MA.     rrol'onnil  stupor,  or  sleep. 

CoN'uri.K  (kon'dil).  A  knob;  applied  to 
certain  projections  of  boties  at  joints. 

Con'klu-ent.  Not  disdnet;  running  to- 
gether. 

Con-oen'i-tal.  Kxisting  at  the  time  of 
birth. 

Con-oks'tion.  Distention  of  parts  Uy  an 
aecumululion  of  blood  in  them. 

Con-iMinc'ti-va.  The  membrane  which 
covers  the  eye  and  lines  the  eye-lid. 

Con'tra-Is'i)i-ca-teu.  Not  indicated;  the 
opposite  implied. 

t.'ouii'iAi.s.  Medicines  which  have  a  grate- 
ful, wanning,  and  exhilarating  effect  upon  the 
stomach. 

Cohn'tku-Iu'ri-tants.  Articles  which  by 
iiTltatIng  one  part,  withdraw  l)lood  from,  and 
relieve  another. 

Ciii'sis.    The  tunnng  point  of  a  dlsoasc. 

Cu'Tr-CLK.    The  epidennis;' the  scarf-skin. 

I)k-<;ii)'ii-a.  a  thin,  exicrnul  membrane, 
within  tire  womb,  thrown  olf  after  ehild-bear- 
in;r. 

I)e-i.iq'iii-um.    Fainting. 

I)K-Miii,'cKNT».  Medicines  of  a  softening 
nature,  which  correct  acrid  conditions,  and,  by 
their  bland  effects,  soothe  inflamed  and  irri- 
tated parts. 

Dk-im-e'tion.  Diminishing  the  ftdness  of 
a  part  or  parts,  as  by  purgatives,  or  bleeding. 

De-sqi;a-.ma'tion.  Separation  of  the  skin 
in  scales;  scaling  off. 

De-tek'uknts.    Medicines  which  cleanse. 

Di-A(j-No'si9.  The  art  of  determining  the 
nature  of  diseases. 

Di-a-i'iio-ret'ic'8.  Medicines  which  pro- 
mote gw<;utlng. 

Di-ATir'E-8is.  Any  particular  disposition, 
itate,  or  habit  of  iwdy. 

Di-u-i>k'si8.    Copious  flow  of  urine. 

Dit.'ii-ENTS.  Watery  drinks  •vhlch  increase 
tho  fluidity  of  the  bloo<l,  and  rci  der  several  of 
the  secretive  and  excretive  fluids  less  viscid. 

Di8-cu'TiENT8.  Medlclncs  which  scatter, 
resolve,  or  <llspersc  tumors. 

Di8-iN-FKC'TANT8.  Articles  which  purify 
or  cleanse  infected  places. 

Di-u-rktMu8.  Medicincg  which  increase 
nrinnry  secretions. 

Dras'tios.    Strong  and  violent  purgatives. 

Dy8I'-n(e'a.    Difllculty  of  breathing. 

K-mh'8I8.    Vomiting. 

K-mkt'ics.  Medicines  wh^h  cause  the 
stomach  to  reverse  Its  action,  and  throw  its 
contents  up  through  the  mouth. 


Km-men'a-uoui)ea.  Medicines  supposed  to 
have  the  power  of  exciting  or  increasing  the 
menses. 

K-mol'i^ignt8.  Those  substance*  which 
have  the  power  of  huiftcning  or  relaxing  the 
animal  flbre,  when  applied  externally. 

Kn-i>em'|(}  Dih-eah'eh.  Discuses  prevail' 
ing  in  certain  Uicalitles  or  districts. 

Ki'-i-oem'io  Dih-kah'kh.  Diseases  extend' 
Ing  over  a  large  extent  of  country. 

Ei'-i-iiUiT'ris.  The  cartilage,  which,  in 
the  act  of  swallowing,  slint'4  down  upon  the 
tup  of  the  wluil-pipe,  and  prevents  food  from 
gt)iiig  Into  the  breath-passage. 

Kr-is-i'As'TK's.  Siili'.tances  which  inflame 
the  skin,  and  raise  the  cuticle,  and  cause  what 
is  called  a  blister. 

Kk-cha-uot'ich.  Articles  which  burn,  cor- 
rode, disorganize,  and  destroy  the  aidmal  tiS'' 
sues,  causing  wlint  is  called  an  eschar,  or 
slough,  which  is  dead  mattt;r,  and  falls  off. 

Kx-i'Ec'ro-UANTH.  Articles  which  act  upon 
the  system,  so  us  to  make  the  discharge  of 
mucus  and  other  substances  from  the  uir-tubes 
more  easy. 

Kr'kiunks.  Substances  which  cause  sneez- 
ing, and  a  discharge  of  mucus  from  the  nose 
when  simfU'd. 

Ks'ciiAK.  Tho  dead  part,  killed  by  caustic, 
or  m<>rtificatk>u,  which  falls  off;  a  slough. 

Kx-ko-li-a'tion.  a  scaling  off,  as  u  piece 
of  dead  bone. 

Fau'ces.    The  back  part  of  the  mouth. 

Fe'huii.e.     Uelonging  to  fever. 

Fe'ces.  The  matter  discharged  from  the 
bowels. 

FKii'Ki-Fd-cES.  Medicines  which  assuage 
or  remove  fevers. 

Fi.a'ti!8.  Wind,  or  rather,  gas,  in  the  stoin- 
udi  or  bowels. 

F<)i-'i,i-<;i.E.    A  little  hag  or  sac. 

F<»-iia'.mi;n.    a  hole,  or  opening. 

Foit-M  i-<;a'tiun.  a  sensation  like  the  cieep* 
ing  of  ants. 

Fi;u-fi-ua'ceoU9.    Dranny,  or  scaly. 

(i  vN(i'i-i-ON.  An  enlargement  In  the  coarse 
of  a  nerve. 

(iAN'cKEXE.    Mortilication;  partial  death. 

(iAS'Titic.    Delonging  to  the  stomach. 

Ges-ta'tion.    The  period  of  jiregnaney. 

Gi.dt'tis.  The  opening  Into  the  wind-pipe, 
covered  by  the  epiglottis, 

UitAN'u-LAK.     Like  small  grains. 

Gkan'u-la-ted.  Covered  with  grannla- 
tions. 

Gran-u-la'tion.  The  filling  np  or  cover- 
ing  of  a  wound,  or  ulcer,  with  small,  red  eleva. 
tions,  looking  like  grains. 

lI.t:-Mui''TY-8i».  liaising  blood  fix>m  the 
lungs. 

IIe-mi-cra'm-a. 
head. 

lIi1':M'OR-RIIAGG. 

IIa^m-or-riia'gic 
bleed. 

IIe-pat'ic.    Uelonging  to  the  liver. 

Hy-per-ca-thar'818.    Exccssive  purging. 

Hy-i*er'tro-i'IIY.  An  unnatural  enlarge- 
ment of  an  organ,  without  change  of  structura 

H  YP-NOT'iC8.    Medicines  which  cause  sleep. 

Icii'oR  {Ikior).  A  thin,  watery,  and  acrid 
discharge. 

In-tkr-cos'tal.    Between  the  ribs. 

Lar'ynx.  The  top  of  the  wind-pipe;  the 
cavity  which  contains  tbn  vocal  ligaments. 


Pain  on  one  side  of  th» 

A  flow  of  blood. 
Having  a  tendency  to 


iCToep- 


I  coarse 


( ovcr- 
eleva. 


lency  to 


arfring. 
enlar;:©- 
ructum 
sc  Bleep, 
id  acrid 


ipe;  th« 
enU. 


0LOS8ART. 


889 


Lax'a-tiveb.  Medicines  which  render  the 
tiowelH  a  little  more  relaxed  than  natural,  but 
do  not  purge. 

Liu'ate.    To  Meciire  with  a  li((ature. 

Lio'A-TURK.    A  cord,  or  thread. 

Lo'ciii-A.  The  hluody  discliurKe  fVom  the 
woml)  lor  some  time  after  child-ltlrth. 

I/>'ciii-AL.    KuliitiiiK  to  the  lochia. 

LvMi'ii.  A  whitish  Huid  contained  by  the 
lyniplmtic  vcuscis. 

LYM-riiAT'it8.  The  vessels  which  carry 
lympli. 

Mac-eu-a'tiox.  The  act  of  Rottcninp;  ^r 
soakln;;  a  tliin;^  by  Icttintj;  it  stiind  in  water. 

Mac'ij-i,a;.    Colored  spots;  hleniishcs. 

Ma-i.a'ui-a.  Noxiou.s  giwes  from  decom- 
posed matter. 

Mam'.ma.    The  female  breast. 

Man-ui»'im,au.    Kclatinj;  to  the  Jaw. 

Ma«-ti-«'a'tion.    The  net  of  cliewin);. 

Mas-tuu-iia'tion.  The  nit  of  exciting  the 
genital  organs  with  the  hands. 

Mi;n'»tkii-1!.m.    Any  solvent,  or  vehicle. 

Mi;t-a-caii'i'iis.  The  hand  between  the 
wrist  and  the  lingers. 

Mk-ta8'ta-ri».  The  changing  of  a  disease 
IVom  one  place  to  another. 

Mkt-a-tak'8ii9.  That  part  of  the  foot  Ihs- 
tween  tlie  ankle  and  the  toes. 

Mi-A»-MAT'ic.  Partaking  of  the  nature  of 
miasm. 

Mu'co-pu'Ri-FOKM.  ConiiMiscd  of  both 
mucus  and  pus. 

Mu'co-sK'no-i.ENT.  Composed  of  both 
mucus  and  serum. 

Nau-cot'ics.  Medicines  which  relieve  puin 
and  produce  sleep. 

N  AU'SE-ANTH.  Medicines  which  cau.se  sick- 
ness at  the  stomach,  or  a  disposition  to  vomit. 
They  are  often  used  as  expectorants. 

No8-ol'o-ojst  (Aose-ol'o-yitt).  One  who 
explains  and  classitlcs  diseases. 

Nu'ci.K  iJ9.    A  central  spot. 

Nu-CLE-o'i.ii9.    A  spot  within  a  nucleus. 

Ok-tiioi'-nik'a.  Great  difHculty  of  breathing. 

08  U'tkk-i.    The  mouth  of  the  womb. 

08  8i-fi-<;a'tion.    The  formation  of  bone. 

O'vuM.  An  eg^.    O'va.  Kggs. 

Pa-1'1l'la.  a  red,  elevated  point  upon  the 
tongue,  or  elsewhere.  Certain  diseases  maiio 
these  points  more  prominent, 

Pau-a-cbn-tk'818.  The  operation  of  punc- 
turing the  chest,  or  the  al>domen,  for  the  pur- 
pose of  drawing  off  water. 

I'ak-a-i'iii.k'oi-a.  I'aralysis  of  the  lower 
half  of  the  body. 

Pau'ox-ys.m."  a  fit  of  disease  taking  place 
periodically. 

Pak  TU'Hi-ENT.  Urlnging  forth,  or  giving 
birth. 

Par-tu'ri-ent8.  Medicines  which  promote 
child-bed  labor,  by  causing  contractions  of  the 
womb. 

Par-tu-ri'tion.    Child-birth. 

Pec'td-rai^s.  Medicines  intended  to  cure 
or  relievo  diseases  of  the  chest. 

Pel'vis.  The  bony  cavity,  or  basin,  at  the 
lower  part  of  the  body,  containing  the  womb, 
abdomen,  rectum,  etc. 

Pkr-i-ne'um.  The  part,  or  space,  between 
the  anus  and  testicles. 

Per-i-os'te-uu.  a  thin,  hard  membrane, 
covering  the  bones. 

Per-i-os-ti'ti8.  Inflammation  of  the  peri- 
osteum. 


FBR-i-To-NK'nM.  A  serous  membrane  lln> 
Ing  the  cavity  of  the  belly,  and  folded  over 
most  of  the  organs  contained  in  It. 

PKT-E'ciii-ii:.  Purule  s)xjis  which  appear 
upon  the  skin  in  low  levers,  looking  like  ttea- 
bites ;  called  aUo  ecchymoses. 

Piia-«k-i>en'ic.  Corroding,  eating,  —  ap- 
plied to  ulcers. 

PiiA-LAN'uES,  The  bones  of  the  Angers  and 

tOi'S. 

Piiar'ynx.     The  npiwr  part  of  the  thmnt. 

Piii.K(i-.M(>'N(HiH  1n-fi,a.m-.ma'tion.  Inllani- 
mation  marked  by  redness,  heat,  and  pain, 
and  a  tendency  to  form  matter. 

PRo<i-xo'8i».  The  art  of  foretelling  the 
termination  uf  diseases. 

Pty'a-i.ihm.    iSallvation. 

Pui'A-i'isM.  A  continued  erection  of  tho 
penis  from  exciting,  morbid  causes. 

Kic-FRKi'Kit-ANrs.  Medicines  which  lessen 
the  heat  of  the  body. 

Hi;-i.ax'ant8.  Medicines  which  relax  the 
tension  of  the  muscles. 

Kk-mis'«ion.  a  lessening  or  miligatii.n  of 
the  severity  of  tho  symptoms  o(  a  disease. 

KK8-o-i,i;'TioN.  Dispersion  of  an  inflanb. 
mation  before  pus  Is  formed. 

Re-vul'8ivk8.  Medicines  or  appliances 
which  remove  a  disease  by  causing  a  deter- 
mination to  some  other  part. 

KiJ-iiK-KA't'iEsrs.  Applications  widch  ex- 
cite the  skin,  causing  the  blood  to  flow  to  it, 
and  making  It  red. 

Sa'mks  a  thin  llnid  discharged  from  ul- 
cers, li  iving  son>c  of  the  propcnies  of  pus  aitd 
blood 

t>i-.i)'A-TivE9.  Medicines  which  diminish 
the  action  of  the  lieart  and  nerves,  and  which 
are  used  when  wo  wish  to  allay  any  excited 
action  in  the  system. 

Sk'hoi.s.    Watery. 

ScKo'TtM.  Tho  bag  which  contains  tho 
testicles. 

,S(;y»'a-i,a.    Hard,  round  lumps  in  tho  feces. 

Si'A-i,A-(i(>(iUK8.  Medicines  wliich  inci-eiLso 
the  flow  of  saliva. 

Si.oi;oii  {Sliiff)  Any  part  of  tho  body 
killed  by  niortilicHtion,or  caustic,  and  cast  off. 

Si'kr-mat'ic  C<>ki»8.  Two  cords,  composed 
of  nerves,  veins,  and  arteries,  descending,  one 
on  each  side,  from  the  abdomen  into  the  scro- 
tum, and  suspending  the  testicles. 

Kyi'A'Mourt.     Scaly;  having  scales. 

Sok'dks.  The  dark  matter  deposited  upon 
the  lips  and  teeth,  in  low  fevers. 

SrKu'Nti.M.    The  breast-bone. 

■Stek'toh.  Noisy  breathing,  as  in  apo 
picxy.     iSnorlng. 

Steu'tor-oi;s.  Snoring  and  noisy,  as  ap- 
plied to  breathing. 

Stim'u-i.ants.  Medicines  which  increase 
the  activity  of  the  system. 

Sto-macii'ic8.  Meilicines  which  support 
and  renovate  tho  stomach,  making  its  action 
healthy. 

Stru'ma.    Scrofula. 

Styi-'tics.  Substances  which,  when  ap- 
plied externally,  have  the  power  to  constringe 
or  pucker  up  bleeding  vessels,  and  stop  the 
loss  of  blood. 

8uu-cu-ta'ne-ou8.    Under  the  skin. 

Suu-MAX'iL-LA-RY.    Under  the  lower  jaw. 

Suu-8ul'tu8  Ten'di-num.  Slight  twitch, 
ings  of  tho  tendons,  which  occur  in  low  forma 
of  fever. 


Mr 

I: 

If' 
1. 


si 

It 


.\, 


W 


Sii-DO-RiK'irs.  Modicincii  which  vnmo  a 
flow  «f  nurHninition,  rather  inuro  frco  than 
(hut  proiliiocd  liv  iliHphureticH, 

Sri'-i'uit'i-TO-KiKH.  Solid  medicinal  8ub- 
■tancen,  of  a  conical  or  cylindrical  Hhupo, 
which  are  placed  In  th«  roctiini  for  the  pur- 
pose of  rolicvinK  constipation  and  thu  pilcA, 
and  for  romovInK  Htrlcturc. 

Syn'oo-i'E.    Fainting;  xwoonitiK- 

Te-nes'mu8.  a  painful  l>enrlii>j  down  in 
the  lowur  bowel,  and  a  dlHtreHMiiiK  dcHiro  to  |{o 
to  stool. 

Ton'ics.  Medicines  which  gradually  pivo 
tone  and  strcn^^th  to  weakened  organs,  or  to 
the  whole  system.  Some  act  upon  the  ncr- 
voua  system.'  und  some  upon  the  other  tissues, 
by  condensini;,  bordenintf,  and  invigorathiK 
tbem. 


Tor'mi-na.    OrlplnRpaln. 

U-re'tkhr.  Thu  tubei*  whicli  ronTfljr  the 
urine  from  the  kidneys  to  the  bladder. 

U-hk'tiira.  The  canal  which  conveys  the 
urine  fh)m  the  bladder  out  of  the  iMMly. 

U'ter-U8.    The  womb. 

Vao'i-na  ( V(id<j>i-na).  The  passoRo  tmm 
the  external  ^t^nilal  organs  to  the  womb. 

Va'ri-«;o8E  Vkinh.  Veins  which  are  mor- 
bidly enlarged,  an(V  present  aiouK  their  course 
Hoi'tj  knotty,  purplish  tumors. 

Vkh'ti-wo.    Dizziness;  Kl<l>l'no8a. 

VE-Ki-t'A'riON.    ItlisierinK. 

Vi'rub.    I'oison;  contagion. 

Vis'ciis.  A  liver,  stomach,  kldnoj,  ueart, 
or  any  organ  within  one  of  the  cavities  of  the 
body. 


It  is  believed  that  the  hai^  words  introduced  into  thiii  book,  and  not  contained  i« 
the  above  GlosBary,  are  nearly  or  (juite  all  explained  at  the  places  where  they  ara 


Mcd. 


Ill 


I 


uyi  the 

r. 

i;o  from 
lb. 

ire  inor- 
r  courM 


y ,  ueart, 
a»  of  the 


unod  !» 
they  are 


• 

• 

I  2sr  1)  h;  x. 

• 

*« 

PAoa 


Abdominal  Cavitri  DImims 

oi; 

AbicR  rnnailvnRlH, 

"      KxcclsB, 

"      rioea, 
Abortion, 
Abacetmen, 
Abnuiici'  or  Monnex, 
Absorbent  VpsmcIh, 
Acacia  Catvoliii, 
AcuiilentH  on  Water, 

"  bv  I'oiMoning, 

Acetate  of  Ooiiper,  poiHoning 


AU, 


282 
017 
6()2 
fi02 
3HI) 
429 

avt 

6(M 
498 
496 

4»7 

"  Leaa,|)oii<oninitbv-,  498 

"     '•      Ointment,  «7r> 

Acutum,  fXtO 

Achillea  Miliefulium,  664 

Acid,  Acetic.  r>90 

"      Citric,  hW) 

"      Diluted  Hydrochloric,    591 

"  "       Hydrocyanic,     591 

"       Nitric,  590 

■•           "    Sulphuric,  591 

"      Nitro  Muriatic,  591 

"      Tannic.  591 

"      Tartaric,  691 

Aconite,  632 

"        PoiHoninfT  by,  4iW 

"       Tine  t.  of,  688 

Aconitum  NupelluK,  OWi 

AcoruR  Calamus,  ■     6.58 

Adipous  .^iircoma,  471 

Atfectionn  of  Chent,  574 

'•         "  Head.  674 

"         "  Stomach  and 

Howela,  670 

AmiKlon.The,  r^Vi 

Age,  Influence  of,  1'>1 

Axue  Koot,  655 

"     Fever  and,  413 

Air  CellH  or  VegfcleR,  35 

■'    "    Hnlargement  of,  231 

'•    in  Cbeit,  236 

"    SwellinK*.  283 

"    and  Veutilation,  108 

Albumen,  15 

Albuminuria,  299 

Alcohol,  691 

Alder,  TaK,  658 

Aletrii  Farinoaa,  655 

Alimentu,  Fluid,  668 

Allium  Cepa,  636 

Sativum,  615 

Almonds,  591 

Syrup  of,  684 

Almond  Mixture,  674 

Aluus  Uubra,  658 

Aloes,  692 

"     Comp  Tinot.  of,  690 

'*     and  Canella,  Compound 

Powder  of,  682 

Alpinia  Cardamomum,  604 

Althca  Offlolnalia,  681 

Alum,  693 


PAoa 

Alumen,  692 

Amaurosis,  4*46 

Amenorrhira,  .354 

American  Hellebore,  592 

"         liMicaouanha,  603 

"          Ivy,  593 

"          Valerian,  tW) 

Ammonia,  Aromutio  Spirit  of,  594 

'•           CurboiiHte  of,  593 

"           Muriute  of,  593 

"          rol!<oiiiii)(  by,  4Uti 

"  Solution  of  Aoetatu 

of,  594 

»          Water  of,  693, 

Amiwlopfis  (juinqaefolia,  593' 

Amusements,  1 14 

"           Games  for,  114 

"            LiKhter,  115 

"            Want  of,  116 

AmvKdalux  ('ommunis,  691 

I'eraioa,  688 

AnuKallls  Arvensia,  647 

AnnMaroa,  318 

Anatomy,  14 

"         of  Bones,  18 

Anchylosis,  466 

AneurisniH,  472 

Aneiirl!<mal  Tumors  of  Heart,  252 

Angina  Pectoris,  260 

Anine,  594 

Ankle.  Dislocation  of,  463 

Aiithcmis  Nobilis,  606 

Anthrax,  4.34 

Antidotes  of  Poisons,  496 

Antimony,  Poisoning  by,  497. 

Aniipatbies,  660! 

Aortu,  37  { 

Apocvnin,  697 

ApocVnumAndrowemifolium,  5B7; 

A|)oplexy,  160 

Apiinren't  Death  from  Various 

(  aiiKfs, 
Apple  Water, 
Aptliae, 
Aqua  Calcis, 
Arachnitis, 
Arachnoid, 

"  Inflammation  of, 

Aralia  Hfspida, 
"      Racemosa, 
"     Spinosa, 
ArbiitUM,  Trailing, 
ArRcnti  Nitras, 
Aristoloohia  Serpentmria, 
Arnica, 

"        Montana, 

Aromatic  Powder,  u»i 

"         Spirit  of  Ammonia,  694 

Arrow  Root,  694 

"         "       Gruel,  681 

Arsenic,  497 

Arsenical  Solution.  668 

Artemisia  Absinthium,  604 

Arteries,  86 

Pulmonarj.  87 


404  j 

581 ! 


1531 

45 
158 
613 
652 
645 
668 
634 
660 
594 
694 
682 


Asarum  Canadense,  662 

Asclcpias  Incarnate,  667 

"         Syriaca,  600 

"        Tuberose,  641 

Ascites,  817 

Asiuiic  Cholera.  290 

Aspidum  KiliK  Mas,  6,30 

AfgafoDtida,  594 
Comp.  TInct.  of,    69U 

ANtbniu,  243 

AtnioHpbere,  Pressure  of,  lOH 

Atropa  llelladouna,  612 

Atrophy,  253 

AtttndaiitM,  Unhircd,  550 

Aurantii  Cortex,  687 

Auricles,  36 

AUHCulation,  210 

Italm,  694 

"      ofCilead,  59S 

Italniony,  5!I5 

liulsam  Copaiva,  595 

Tolu.  595 

nalsamtidendron  Myrrha,        <<84 

HandHges.  Wet,  540 

Kuptlsia  Tiiicturia,  662 

Itarherrv.  696 

Itnrbers'  Itch,  140 

Harley,  77 

"           oflTie.  670 

Itnrosma  Crenata,  601 

Barrenness,  871 

Basilicon  Ointment,  667 

Bath,  Cataract,  634 

"      Cold  Foot,  630 

"      Douche.  588 

"      Kve  and  Ear,  640 

'•      Half.  M5 

>'      Head,  636 

"      Hose,  634 

•'      l^g,  686 

"     Mouth  or  Orai,  l'41 

"     Nose,  640 

"      Plunge,  586 

"      Shower,  684 

"     Sitz,  587 

"     Towel  and  Sponge,  538 

"      Wading  Koot,  640 

"     M'arm  Koot,  640 

"     Wash-Tub.  637 

"     Wave  or  Sluice,  538 

"     Cold.  542 

"       "      F,fl"ects  of,  648 

"      Hot,  642 

"        "      Efleotsof,  644 

"     Tepid,  642 

"        "         FJTectsof,  648 

"     Vapor,  642 

"     Warm,  542 

"         "         RffiMStsof,  6*4 

Baths  of  the  AncienU.  108 

"      Cold.  106 

»      Division  of,  641 

"      Names  of,  104 

"      Negleot  of;  IM 


892 


INliEX. 


nntlui,  Bc^ction  after, 

"      8hi>«<M', 

"      HpoMKe, 

"       \ii|M)r, 

"       Warm, 
tiuiliiii)(  uiiil  (;i«aiiline»v, 

'■       Si.'ii, 
llaylxTry, 

(Miitmcrit, 
It<;*:iii,  St   I);iiutiuii'«. 
IWuur, 
Itcmiji'iTy. 
Ht'ils  mill  lii-diliiif;, 
liicl  Till. 

'•       tJlM-'llCt!  of, 
ttOKtK. 

llwivcs'  (iallx, 
liulluiliiiiiii'.  Atri'|>a. 
"  Oiiifmcnt, 

"  )'l»»itlT, 

ri)i»oiiiiiK  by, 
Hensiiii!  Aciil, 

livil.'.nlli, 

I'lUiip.  Tioct.  of, 

ISKibvris  ViilgHrlc, 

1 '.('til  mot, 

ilili;  ill  .siomnch, 

r>iiiui'y  ('iiifiili, 

KilioUN  (  olit:, 

Kt-iiiitteut  Fever, 

UiHiiiiitli, 

"        NltratiMif, 
"        Xubiiili!il«  of, 
"         1  rihiiitiiili'  of. 
"        White  Oxido  of, 

IJItllT  Itoo!, 
Illllt'lSWlK'l, 

llliii;k  Aider, 
"      l'olit>»h, 


#40* 

W7  Bruit!,  AbfierM  of, 

109!  • 

11)5 1 
KM)  I 

Km  I 

""'  i 

644 

tiTrtI 

(i6«i 

70-V8i 

ft:'6i 

/yiril 

6ta 

;'.> 

fi7>!| 
()7i> 


TAO* 

]56 
15H 
16»> 

m 


Hrvytfy  ol, 

Kiilarfjvnicnt  of, 

lOxertfliw.'  of, 

I'Vvi.T, 

lU/nltli  of, 

liiituratiitn  of, 

'  iiIlHinniulioii  nf, 

.ml  Nvrvi.'M.  tiidCttsesof,  162 1  (JajiKin  Aciilifoiia 


Carunt  Cami. 
C»rtitaK<:,  Arytenoid, 
"  <  rvcoid, 

"  'lliyroid, 

l,''i^!>Caryop)iillii!<  Arumulicua, 
f>7  '('aMisiiilla, 
ir)ij|Cai>(!iti<', 
IMi  CuM'K  'I'reatcd. 


96 


"      (Jill  IVopleH, 
"      Overworitinff, 
"      Sliriitki)«K  of, 
.SnlW'iiiiii;  ol, 
"      'J iiinois  of, 
Uraii.  lii'Ooctioii  ol. 
Kritiiily  Mi.vtint-, 
Itifiiil  iiikI  SV liter  I'oultice, 
ilrt'ii^t  Hull!'.  Kriicliirf  of, 
r.rolicii, 
liiHuiiiinqtioii  of, 


W)  Bn-atliiiiK,  OI/jfciH  of, 
fiiXi  '■  riiiloMipliy  of. 

f('t'-   UrijihlV  I>iM;ii<i!  Ill   K'iilnoys, 
OlMt  Itiiild'ii  Itoiicx, 
5!ir>'  UroiicliiuS  I'lilicfi, 
61)7;         ••        riniHiiniption, 
(14   I'.roiicliitii<,  Ai-ulc, 
2iiH  '■  t'liniiuo, 

2HJ  liroi-ftiocele, 
411    ItriiiKufi, 
f)!'7    lliilio, 
fill7   J'lucliii, 
r,!l7i      ••       finct.  of. 
fi!i7   Hih'kliiini  ISi'skf, 

f)it7'  rilH'kllKHIi. 

Wi7  Itiifkwlit'iil, 

f.'.t7  l',ii»!;l(:\vt'i;(l, 

.MIS  iliiiiioiii', 

i'.lH  llKiiliick, 


tiWi 
4^,2 

lilH 


Conip.  Tinct.  of,  (i'.il  ISiirnmnly  fitch, 

"      Hoot,                                 (!(•;>  lluriM. 

"      Williiw,                             m>  ItiitK.'iiitit, 
llhuiitlxjrry,                                    TillK 

BhidiliT.                                         ;M  CiiiiOufjc, 

"     Acute  liiltitnitnatiun  of,  2Ui  "         .Skiiiik, 

"     <'1ii(iiiii;        ••              "    1!!)H  t'aluniiiie  t'eiute, 

HleediiiK  I.  :>m  KiiiiievB,            aiZ  •■          I'lepured, 

"           "      N'lvc,  "               4UI  f'al.iniiiie  I'lii-parula, 

"           "      Wounds,    878,  4il3  ialoiiit'd  fkcu.'B  Horn, 

IlJetiorrliiiKia,                              311  <  uk.iiliis, 

Hiiflecin^  I'luhler,                       (1117  (aitV  hf.'t  .Jully, 

Illuud  ill  Scrotum,                     474  (  ah'o  Hutlt, 

ItloddriKit,                                 fi'.Hi  Citlomol, 

JJIoolv  Khix,                              Z)'J  (':il.\, 
Uluo  t  ohOKli,                             fitmi     "     Chlorliiat*, 

'■         "        Comp.  Tinct.  of.  01)1  Caiiiplior, 

••    |)iMca«c,                            '  408  "          Liniment, 

"    KIUK.                                    Oliol         "  Wiit.r, 
"     I'ill, 
llody,  ^itrl^clur^•  of  the, 

•'    riieiui'Mtl  I'nrMTtlesof, 
riiysieal 


61M      '•      Uudi 
5i>  I  Castor, 
iriij      -     Oil, 
l.''>4;  Castoreiim, 
ITi/i:  (.'atiilcjuiy, 
57H|  OatiipliiHiiiR, 
»;;t   t  uiuracl  bath, 
C'aturrli, 

t'Htiinliul  Opthalmia, 
t'ateuliu, 

"         Tliict.  ol. 
"         t'oiiip.  riiiet.  of, 
"         ('oiiip.  Towder  of, 
2'.Wi  Catnip. 

44('|  ('uuli>pliylluii)  ilialii^troides, 
'■■  •  Cuuiopliyliiii, 
<  ayeiiiie  I'epiier, 

Tiiict.  of, 
)'i-aiiolliu)>  AraericauuH, 
(  eluiidyiie, 
(JerateM, 
Cerebellum, 
Cerelinini. 

Centvisue  I'cruientmn, 
Cefaiitiiiii  ol  Mt'iiueJ, 
Celiiccuin, 
C<-li',iiia  Isluiidica, 
Cliuliii^f, 
Cliulk, 

■•      Mixture 
•'      Coiiip  Powder  of, 
"      Coiup.  I'owder  ul,  with 
Dpuim, 
Cloimiiiuile,  ' 

Clii;ii,'iial, 

Clieliiioiiiiiiii  MajuH, 
(.'lieloiie  (liiitoa, 
C'lii'iiiical  Kood, 

lujurieo. 
(1(12  Oiei.opodiiHii  Aulhciniinti- 
815' ,  cum, 
6W<!Cherrv,  Wild, 
(133:  Cheat,  AlliulioiiH  of, 
«U2'       "       Air  in, 
62«|       "       l»i!-<aM(.  of, 
aiH        ■'      Water  in, 
6(13!  (Niic!(('ii  Waicr, 
('.71    .'hick weed,  nv\\. 
•  17:1  CliiililuiiiH, 


21,: 

2;ii( 
2;i;i 

4.;t 

4«>4 
821-321' 

liOl 

(iOI 
tiUI 
7i» 
W> 
4(;7 
6irj 
ijifi 

435 

mi 

70 
(i61 

»>)(i 
m-, 


TAOt 

«0{ 
4! 

41 
41 

tKI7 
(ill4 

i<; 
2t.;j 
(i60 

titl7 

(im. 

004 
(IU4 

KM 

m> 

484 
604 
lifrt) 

m) 
mi 

<HJl 
f/ilU 
(iOU 

m, 

f,S!( 
()47 
Wfc') 
(jtiii 
4» 
ti 
IK  J 
;i':2 
(in 
<J'-1 
4!'2 
(Jli.> 
(174 
tiUl 


OK)' ramphorated  Soup  Liniment,  (172  Cliild-Hid  I'ecer, 
14;  Caiialiiik  liidiva.  fiiict.  of,  IIH!i  Cliildren,Cuie«ii({ 


"      Vital 
Boiled  t'loiir, 
lioilri, 
Uor.en,  Anatomy  of, 

"      IUkcbrck  of, 

"      Death  ol, 

■'      of  [lead. 

''      "  Trunk, 

"       "  lJp|K!r  Kxlremtiiea, 

"       "  Lower       •' 

"      1  ime  re<iuireU  for  e.nit- 

i>>K< 

"      t'lniawrAl  (irowth  OS*, 

"      ulce'atlou  of, 

"      Use',  of, 
'Soncnet, 
Itorax, 


)4'  Caunda  i'lati^iitn 

Kii       "        KleiiliBiie. 

m\       "        HuukelEoQt, 
N<2  Cancer, 
4:i3|       "        of  Mouth, 

18  Caiicnjni  Oris, 
4(i&|Cunii!Ia, 
4U5!       "       Alba. 

2()iC«nkcr  lA'ltiuie, 

21 :  Canthaiis  S  I'lsieatoriiL, 

ZiV'aiitharidi'H,  I'iiict.  of, 

24;  CfiplllurieH. 

itjHpi'iouin  Aniiuum, 
447]        "         I'lHHter,  C 
4(i5  Caput  ilbiitipuin, 
405,  Caraway, 

■,<6!CarbuLi)(ni, 
(iOO ;  Carbuncle, 
aia.  Cardialida, 
4<lii  Cardunioin, 
677  (  oiop.Tinot.  of. 


.'omp. 


Dowel,  lallinff  of, 

MoweiK,  AlIectlniiH  of, 

"      Ai'.utelnntmiMtttionof, 2MI  Carditlfi. 

"      Chr  ulu       '  '•    '(Wi  (.'areot ChildrRn, 

"      Lo/)^eu«(«  of,  2a)-4<i3      "    •'  Teeth, 

JHr«etilu)  I'leiiu*,  «7  Cariex, 

JHntin,  44  Carruti. 


08.: 

(joi; 

(iOli 
liti.'j 
C!f, 
tihil 
4r>.7 

out 
^m 

C'4 
2H(! 
2(1) 

a;i7 

'J47 

4t)8 

3^7 

il)liteiUici9of,3'JI 

0():)           ••         Niii>iiiK  Sick,  KM 

<i(Ki          "        WeauiUK  m.  .MC 

(><^J;Chlrnapliil>.  Uinbellula,  oil 

4'!'i)i  Ch!oriitoi-.u,  'ii"! 

Hii  Chloioloiniuin,               •  i>"l 

4(K)  Chloriwis.  am 

e.l3  Choloe  ol  Hfek-Koom,  6ol 

6(''     ■holcra,   Vxiatic,  2Vi) 

f    ,        "           nfunlum,  <>>1 

064        "         MorbuH,  HX 

tm  Ciunca,  jtU) 

37        "        Chronic,  li'i) 

6<)5  Choroid  Coal,  49 

(17!)  Cliyle,  C-1 

480  Cliyriie.  (14 

(Kk't  ciliary  rrocetwcH,  41) 

WK!  Cirnieifuna  Kaceinonn,  PUS 

434  CiniieifiiKin,  5I)D 

270  Cinv'lioiia,  031' 

M.H  I  iiielionia,  liTfJ 

(!t<()  (  iiiiiainon,  61'* 

arD'         '•         Tinct.  of,  089 

891 !          '•         Coinp.  Wnot.  of,  OHO 

401  rirculnflon,  Organi'of,  3« 

4(i6-4i(l  (;irtocele.  47S 

79  Citric  Acid.  Syrup  of,  984 


w. 


of, 
er  of, 


;t.  of, 


nan 

0nt 

41 

4) 
41 

(K»T 
(!l)4 
M 
2i:t 
Wi 
OUT 
ti04. 
004 
(114 
liM 

5114 

IW 
4H4 
C04 

(»«» 

(HJl 

f.ity 

fitir, 
r>s;l 
Ml 
m't 

Oiti 
4» 

u 

(iri 
<?.i 

41''-'. 

«;•"> 
tiVl 
Gill 


r  of, 

;r  of,  with 


ftiminti- 


ti«i 
fVitl 

hi  I.) 

Will 
4»>-'j 

iWl 
(itil 
t,'4 

211) 

•i;n 

,'KJ 

•ill 
)laeiu?ci8of,  ifJl 


ick, 


ina, 


I. 

1  Iviot.  of, 

I'  of, 

of, 


:>i.2 

(>U 
'iin! 
(.11! 
HHP 
twl 
HVi) 
^J4 
iUO 
jCiO 
1.1) 
4U 
&t 
<>4 
4^ 
WIS 

(Kf'.* 

euu 

3« 

4;s 

084 


INDEX. 


CitniB  Limonum, 

Map. 

(  IciinitiRtlioTt^th, 

(  k-aiiliiiL'Mi, 

('l»'«Vt'|-tl, 

Clergy  men '«  Sore  Throat, 

riimiitf, 

C'loitii'H  Culcliing  Kire, 

Clotliiii);, 

"        Color  of, 

"        Cotton, 

"        Uiiir  UH, 

"        J.iii<'n, 

"         i'oroiitt, 

•«        .Silk, 

"        Ti«lit, 

"        Woollen, 
Kol, 


PACII 

62-1 

asii 

100, fA5 

mil 

1!>1 

'' 

4iHl 

i«! 

ItXIl 

Hit; 

!W 
100 

no,  111 

!l't 


•I 


("lover, 

CloMV, 

rioviis, 
<  h»ti'l>, 

(  IWCIIH  ('HCti, 

(  oi't^iilii-^  I'almnlua, 

(  oCllilK'lll, 

(  oclik'urlu  Armomcia 

(■(Ml  l.ivi'rOII, 

lofli'i', 

Bwrley, 
(       "       CrHiit, 
I      "       Milk, 

I  "         Coiiip.  Tiuct.  of, 

!  Cold,  KiToets  of. 
I     "     Foot  Itutli, 
|i  Cold!', 
'  Colic, 

•'      Biliouii, 
II      -'      l'aiiitvr'8, 
••      Win.', 
(diiuii  rici'iimm, 
I  iiilli". 
I  iiloi;.\  iidi, 
I  i>liiili'>ii, 

I  iilollll'O, 
('dloll', 

I  (ilC'loot, 

[jlollV  Joot, 

Ciiriifruy, 

•'        Corop.  Wine  of. 
Common  (Siik  Weed, 
I  (iin|)loiiiu  AH|,tenifoUn, 
Coiup.  Kiactures,  44(J— 456 

"      lufudiuu  of  Catecliii,       fiTO 
"  "  "  (<<'iitiiiii, 

"  "  "  (leraiiium 

"  "  "  I'arHley, 

"  "  "  .Senna, 

Comn.  InfURion  of  I'ruiling 

.\rmituK, 
ConipreiKw, 
luuleotioiiK, 

Aiomalic, 
"        ol  (uteului,  Comp  , 
"        of  .Senna, 
fi)nffe.«tivi'  Kever, 
(Aiiiiiiin  Muciilulitin, 

I'oihOiiiiiK  by, 
dini'erv,'!!, 
I  oiiHtipHiion, 
CoUHtitutlon, 

"  Idliwvvicmoy  of, 

rnnMitiitional  OidTercncei", 
CimiiUinptioii, 

A  d'ciieriil  DlccaHe, 

Uroiiclinil, 

(  u>)M'»  of,        2ir>- 


(147 
(iOT 
I4r> 

(in, 

(107 1 
(i08 
007 

cao 

(107 
84 
r.79 
679 
f>86 
(i;!2 
(>!•!  I 

4;ifi 

6.3SI 
20.-) 
41 '6 

a-i 

28.1 
2S2 

•JS.'. 

(KH 
(lOH 

lill'( 

(KiS 
(i« 

•m 

073 

(5r,7 


PAOI 

Com,  Indinn,  78 

Cornea,  49 

"        Inflammation  of,  486 

Coriu'itis,  485 

('oriiN,  145 

Coniii  Cervina:  L'Htum,  602 

Coniii.s  Kloridu,  013 

"       .Sirviceii,  ()67! 

Coriowiie  .Siililimute,  609 
"     roiBoningb/,4y7 

Cov>  jliiii^  i'oinioKa,  (169 

Co»ii»  tiic^<,  28(J 

Cotton.  (ilOl 

CoU|Mie  .Soliel,  l(i2{ 

Cow  I'ox,  IJUi, 

Coxiiluiii  466 

(  iiiinp  liHik,  flIOl 

Cnini|iM.  171 

{  iani'>l)ill,  (ilOj 

Cruniil  Nerve*,  4.1 

Crii«ley,  tilO 

Creiiin  of  Tartar,  (iCi 

t;reonote,  till 

"       Ointment,  i>7ti 

Crcosoluni,  tUll 

Crocu^  .S:itivi8,  (MSl 

Croton.  I'.lMtyria,  (!04! 

"        Oil,  (111 

"         "    Liniment,  n7-.' 

"       TlKliuin,  c,li 

Cnitip.  401 

Crow  Con:,  liiVi 

Cruiul  I'hli'bitis,  .'W7 

Cril.«t  CoH'ee.  679 

(  I  n^lni  letter,  142 

Culi-li.r,  (ill 

Ciihi'hs,  (ill 

(  II.  ufiiljer,  Willi,  002 

(  iiciiiniH  (OloeyntlilK  008 

CtilverV  lioot,  till 

(  iipri  SiibiiOi'liiH,  (i09 

(  ii|iri  SulpliaM,  609 

Ciipiinn,  609 

Cjiiiiovirt,  408 

CyiiiiiH'ilin.  (iiki 
(  \  liiijii'iliiiin  rubewceiiH,  620,  (iii.1 
Cvytiiie  OepositH  in  Urine,         .')lt 

Cvdlirrliuju,  2'J8 

CjstitiB,  297 


Didlocations  of  Hip  Joint,  M 
'•            "    Knee  Pan  <r 

I'atella,  4fN| 

"  "    Knee  Joint.  V8 

"  '•    Lower  Juw .  'M 

"  "  .slionlder 

Joint,  4f» 

•'  "   Wn<-t,  «"•> 

UiKtnrbed  .Sleep,  \\.-i 

l>i//in('>s.  Ul 

Doek.   Vellow.  tfii 

Uoj<»OII(l,  <iu 

"  I'oisoning  by,  iJS 

"  .SHiinip.  >t: 

Doniest ie  >l ii iiuf^ement  of  tbt 

.Sick-liooin,  ri6t 

DoM!*.  IW! 

I>oiiclie  Itiilli,  .\n 

I'lijl,  ';H 

Dover'K  I'ovvder,  <iK\'J 
l)iii);on  Kool, 
DroM,  Wei. 
Drink,  I'lea.xiint, 

l)iop.-y  ol  Kelly,  V.I 

Mg,  ■:i'i 

"      (ic;.ii<,,  ;;i8 

Dry  rinipk.-.  ;« 

Diinikiiid'H  Oelirinm,  i^ 

1)11111  .Mater,  •).,'> 

"     Inllammation  <<f  1S9 

l»H!nl  Kldor.,  CsS 

t))>enlery,  «»K 

Cbronic,  •.S.fi 

I  Dysnienorrlitca,  ^t^i 

D}I<|M'|I~JU,  U 

"        Can?e8  of,  '/".V. 

I'reatinent  ^>f,  !iT4 


"        Tnbrn'iilar, 

[''oMtiiKeii  Wo'indit, 

|<  ontusioiiK, 

ICunvolvuiiiK  Kcaniiiionia, 

ICookery  fur  Sick  lf«M»iii, 

|f  opiiitera  Ofllcinuli'i, 

|lOji]M'r, 

"        Siibacetnte  of, 
"        .Sniphate  of. 

ICoraltorhiz*  <>loutorhiz*, 


(170 
(170 
070 
ti70 

671 
549 

(Vi8 
008 

412 
641 

499 
(i08 
28(i 
I -JO 
121 
217 

ai'.i 

'J'.'O 
217 
-218 
212 
411 

v;\ 
I'M 
r,7s 
r.or, 

I10!> 
(iO!t 
(109 
610 


UHiioini;,  92 

Duiideiron,  ei'J 

Datura  .Stramonium,  660 

Deadly  NiKltt^liadv,  612 1 

UeMfneiw,  4!>0 

Dealli  of  UoneH,  4(i6 

Decoction  of  Bran,  .178 

Dieoctions,  008 

UeformitieH  of  iSpilM,  478 

DeliHler'n  Cerate,  O07 

Delivery.  .Wl 

Deliriuin  Tremena,  1.1.1 

Dementia,  176 

)>ens  Leoniii,  (>I2 

DerbvHhii'H  Neok,  47.'J 

DialH>fi'M,  301 

Dlarrbu-a,  289-4(W 

"          Chronic,  2Ht 

Dictionary,  717 

Diet,  228,  604 
"     in  Di^ense  and  ConvaleH- 

eenee,  .Kil 

Diincnlt  ieetlkCuttinx,  401 

l)ii(e.-<tion,  01 

Table.  69 

Di);ei<tive()rKaiiH,  31 

DiKitiili^  I'liriiMiea,  014 

Dlor^ooiea  Villosa,  ()»i2 

|)iotipyroH  Virjfltiiana,  039 

Dixeareii,  (ieneral,  670 

olCbibiren,  391 

UiKlocatloiiH,  4r)7 

of  Ankle  Joint.        40.3 

"  BoneHol  lleiid,    461 

I         "  "  Collar  Bone,        469 

i        "  "  Kibow  Joint,       400 


Dy.-ipeiiticii 

Kar,  AirielioiiK  of, 

'■     Diiini  of, 

"     K.Nteiiiul, 

"     h'orei).'!!  8ub8t«noca  i 

'•     Wb.\  in, 
K.araelie, 
F.clfelicn, 
Kestany, 
Ketlivma, 
Fx'zeniB, 

Kllei  vetciii);  Draiiuht, 
Kuyptian  Ophlbarmia, 
EIIJov<',  Fraetnies  of, 

"      Joint,  Didlocation 
Klder, 

Dwarf, 
Klecain|iane, 
Fleet ro  .Magnetism, 
KlecKiariiH, 
Flectnary,  lenitive, 
Klixir  .Salntix, 

'"       Vitriol, 
KIni,  .sli|i|)cry, 
Kni|>hyKemH, 
KneepbalitiH. 
F.iieeplialoid  Tumor, 
I'jieyMed,  " 

F-iidoeanlilin, 
Kninigi  d  Veini*, 
F.noiM  mux  Atrupiir.iuivt 

Klllelilix, 
F.neiircsis. 
I''.pi).'ii'a  BepeiiH 
I'ltinlodix, 

"  I'  ilammatinu 

Kpile|ii>v, 
F.iiile|)tle  Fits, 

KpihtuXiM, 

Frfot. 

Ki  iKeron  (  anadenae, 

KriiptionK,  .Scaly, 

Kr>  xi|M>lai<, 

F.rytbeiini, 

Fr'ttbennitic  .Stomatitis, 

h^wneeH, 

Fwenoe  of  B««f, 


(>-■ 


Urinary  Uepo«ttaW.  itTS        ! 


I  , 
M 


■■■ 


— -^    -—   ,'«^y«"Mi>l,.yr«».>^    j.^ 


~:rjss^iC.-f..:r'''TT 


■siftV 


m 


r 


j^^^*^- 


/■     .        V 

•ZU^&,^,:-J«.  -   f-u. 

riflt 

■    1    tluliu, 

601 

Flaxseed, 

614 

Gclsemlnin, 

6<!JS 

,  ',.'tioi'liini  rcrfoliatum, 

(m 

Flies,  8panMl, 
Flour,  Jfloilcd, 

654 

Gelseminum  Sempervireiis, 

t>;4 

"           I'lirpureun^ 

646 

682 

Uengivltis. 

m 

Vu^  .'inrbiu  Ipc'Oac, 

bm 

Fluid  Alinieutg, 

668 

General  Disease*. 

"       System,  Discaies  of; 

571 

J   :i'iirpiiriii, 
KuKmcliiuii  Tube, 

Mi 

"      Extract*, 

669 

4o9 

61 

"      Nutritive, 

686 

Gentian. 

tJ15 

l{X'.:oriHtiuii, 

402 

FIiiorAlbiM,                      86S,800 

"       Conip.  Tlnot.  ot, 

i;>)l 

*\  rciw;, 

8S 

Folded  V/et  Sheet, 

681 

Gentianu  l.utea. 

«I5 

"    Activo  and  PHSslve, 

8&-93 

Folllcloa, 

40 

Geranium  .Maculatum, 

')|i| 

"    KxccKsivti, 

80 

Follicular  Inflammation  of 

Gill-over-the-grouud, 

«I7 

'•    Iii-iloor. 

03 

Mouth, 

800  Uinger. 

Gir> 

"    Mciitul  CoUperatlon 

In.  ill 

FomentotionM, 

069,       ••        Wild. 

WJ 

"    Out-door,                   W— 'i2f) 

Food. 

(>1 

"       Syrup  u^ 

m 

*'    l'luu.«uriible.,             , 

80—94 

'•    Albnminon^, 

74 

Ginseng. 

m 

"     KvkuIhi', 

89 

"    Amount  of. 

80 

Glands. 

40 

"    for  SludenlH, 

90 

"    Animal  and  Vegetable, 

81 

I4ichrymal, 

»< 

"     WIhmi  to  take, 

80-05 

"    Articliaof. 

76 

"       Oil. 

4a 

•'    for  Youuj{  Women, 

01 

"    Azotized  and  Non-azo* 

"       I'arotid. 

31 

•    halaiiU, 

40 

tlzod. 

67 

"       .Submaxillary, 

31 

!  .  Off osiH, 

4<t5 

"    Choice  of, 

70 

Sweat. 

4? 

KxtrucU, 

UHO 

"    Coat  of 

74 

Gluubur'a  Salts. 

ai 

Kluid. 

Ii*l9 

"     Digestibility  of. 

68 

Gleet. 

8.» 

Extniotx  ol'liliubarb  and  I 

'»>- 

"    Fatty, 

76 

Ghwwiry. 
Glottis,  Spasm  ot. 
Glycerin. 

721 

tawu, 

c:4 

"     Heat-^'eneratlng. 

68 

4112 

Kyi'brows, 

«» 

'•    Mature  and  DeKiination 

f.lii 

Ky<?lM»beH,  Disorder  of. 

4WJ 

of. 

66 

Glycerrblza  Glabra, 

t.-j! 

Kyulids, 

no 

"    Nntritive. 

68 

Goitre, 

472 

"        Iiillammatiou  of, 

481 

"    in  ()1<I  Ago, 

78 

Gold, 

61« 

Eye,  (Umis  of, 

48 

"    <>rf;anic, 

66 

Golden  Seal, 

r,|.; 

"    and  Kar  Hatli, 

fi40 

"    Ktaruli  and  Snijur  a». 

76 

•'         "    Comp.  I'owder  ot,  nf^'i 

"    Koi  I'ijrii  Itodleg  in, 

480      "    Tables  of  Viilui- of.    ' 

70 

"       "     Tinct.  of. 

'Ill 

"    (ililic  ol. 

48      "    in  YoiitliHiid  Manhood 

,   78        "         "        "      Wiueol. 

li-..l 

"     lliiuiorH  of. 

49  Foot  Hiilli.  Coid. 

^Sn:(;olden  Tincture. 

■:  1 

•'      Warm. 

640l  (ioiiorrhoea, 

4o.')i  (Ku'Hyplum  llerbaeeum, 

*'! 

Kaba  Saocti  Ii,'DatU, 

(BO       "    Fracfiiiesof. 

Bin 

KalntiuK. 

181    Fore  Arm,  Fra>,!"re«  ot, 

4r>0  (iout. 

417 

FnlliiiK  uf  llowel. 

4()r>   Foreign  Itodien  in  Kye, 

480|  Uranulation, 
17)3  (Irasa,  iStar. 

Ui 

"  Womb, 

3'i8   Fouler'H  Solution. 

rr,-' 

■    "      over  of  Womb, 

8G8   Foxglove, 

614  travel" 

am; 

KoIhc  drape. 

6(«  Fnicturc-B.                      87R,87" 

-442        •'       Root. 

iVI'i 

"      Joints, 

447 1         *•         ComjMHiud, 

l.'tf          "         of  Hones  of  Foot, 

4f.A        "      Urio  Acid, 

m 

'•      iloanlos. 

4<y>  (in-en  Sieknecs, 

^  it 

"      !San>aiinrilIa, 

(Va          "          "      "      "  Nose, 

417  tirimthn  M)rih  Mlxtxit^ 

"      Unicorn, 

618          '•           "  Brtant  Hone, 

462:  Ground  Ivy, 

i.i; 

Fat. 

1(1          "           "  Collar  Hone  or 

i       "        Hice  Milk, 

w 

Fatly  Tumor, 

471  :                            C'luvlcl«, 

448  Grubs  or  Worun), 

u» 

FavuK. 

151           ••          .'<■  F.lbow 

4W  Gruel.  Arrow  Uoot. 

r-i 

Kul  boTinurii, 

COtli        "          "  Fore  Arm, 

4W        "      KIce, 

m 

JVIon, 

407  ■■        '•          "  Uund  and  Flii- 

,      "      SaK<), 

VI 

Female  Dlgenaes, 

mt  1                             vera. 

461  i      "      Water, 

^«i 

Feri>. 

«r>7          "          "  Ilauncli  Boue« 

(Mialac,  Animouiatftd  Tiuct. 

F«rM  Ammonio  Citraa, 

6'.';t                            or  IVIvia, 

4.V2       of. 

njii 

"     t'ltriis. 

613          "          »  Kuecl'au, 

4.^4  GuaiH,uum. 

<!i; 

<♦      lodldum. 

62.1          «•          '•  Ug. 

456  (iiillet.  Foreign  Bodies  in. 

4li: 

••      l<acfa«. 

623 

'•           "  Lower  Jawi 

448  Gum  Arubic. 

i;i; 

•*     Uxlduni  Hvdratum, 

62:! 

«           ••  Rlbai 

451      "     llemioctt. 

I'r 

•«          "        Nigrum, 

623 

•<          •'  Shoulder  Ulade 

440      "    Hwe«'t, 

"     Phoxphaa, 

«24 

"          "  Skull, 

447  Gum*.  luflum/nutioii  of, 

ii« 

"     et  I'otaitra!  Tartraa, 

62f> 

«          "  Thigh  none. 

4.')2  Gnnsbot  Wounds. 

44. 

"      rroto\uiuin, 

824 

•'           "  UppcrArmBono.440  Ciyninaatios, 

i,. 

"      l'Hlv;g, 

624 

"          "  WrlBl, 

451 

"     et  (^uiiiic  Citrma, 

623 

Freezing  Mixtures, 
French  Decimal  Weights. 

606  Ha'maptasla, 

'ii" 

"      8iibriirbon»8, 

624 

680  lln'inattM-ele, 

4') 

•-■<^      SMildlMS, 

(i26        ••        Mlllc  I'orrldge,    ' 

682  iiaiiiatoxylon    Campechla- 

■>     SvripuB  lodldl, 
•'     Tiuc  ura  Chlorldi, 

025  Froat  Bite, 

436;     iium, 

('■-' 

626   Froat^veud, 

614iHicniaturla, 

Fernini, 

62'i   l''umIf{Htion  of  infected  places 

604' Ilalr.  Disorders  of, 

u 

KurunouluB, 

483  F'uiiirus  Hematoidea, 

470'liair<  aiiMoM, 

i\n 

FeviT, 

4()1»  1 

Hairitatli. 

:,:v 

'*      and  Ak  le, 

413  KiallMinum  Plaater,  Comp., 

670  ilammainelis  Virglnlca. 

■■-> 

"      milou-  1    mittent, 

411  Ualinm  Apariue, 
4 12, GsU  Bladder, 

007  Hand.  DUIotution  of  Uouun 

"     (■ongP''tb   , 

88'               Of. 

■I'i' 

"      Iiitfrmitlei  •, 

413!    "    Moi>«a, 

268       "     Fractures  of; 

1  1 

"         UlDj!, 

i'40  Galla. 

6T5  Hardlia.'k. 

'1- 

"      I'eniicious  Ini  rniiil<'i,t,H8!     "     romp, Ointment  of. 

676  llardlcaft.ol.'erRod. 

i;i- 

"      HefreeldnK  Urintioii 

41(rGWl^-#e  of  Ucuiiit 

615  iiauiicli  Itoiies,  Tracturcs  of 

I': 

"      Tyijbold, 

"          ^'          LunK, 

4fH)  Hazel,  Witch. 

I't'.^ 

242  (iarHt, 

•M'.!  Heariacliesi, 

\^' 

Feverfew, 

«I8  (iarlkJ, 

•llo  Head.  AtfretionH  of. 

;j  ' 

Fibrlnc, 

5 

"     Syrtip  of, 
(iastrlo  FeviT  of  liifl(D«y 

';<'4      ••      IJatli, 

"l 

Fliiworf, 
FiriiiR  IVeth. 

6l4 

HW      "      Water  111. 

li'i 

602        "      Juk*, 

<I2  Hearing,  <>rgaii>' o>> 

KlnirerH,  FmctnrM  of. 

4ni  (iaotrltiK. 

•Mi  llvarl. 

;) 

I     '    t'lotbes  (  aMiing, 

4«fl  ".aKtl-odvuia. 

0-. 

' 

!  ■     .  ..^  '  ..y,.   ■.-.-•">» 

J                       >(*.  fiout«t»    • 

■  >/#.  ,;/',<,».. 

,-f-                  .("■'•is.nw.J'^' 

- 

-ffi^^'..    --..  -jss;^;:.,..^  ..::^ 

.'^■. 


FAflt 

m 

mpervlreiw,      M 

it  f"^ 

■  bincaaea  of,     ^lO 

Tlnot.  ot,  tai 

J  Olo 

ulslum,  ';|'i 

ruuud,  ';  i 


ot, 

jinal, 

id, 
axillary, 

I. 
t». 

noC 

ilabra, 


Oomp.  I'ovrder  ot,  <^. 

>•      Wiue  o^     <>;'< 
ture.  ^,{ 

lerbaceuBi,  B'^.' 


Aeld, 
)  ri  h  MlxtMr», 


.'  MilV, 
w  Uoot, 


,monJ«t»d  Unct. 


>ij{n  Bodle*  In, 
(ii'R. 

irumatlon  of| 
'ouiid«. 


514 

firt! 


<',K 
4:1: 

>r. 

44'. 


le 


lim    Campaclilft- 


rdem  of, 

JlldVirftlnlcf. 
locution  of  llont* 


4'H 


l.'ii| 


cttires  ofi 

'.ol.'ep  Bod. 

oiR'n.  i'lftctur*"  "'•    'I 

Itch. 

s, 

fe«:ttonii  of. 

^^   . 
■ter  111. 

Orxau'O'i 


INDEX. 


8y;"» 


FAnil 
Heart,  Atrophy  of,  2W 

"       Hone  mill  v'BrtilnRO  in.  2.VJ 
■'      Uilatuliiiu  o.''  Vciitrick'H 

of,  aw 

"       DI-'pliici'mciitH  of.  <ii)l 
"       KiilarKt'mi'Ut  of  Wiitri- 

clts  of,  24« 
"  Kiitty  Dcifcnorationcof, 2.V.i 
"       llvpi'i'trupliv  ami  Dlla- 

lalioii  of.'  2-')l 

"       Iininilsu  of,  '247 

liiiliiralion  of,  ZV2 

"      liiMiiiiinintioii  of,  'iV) 

"       liifliiiiiiiiutiuu   of  IJii- 

iiifjcif,  2V> 

"      Ni'iiniljsia  of,  'Jint 

"       l'<r<Missioii  of,  -J!** 

"      rolvpiis  o(,  2(il 

»      Slir'inkiiiK  of,  aM 

"      SottcniiiL'of,  'i.\i 

•       .SoiiikIh  of,  247 

"       Vulv«8  oi;  2.V) 

lipartbuiii,  'ivil 
Ili'urt  case.  Acute  Iiiflaiiima- 

tlon  of.  'iVI 
"           Chronic  Inflaiitma- 

tion  (It,  2."i4 

"            W  iliT  in,  2.'.!l 

llrdi'oma  riilfglodfK,  iHH 

llciiantlicmiim  CiinadeUHe.  )>14 

llcliantliii'<  Annuus,  <■." 

llcll,l)(ir.',  Wliite,  iv;i 

llflonias,  (lis 

Dioioa,  lilH 

llrmicrHnia.  172 

lli'niiplili-);ia.  Iii2 

llcinlocU,  Comp.  Tlncl.  of,  tWl 

(iiiin,  lilT 

llomorrhoidH,  287 

li.Mi)    '  UIH 

llri  645 

III').   '         '  .lerioaua,  fUH 

lliTiiiii.  47t! 

iict|if»,  i:e) 

Hicronifli,  ISil 

llisili  ('ranbi-rrv,  «Ut 


41' 


Hi 


CompTinctof.nttl 


loint,  DiHcuHc  of,  4i'i». 

•'        "      dislocation  of,  4'il 

lli|ipiiric  Acid  in  lJrin<%  .Il'l 

lli<in(i!opatiiv,  7 

lliiinieo|Mithiu  KeinedieH,  ,'iOR 

lio>«|MnK  (Jough,  40.*^ 

Itoin,  6I» 

Hordeolum,  4H1 

llorelioci  il.  419 

Water,  •« 

lli)i'H)>mint,  fiO 

lioriMTadich,  W) 

■  Ion.   Itath,  A9t 

Mot  rtrnpn,  WJ 

lions.  .~-k,  ti20 

ll'iiiMrt  TfUor.  r^ 

IlnmiiliiH  l.iipulu!<,  niO 

lliixliiinrK  I'incture,  • 

llvdHtliln  rtrrine,  '.' 

llyilntiiKKU.  1)2*1 

AliorpKCenc.  (520 
llyd'WKyri  Cliloridum  Mite,    602 

i'ilhilir.  (VK) 
Hvdriwtin,  Comu   I'owdi  r  of,  flS2 

HvdraMtiH  (^BnaiirnidR,  filt; 

llvH'^iodatu  I'otaioa.  <W 

IIm1<-.»»I»-.  4(ft 

II\>l<<>)«»'hv,  61 

Hyilroy«thic  Treatment.  1)281 

t(\dr<>p<>ricardiuin,  269 

llvdrcv.hobia,  1(V) 

llydr'K-.t'ptialun,  Acute,  157 

"                ChroDio,  l5Hi 

llydrotlinras,  287 1 

llyaii'iM'.  -" 

KyoACyamtw  Tfixer,  ''' 

"  PoTdoning  by,       4'r. 

Ilviior'ropliy  »r  Jjunitii,  2361 

Hyp<«hoiMb«»  1781 


IIy(>ophu<<phiti:8,('ump.  Syrtip 

of, 
llyssnp, 

HysKopim  Ofllclnalis, 
Hysteria, 
Hyiiierlcg, 

Ice  l"ir,;>», 

U'('lan<l  M08H, 

IclitliyiK!i>!ia, 

Ictenis. 

Idiocy, 

li;niiliii  /iinara, 

llcnni,  y 

lnii>'.  Ms.'o. 

Inciwil  H'oundt, 

inciiliiiK, 

ludiuii  t'orn, 

'•      Hemp, 

"  '•     Tinct  of, 

"      Turnip, 
Indi|2eKtioii. 
Indigo,  Wild, 
lnfane\  of  lteln|{. 
Intanli.  linHtric  Fever  of, 
'■       .Milk  lor. 

"      Snminer  Cotnplaliitx  of, 
Iiitlaiii'niitlon, 
Inlhiiiimiilory  ItluKh, 
Inilnen/a, 
li\t'usiiin  of  Malt, 
liifnsions,  WKi, 

InhalaiitN, 

Ob.lectH  of, 
IiilnilHtion.  .\tiniisiiheriv. 
Iiiliiiler,  .Mi'dieiitcMl  Vapor, 
llilialiii;.'  I'owder, 
InjectionH,  .>l"i, 

"  t'hemical, 

"  Mi'chanlcal, 

In!<anity, 

f'anses  of, 
"        On  OIK'  Subject, 
InstrumenI,  Tonsil, 
Intiralcia. 
InterinurriauPK, 
Intermitteiit  Fever, 
IlitextineH, 
Introduction. 
Inula  lli'leninm. 
Iodide  I'otaAsium, 

loilllie. 

Ixditiiini, 
Ipfcaouanha, 

Comp.  Powder  of 
"  .Svrupof, 

"  Wine  of, 

Ipomirt  .lalapa, 
(ridih, 
Iris, 

"     Inllaniinatiun  of 
"     Ver«i(;(.la, 
•  riah  MuMt,  Jelly  c.f, 
Irltw, 
Iron, 
"     .''.tn'r..jtiio  t'ltriite  of. 
"     Black  Oxide  of, 
"    Ml  rated. 
"         "        '    and  (^iiinia, 

"         '  .Strychnia, 

'  omp  Mixture  of, 
'     H>drated  <»xld«"  of, 
"     f/f'.de  of. 
"     l.,tir';iti.  of 

"       F.r 


I'l  t 

J'ou  lit  f  i»r, 
rrecipilatud   Ci 

of, 

rroloxido  of 
8'>luiioni  of  frotoxid* 

•.f. 

ilphate  of. 
.;,,  rup  of  Iodide  of. 
Hyfup  of  Iodide  of,  and 

lUogoiiece, 


flS4 

t;2i 
>ai 
■■m 
am 

821 
d21 

G2n 

2H7 
17(t 
6M 

82 
142 
4:is 
182 

78 
1121 
G8il 
lai 
271 
(i(i2 

r,2 

40<> 

r,wi 
41  ^ 

425 
liW 
20') 
.'■.7'.> 
•170 
221 
22.1 
227 
'*2.1 

r^'i 

(171 
4.3> 
437 
17.1 

177 
17.-> 
2(>2 
2J.2 

67 
41.3 

»2 

5 

tU.3 

(r.'2 

tt22 
622 
fi22 
(18.3 
685 
673 
62(1 
tKKt 
4!) 
48.'i 
BOO 
681 
485 
623 
623 
(12.3 

(rii 

Rt! 
•ELI 
'•m4 
628 
62.3 
623 
624 
624 


It* 

8»l 


Iron,  Tartruteof,  ami  I'otaNia 

"     Tinetiire  of  Muriate  of, 

"     Valerianate  of, 
iKchiiria  K"iiuli.'<, 
IbinKla.-H, 

"        .lellv, 
llc'.i, 

"     Ilnrlier!"'. 

"    .lackMoirx, 
Itchin;f. 

I      "        of  Ivxtemal  Tarts, 
Ivy,  American, 

"    HiK. 

"    ( I  round, 

"    I'oisonitiK  bv, 
I 

.Tackxon's  Itch, 
Jalap, 

I     "      Comp  I'owder  of, 
.lamestown   Weed, 


•lani|.>i.i  .Mi.niliot, 

•laiimllee. 

Jaw,  Fractures  of  Lower, 

"     nislocation  of   " 
•lejiiiiiim. 

J.OIv,  Culfs  Feet,' 
"      Irish  Moss, 
"      lKinf!liL«», 
"      Tapioca, 
Jerusalem  Oak, 
.lessamine.  Yellow, 
i.lointH, 

!      "      l)isea!>uH  of, 
I       "      False, 
iJiielandin, 
Inplans  (iiierca, 
liini|ier. 

Iiiiiilieris  Conimunln, 
iluniperus  Sa'iiiia, 


TAnn 
.  62/i 

112(1 
.•!'>.3 

(iu; 
rm 

l:«» 
Ui> 
149 
lid 
.370 
.'/.•;! 
(1.33 
(il7 
490 

14« 
(120 
(!«3 
(>56 
6.->9 
267 
448 
463 
32 
683 
681 
f)81 
6«1 
664 
604 

46r> 

447 

<ii>2 
602 

(12(1 
649 


Kalniia  .Xnuuxtifolia,  (133 

l.atifolia,  KVi 

Kidneys,  .34 
"        Acute  Inflammation 

of,  ^.n 

"        Chronic    Intlarama- 

tion  of,  296 

"        nieediiiK  from,  .302 

"        Uriglit's  Diseast  of,  Zr.) 

Kin);').  F.vil,  419 

Kinu,  t!26 

"      Comp.  Powder  of,  r.8.3 

Kneu  Joint,  Dislocatian  ot.  i'''8 

•'      Pan,            "                ■'  4<>.. 

"        ■'         Fractures  of,  454 

Krameria  Triandra,  647 

Ubor,  381 

r.abyrinth,  51 

I.aciTatiil  Wounds,  441 

Laehryn  al  Canals,  60 

"            (ilands,  &• 
"           Sac,  Inflammation 

of,  482 

r.acteal<«  .32 

Lactuea  .Saliva,  627 

I.adie«   Slippi'r,  Kii\,  (I'm 

Lappa  Minor,  fUfi 

l.aryiiKeal  .Shower  .Syringe.  1% 

LarygismiiK  StridulUH,  402 

LarviiKiiis,  Follicular,  I'.i'i 

Larynx.  40 

Inflammation  of,  19:^ 

liaudaniim.  689 

"            Poisoning  by,  49lt 

T4tur<'l,  Narrow  l.ea^  (J.3.3 

•'       Sheep,  d."*? 

f.aiirus  .SassafrBR.  ('.19 

Mveiider,  Come    Tinct  of,  692 

l-ead,  tr-T 

"      Aeetate  of,  '•27 

"     >Mnlmcnt,  Comp.,  i>78 

"      falsv,  164 

'       PI|)C8.  87 

'       I'laatcr,  RW 

"         "       Comp.,  «7» 


.^5 


israt:tsctliif  ■>^fm 


I 


i 


i.'iv 


INDEX. 


r 


rAoi 

iMidff^.  e^oiiaenrative!  11 

£|J|  Wtlh,  M6 

"    f  CActurca  of,  4fi6 

'       Svrup,  ti85 

'f«       Watur,  679 

{jtfttl'ttiarie,  680 

.i^'tiirivo  Klcctuarv,  608 

l^iruiiuriis  Cardiaca,  682 

lAHtt'urJ'H  Itnuc,  CM 

U:\'n,  143 

>  i«9Mra>y,  14^ 

^|,nnin.)lraVirginioa,  611 

Jettiio',  627 

'  t,i!Ui' trrliaia,  863 

,   U'b.iauty,  10 

l.«tri|Mi,  144 

Ltfc,  62 

♦•    Itoot,  627 

'  Ul;),  White  Pond,  601 

I.fitet,  62H 

'    iljilorido  of,  e-iS 

'•    'iVali-r,  628 

■  I.  nVunits,  6;l 


Masturbation, 
Matei-ia  Mediea, 
Matico, 

Hattory  Piinplea, 
Headow  Caboafi*, 

'■       Saffron, 
UeaHlea, 

"     Falae, 
MeaHuniH,     . 

'*        Doine«tio, 
MeatK, 
McntuR  Aiulitorus, 

"       Inflammation  of, 
Mvoliaiiical  Injuries, 
MuUioated  Waters, 

Wines, 
Medicine,  I'ro);rei*s  of, 

"         Cliest,  Articles  for, 
Sleillclnes, 
MuduMa  Oblongata, 
Melunclioly, 
Mi^lnnaoJH, 
Melifu<a(>mcinall^ 
MuniKp4>rmum  Canadeusc, 


LiUJItsu  tit  of  Ammonia,  Corop.  671  Monorrlmula, 

'♦•'       l'iiiu|ilior,  671  JlenBos,  Absence  of, 

Caro|)liorat«d  Soap,  672  {      "       Cessation  of. 


Comi).  Camphor, '     671 

'     '»       <'rofont>il,  67? 

,■■''*       ofOpium.  672 

MlAHi  ^liitutlH^imllm,  614 

i.icinM«nibcr  8tyruciflua,  668 

U^Mur  AmmouiO!, 

''  "  Acutatlo, 

,■   lorioe, 
t.  '  iaIi  idron  Tuliplfbra, 


tlenstrualion, 

"  I'ninfui, 

"  I'roiuse, 

Mentha  IMperlta, 
"        Viridfs, 


66!) 

83 

'3ute  Intiammation  of,  2(>t 


"     Clironio 
H     ,t  Sulphur, 
t»ff*i<rt, 


ti 
■■/>> 


Inflata, 
Tiuct.  of, 
Comp.  Tinot.  of. 
and  Capsicum,  Comp. 

Tinot.  on 
Vinegar  pt; 


^,ti'.»t  I'alsy, 
l.*5«t«i|  Jaw, 
'.(Vfoi-d, 

i.(^M(«n>-M  of  Bowela, 
jUiintttiTlMexua, 
^Jbfti^  t'«>ver, 

*%"«•• 
»•     Urpertrophy  of, 
^     Hwelling  of; 

I.ftpiAia,, 

Itonna, 

LyMJMx  Virginicus, 
Lyt%  ruisonfiig  b/, 

ty«M'»{lc«, 

liaaai)", 

Cnrbmate  of, 
'  Sulphate  of, 

"  Uiita, 

Itntm'lx  Carbonas, 
»         Sulphas, 

WaJa  '■'•■ni, 
ktif  mint  Pustule, 

■*ait,  ]*ri^ii>ion  of, 

-M<m»»W-iry  Abscess, 

^Aiidi  ,!<e, 

•'       APotUMV 
jSattlut.  .   . 

m«»Mli  Arundlnaela, 
'.H><ratii.i.^Iluw, 
.  Mbti-jrti  H  kxeniary, 
itfunti  ittm  Vulgare, 


608  Mesenteric  Uiseaso, 

604 1  Metritis. 

628  Meltauei's  Anerient, 

Micotintinni  i'ub^cum, 

Midwifery, 

.Milk, 
205      ••    CotTbc, 
645      "    for  Infants, 
628      "    Leg, 
628      "    Poiridse, 
62H      "    Siolcness, 
68!)      "    anil  S(«1b  Water, 
692  Millet,  ccd,  Hwnmp, 

Mind,  Uurunucnient  of, 

Mindererus,  spirit  of, 

Miscarriage, 

Miiicellunoons. 

Mitohella  K<'|)ens, 
,  Mitral  Valves,  Diseasea  of. 


098 
620 
168 
160 
629!  Mixtures, 


174 

14n 
t!20 
630 
680 


389,  408  i  Modus  Operandi  of  Water, 
47 :  Momordica  Elaterium, 
240  Monarda  Punctata, 
85  Monicshood, 
286  Monlc<*  Mood, 
285 1  Monomania, 
620  Monotropa  ITniflora, 
144  Monsei's  Styptic, 
467  Morphia, 

'•       Acetate  of, 
"       Muriate  of, 
"        Sulphate  of. 
"       Valerianate  of, 
Morphine, 

'•         Poisoning  by, 
Mortification, 
Mother's  Cordial, 

"       Marks, 
Motherwort, 
680  Mountain  Laurel, 
680  Mouth  or Oral  Hath, 
680        "      Iiiflr.inmation  of, 
434        "      folMcMlar  Inaamma- 
679  tinii  of, 

888        "      Gangrene  of, 
f)80 ,  Mucus, 
17j' Mullein, 
lli6  Mumps 
6R0  Muriate  of  Soda, 
694  Muriatio  Acid,  PoiMMiMg  by, 
631  MuKCX  Volttantos, 
631  Muscles, 
619^      "       Aolfon  of. 
6U<      "       K  umber  of. 


rAOt 

886 
686 
682 
142 

661 

6»2 
181 
138 
687 
680 

77 

51 
489 
437 
672 
673 
6-9 
68: 
68'i 

46 
174 
470 
694 
666 
866 
364 
3IS 
310 
86; 
356 
t>iJ8 
654 
40' 
8T 
675 
&->8 
377 

74 
585 
r)80 
387 
681 
278 
584 
657 
178 
5!H 
380 
604 
i-87 
257 
674 
640 


Muaeles.  Shape  of. 
Mustard, 

"       Volatile  Oil  Of 
Myriea  Cerifera, 
Myrlcin, 

Myristica  Mosohatu,  i 

Myrospernuui  Toluiferft" 
Myrrh,  i 

•'      Comp.  Tine*  of,  i 

Naptha,  'i 

Mupthaline. 

Nai<al  Catarrh, 

•'      Duct. 

"      Sho«ver  Syrir     , 
Necrosis, 
Ne|H-ta  Calarla. 

*'        (jlechoma,  '< 

Nephritis, 
Nerve  Koot, 
Nerves,  Crnnial, 

DiiieaHcs  of  Grain  nuA, 


Optic, 
Pain  in. 


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632 
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637 
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"  "      Symte^llL,  "i 

Nettle  Rash,  1^1 

Neuralgia,  ITl 

"         of  Heart, 
Neutral  Mixture, 
Neutralixiug  Cordial, 
'  Kxtri    i 

"  Pow       , 

Nevus. 

New  tiersey  Tea, 

Nlfrhtniare. 

Nitriitu  of  Merou 

••        oi  Pota." 

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"       of  Silver 

Nitri), 


iilitnfKM>t 


Sweet  Spirit     i',         aSI 
NitrJo  Acid,  PoiK    'ng  by, 

"      Kther,  8pir     jf, 
V.oxo  Bath, 

•'    Bleeding  fron.. 
•  "    Foreign  SubsltfMiyi  la, 

"    Fractures  of. 
Nurse, 

"     Activity  of, 

"      Age  of, 

"     Education  of, 

"      Habits  of, 

"      Health  of. 

"      Strength  ot, 

"     Tem|ier.  etc.,  of, 
Nursing  Sore  Mout  i, 
Nutmeg, 
Nutrition  Table, 
Nutritive  Fluid, 
Nux  Vomica, 


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Oak,  White, 

*»i  Oil  ('iland*,  Dixordeioa, 

686!    "    ofCajeput. 

146'   "    of  Turpentine, 

632  OttttmentP, 

1)33  Oka  Kunii;*, 

541  Olfiim  (  iijiipati,         • 

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